Assessing Factors Affecting Readiness for Reproductive, Maternal, Newborn, and Child Health Services, Ethiopia SPA Survey 2021-22

ABSTRACT This study assessed the readiness of health facilities across Ethiopia to provide essential reproductive, maternal, newborn, and child health (RMNCH) services. Using data from the 2021-22 Ethiopia Service Provision Assessment (ESPA), a comprehensive analysis of service readiness was conducted, employing principal component analysis (PCA) to identify the underlying factors affecting preparedness. Readiness scores were estimated for the critical RMNCH services of family planning, antenatal care (ANC), prevention of mother-to-child transmission of HIV (PMTCT), basic emergency obstetric and newborn care (BEmONC), comprehensive emergency obstetric care (CEmOC), child vaccination, and child curative care. The analysis revealed significant variations in service readiness among regions and types of facilities. Referral hospitals, despite being at the top of the healthcare pyramid, often demonstrated lower readiness for certain services compared to lower-level facilities, suggesting potential challenges in resource allocation and prioritization. The PCA further highlighted the complex relationship between factors influencing service readiness, emphasizing the importance of resource availability (essential medicines, equipment, and supplies), presence of trained healthcare personnel, availability of WASH infrastructure and electricity, and availability of service guidelines. These findings emphasize the need for a comprehensive approach to strengthen health systems in Ethiopia. We propose improving the availability of essential resources by investing in supply chain management, staff capacity building, and infrastructure (water and power access) development. Strategically investing in health system strengthening by addressing regional and other disparities is critical to achieving equitable access to quality RMNCH services.