Predictive Relationship Between Health System Attributes and Access to Essential Maternal and Child Health Services: Evidence from a SARA Survey

Alhassan Fouard Kanu


The robustness and responsiveness of a country’s health system predict access to a range of health services, including maternal and child health (MCH) services. The purpose of this cross-sectional study was to examine the influence of 5 health system characteristics on access to MCH services in Sierra Leone. The study was a secondary analysis of the Sierra Leone 2017 Service Availability and Readiness Assessment (SARA) dataset, which comprised 100% (1, 284) of the country’s health facilities. Data analysis included bivariate and multivariate logistic regressions. In the bivariate analysis, all the independent variables showed statistically significant association with access to MCH services and achieved a p-value < .001. In the multivariate analysis; however, only 3 predictors explained 38% of the variance (R² = .380, F (5, 1263) = 154.667, p <.001). The type of health provider significantly predicted access to MCH services (β =.549, p <.001), as did the availability of essential medicines (β= .255, p <.001) and the availability of basic equipment (β= .258, p <.001). According to the study findings, the availability of the right mix of health providers, essential medicines, and basic equipment significantly influenced access to MCH services, regardless of the level and type of health facility. The findings of this study might contribute in helping the authorities of the Sierra Leone health sector to identify critical health system considerations for increased access to MCH services and improved maternal and child health outcomes.

Keywords: health system, health services, maternal health, child health, healthcare access

DOI: 10.7176/JHMN/76-06

Publication date:June 30th 2020

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