Table 4.
BSC for the HEP performance measurement by agroecological zone in rural Ethiopia, 2010
| Indicator | Agroecological zones | P value | ||
|---|---|---|---|---|
| Pastoral | Mixed | Agrarian | ||
| Capacity for service provision | ||||
| Staffing index | 53.0 | 56.9 | 66.5 | 0.016 |
| Infrastructure index | 43.9 | 59.0 | 60.4 | 0.011 |
| Equipment functionality index | 62.9 | 81.9 | 82.0 | 0.001 |
| Commodity availability index | 54.8 | 69.9 | 56.3 | 0.000 |
| Supply distribution system | 26.8 | 59.3 | 49.8 | 0.001 |
| HEP guidelines and IEC use index | 73.2 | 79.3 | 77.7 | 0.367 |
| HMIS use | 60.2 | 72.5 | 72.8 | 0.046 |
| Health center capacity index | 60.0 | 63.3 | 60.3 | 0.753 |
| Management capacity index | 73.0 | 81.3 | 84.6 | 0.189 |
| Supervision index | 65.3 | 66.0 | 67.1 | 0.655 |
| Financial systems | ||||
| Financing referral system | 85.0 | 74.8 | 77.1 | 0.150 |
| Financing medical supply | 43.3 | 48.8 | 55.6 | 0.458 |
| Human resource development | ||||
| HEW knowledge | 61.1 | 67.9 | 69.9 | 0.010 |
| In-service training index | 50.5 | 63.5 | 56.5 | 0.451 |
| HEW satisfaction index | 52.8 | 49.4 | 48.8 | 0.532 |
| HEW perception index | 59.0 | 61.4 | 58.1 | 0.421 |
| Retention rate of HEWs | 97.6 | 93.7 | 93.6 | 0.006 |
| Service delivery process | ||||
| HEP package services availability index | 51.8 | 58.3 | 69.3 | 0.045 |
| Quality of RMNCH services | 59.8 | 65.9 | 61.1 | 0.115 |
| Infection prevention | 35.9 | 46.6 | 44.6 | 0.409 |
| Referral linkage index | 52.6 | 50.9 | 50.7 | 0.852 |
| HEW time use index | 60.6 | 70.0 | 65.9 | 0.220 |
| Model family delivery index | 50.6 | 58.6 | 62.0 | 0.013 |
| Community engagement | ||||
| Awareness and access to HEP | 67.3 | 72.2 | 73.1 | 0.124 |
| Community and volunteer participation index | 54.6 | 68.5 | 61.4 | 0.117 |
| Model family engagement index | 63.8 | 82.0 | 74.0 | 0.017 |
| Village health committee functionality | 48.3 | 50.0 | 58.7 | 0.102 |
| Delivery output and outcome | ||||
| Maternal and child health output | 40.0 | 29.5 | 40.0 | 0.038 |
| Family planning output | 45.3 | 24.7 | 51.6 | 0.002 |
| Satisfaction with services received | 68.2 | 69.4 | 72.5 | 0.619 |
| Satisfaction with HEW performance | 80.6 | 67.6 | 68.4 | 0.757 |
| Overall community satisfaction | 78.6 | 73.7 | 77.7 | 0.945 |
| Overall performance measures | ||||
| Mean score of all indicators (composite score) | 58.8 | 63.6 | 64.6 | 0.006 |
| % of indicators scored above bottom quintile | 66.1 | 75.8 | 76.9 | 0.046 |
| % of indicators scored above top quintile | 12.1 | 17.8 | 17.0 | 0.079 |
BSC = balanced scorecard; HEP = Health Extension Program; HEW = health extension worker; HMIS = health management information system; IEC = information, education and communication; RMNCH = reproductive, maternal, neonatal and child health.