SPH Assignment

Social and Public Health
Group assignment
Group members
Submitted to- Abrham G (MPH, MAPM) Ass.professor PH
Submission date- September 20, 2024

1.1 Introduction
Primary health care (PHC) is essential for ensuring that health services are delivered effectively and
equitably to individuals and families in the community. It encompasses a range of practical and socially
acceptable services that prioritize accessibility and community involvement. This study focuses on the
services provided at Abebe Bikila Primary Health Center in Addis Ababa, aiming to evaluate the center's
performance in delivering these essential health services.
Through comprehensive interviews with doctors, nurses, patients, administrative staff, and other
personnel, we seek to gain insights into the operational dynamics of the healthcare center. Our research
explores how well the center meets the accessibility criteria inherent in the PHC model and assess its
alignment with the broader goals of primary health care.
Additionally, this study highlights the various challenges faced by both patients and medical professionals
in fulfilling the core components of primary health care. By identifying these obstacles, we aim to
contribute to a deeper understanding of the complexities involved in delivering effective health services
and to propose potential improvements that can enhance the overall quality of care within the community.
1.2 About Abebe Bekila Public Health unit

The Abebe Bekila Public Health Unit is situated in a residential area, far away from the main road, with
insufficient transportation options connecting it to the main road.
The unit provides essential free services such as
 treatment for TB and leprosy,

 prenatal and postnatal care,
 family planning services,
 maternal and child health care,
 HIV diagnosis, and
 epidemic monitoring and control.
The building features include a secure entry point and designated no-touch hand wash stations to prevent
the spread of contagious diseases. Inside, there are waiting areas, though not adequate for a large number
of patients, along with private consultation rooms for each service offered. Restrooms are available on
each floor, and there are break rooms for staff members, including guards. The PHU also includes a
pharmacy inside the building.
Additionally, a board near the entryway helps patients navigate the facility which showcases where each
service is given on each floor. The facility is equipped with a ramp to provide access to the first floor for
patients with disabilities or limited mobility, as well as for pregnant patients, where comprehensive care is
provided. This ensures that all individuals can easily access the necessary care, including the labor and
delivery room, without any hindrances due to physical limitations.
Furthermore, there is a board in the PHU that provides comprehensive information about the different
types of vaccines available, their respective dosages, and the specific days on which they are available
and administered.
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1.3 Overview of Abebe Bilkila Primary health care unit
From the assessment that we have made in this primary health unit we were able to know that in 2016, the
healthcare facility received a total of 81,370 cases. This included 215 inpatient cases, 972 emergency
services, and 1,061 total referred cases with 261 emergency referrals.
The card room experiences a daily patient volume ranging from 150 to 200, with approximately 30 new
patients each day. Currently, the only digitalized aspect of the system is the registration process, which
began last year. This limited digitalization forces staffs and patients to go up and down the floors several
times each day,making it a hassle and inconvenient. Notably, around 2000 patients have health insurance,
with most chronic patients suffering from conditions like hypertension and diabetes covered. Staff have
highlighted several concerns, including the need for further improvements in digitalization, issues related
with room discomfort such as broken chairs, the impact of inadequate facilities on patient experience and
the existence of some communication challenges, as patients often seek directions and clarification on
what to do with their paperwork. Additionally, they noted that payment rates for staffs are insufficient
given the rising inflation.
The emergency department on the other hand handles 15 to 20 cases each day, including 5 to 6 children.
Each month, it encounters around 78 to 90 patients. Typically, 1 to 2 patients are transferred to SPHMMC
because their needs exceed the department's capacity. The most common cases include trauma from
fights, strokes, and dog bites, while children frequently come in with pneumonia and tonsillitis. The
department faces several challenges, including shortage of normal saline, insufficient ambulance services
given that one ambulance is assigned for 3 Woredas, occasional shortages of oxygen and inadequate
number of medical professionals.
Most patients have health insurance which covers their medical expenses easing them from unnecessary
financial stress. The inpatient cases primarily involved conditions such as malaria, asthma, hypovolemic
shock, relapse fevers, and pneumonia. Patients typically stayed in the hospital for 1 to 3 days for
treatment. Patients without health insurance typically pay between 300 to 2000 birr, depending on the
treatment they require.
In an interview with a Patient we encountered, they indicated that they have a monthly income of 10,000
birr and live in the same neighborhood. The patient rated their overall satisfaction with the healthcare
services as a 6 out of 10. The didn’t have health insurance but mentioned that the payment for the service
has been fair enough.
In the meantime we also had an interview with a staff member named Bethelhem, who works in the Early
Childhood Development (ECD) unit, which serves children aged 0-6. She rated the patient care provided
as a perfect 10, as she herself was there as an attendee for a patient, reflecting her satisfaction with the
quality of care. Bethelhem works from 2 PM to 11 PM, five days a week, and feels that the payment is
relatively fine. She highlighted the positive impact of the community service done as ECD unit creates
awareness about current health issues.She mentioned that the majority of the community enthusiastically
accepts the information and translate it into actions. However, she also stated that rarely they meet
community members who are against the awareness.
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Social and Public Health

Submitted to- Abrham G (MPH, MAPM) Ass.professor PH

Submission date- September 20, 2024

1.2 About Abebe Bekila Public Health unit

The unit provides essential free services such as

 treatment for TB and leprosy,

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