PMID- 33280608
OWN - NLM
STAT- MEDLINE
DCOM- 20210924
LR  - 20210924
IS  - 1471-2296 (Electronic)
IS  - 1471-2296 (Linking)
VI  - 21
IP  - 1
DP  - 2020 Dec 6
TI  - Experiences of managerial accountability in Ethiopia's primary healthcare system: 
      a qualitative study.
PG  - 261
LID - 10.1186/s12875-020-01332-5 [doi]
LID - 261
AB  - BACKGROUND: Despite calls for improved accountability in global health systems, 
      and a set of clear and consistent theoretical accountability frameworks, 
      empirical descriptions of how accountability is experienced and enacted in low- 
      and middle- income country (LMIC) settings is limited. Therefore, we sought to 
      characterize how managers at all levels of Ethiopia's primary healthcare system 
      experience accountability in their daily practice. METHODS: We conducted in-depth 
      key informant interviews with 41 key stakeholders across 4 regions (Amhara, 
      Oromia, Southern Nations Nationalities and Peoples, and Tigray) in the context of 
      the Primary Healthcare Transformation Initiative (PTI). Consistent with the 
      principles of grounded theory, our team used the constant comparative method to 
      identify emergent themes related to concrete areas that could be targeted to 
      allow an overall culture of accountability to flourish. RESULTS: Emergent themes 
      were: development of a shared understanding of system-wide accountability, 
      streamlining of managerial reporting lines, strengthening of medico-legal 
      knowledge and systems, and development of mechanisms for bottom-up 
      accountability. CONCLUSIONS: Findings may be valuable to policymakers seeking to 
      create more effective national accountability frameworks; practitioners and 
      development partners seeking to strengthen implementation of evidence-based 
      accountability systems and practices; and researchers aiming to develop 
      meaningful, practical measures of accountability in public health.
FAU - Fetene, Netsanet
AU  - Fetene N
AUID- ORCID: 0000-0002-3208-0055
AD  - Yale Global Health Leadership Initiative, Addis Ababa, Ethiopia.
FAU - Patel, Akshar
AU  - Patel A
AUID- ORCID: 0000-0003-4908-8595
AD  - Yale School of Public Health, New Haven, CT, USA.
FAU - Benyam, Tibebu
AU  - Benyam T
AUID- ORCID: 0000-0002-0714-9655
AD  - Yale Global Health Leadership Initiative, Addis Ababa, Ethiopia.
FAU - Ayde, Assefa
AU  - Ayde A
AD  - Reform and Good Governance Directorate, Federal Ministry of Health, Addis Ababa, 
      Ethiopia.
FAU - Desai, Mayur M
AU  - Desai MM
AUID- ORCID: 0000-0001-6616-0945
AD  - Yale Global Health Leadership Initiative and Yale School of Public Health, 60 
      College Street, PO Box 208034, New Haven, CT, 06520-8034, USA.
FAU - Curry, Leslie
AU  - Curry L
AUID- ORCID: 0000-0002-3419-4654
AD  - Yale Global Health Leadership Initiative and Yale School of Public Health, 60 
      College Street, PO Box 208034, New Haven, CT, 06520-8034, USA.
FAU - Linnander, Erika
AU  - Linnander E
AUID- ORCID: 0000-0002-3417-1049
AD  - Yale Global Health Leadership Initiative and Yale School of Public Health, 60 
      College Street, PO Box 208034, New Haven, CT, 06520-8034, USA. 
      erika.linnander@yale.edu.
LA  - eng
GR  - OPP1131084/Bill and Melinda Gates Foundation/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201206
PL  - England
TA  - BMC Fam Pract
JT  - BMC family practice
JID - 100967792
SB  - IM
MH  - *Delivery of Health Care
MH  - Ethiopia
MH  - Humans
MH  - *Primary Health Care
MH  - Qualitative Research
MH  - Social Responsibility
PMC - PMC7720402
OTO - NOTNLM
OT  - Accountability
OT  - Ethiopia
OT  - Health management
OT  - Primary care
COIS- The authors declare that they have no competing interests.
EDAT- 2020/12/08 06:00
MHDA- 2021/09/25 06:00
PMCR- 2020/12/06
CRDT- 2020/12/07 05:23
PHST- 2020/06/16 00:00 [received]
PHST- 2020/11/25 00:00 [accepted]
PHST- 2020/12/07 05:23 [entrez]
PHST- 2020/12/08 06:00 [pubmed]
PHST- 2021/09/25 06:00 [medline]
PHST- 2020/12/06 00:00 [pmc-release]
AID - 10.1186/s12875-020-01332-5 [pii]
AID - 1332 [pii]
AID - 10.1186/s12875-020-01332-5 [doi]
PST - epublish
SO  - BMC Fam Pract. 2020 Dec 6;21(1):261. doi: 10.1186/s12875-020-01332-5.