ArticleBMJ global health2020
The impact of a health facility construction campaign on health service utilisation and outcomes: analysis of spatially linked survey and facility location data in Ethiopia.
Article in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- What improves access to primary healthcare services in rural communities? A systematic review.BMC primary care · 2022Pooled it
- Location of births by health facility type: a time trend analysis from 1995 to 2023 in 130 low- and middle-income countries.EClinicalMedicine · 2026Article
- Changes in child mortality and population health following 10 years of health systems strengthening in rural Madagascar: A longitudinal cohort study.PLoS medicine · 2025Article
- Healthcare-Seeking Behaviour for Obstetric Complications in Ethiopia: A Multilevel Mixed-Effect Analysis.Health services insights · 2025Article
- Timeliness and quality of peripartum care provision during a health system strengthening initiative in rural Guinea-Bissau: a qualitative situation analysis.BMC pregnancy and childbirth · 2024Article
- A consolidated and geolocated facility list in Senegal from triangulating secondary data.Scientific data · 2024Article
- Explaining changes in educational disparities in competent maternal health care services in urban and rural areas in Ethiopia.Frontiers in public health · 2024Article
- A geospatial analysis of accessibility and availability to implement the primary healthcare roadmap in Ethiopia.Communications medicine · 2023Article
- Epidemiology of neonatal mortality: a spatial and multilevel analysis of the 2019 mini-Ethiopian demographic and health survey data.BMC pediatrics · 2023Article
- The impact of institutional delivery on neonatal and maternal health outcomes: evidence from a road upgrade programme in India.BMJ global health · 2022Article
- Article
- The unfinished agenda and inequality gaps in antenatal care coverage in Ethiopia.BMC pregnancy and childbirth · 2022Article
- Large local variations in the use of health services in rural southern Ethiopia: An ecological study.PLOS global public health · 2022Article
- Audit of Clinical Care for Women with Preeclampsia or Eclampsia and Perinatal Outcome in Ethiopia: Second National EmONC Survey.International journal of women's health · 2022Article
- Health Care Readiness in Management of Preeclampsia/Eclampsia in Ethiopia: Evidence from National Facility-Based Survey.Risk management and healthcare policy · 2022Article
- The origins of Ethiopia's primary health care expansion: The politics of state building and health system strengthening.Health policy and planning · 2021Article
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4 authors.
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Abstract
backgroundAccess to health facilities in many low-income and middle-income countries remains low, with a strong association between individuals' distance to facilities and health outcomes. Yet plausibly causal estimates of the effects of facility construction programmes are rare. Starting in 2004, more than 2800 government health facilities were built in Ethiopia. This study estimates the impact of this programme on maternal health service utilisation and birth outcomes.
methodsWe analyse the impact of Ethiopia's health centre construction programme on health service utilisation and outcomes, using a difference-in-difference design. We match facility opening years to child birth years in four rounds of Demographic and Health Surveys (DHS) using georeferenced data. We also use event study models to test for pre-trends in the outcomes of interest.
resultsOpening of new health facilities within 5 km increases facility delivery by 7.2 percentage points (95% CI 5.2 to 9.1) and antenatal care by 0.38 visits (95% CI 0.24 to 0.52). It is not significantly associated with changes in caesarean section births or neonatal mortality. Opening of district hospitals increases facility delivery by 18.2 percentage points (95% CI 12.7 to 23.7), and caesarean section births by 6.8 percentage points (95% CI 2.5 to 11.2), but is not associated with reduction of neonatal mortality.
conclusionsEthiopia's facility construction program improved access to antenatal and delivery care. However, there was no detectable association between facility construction and neonatal mortality. Increased access to care must be combined with health system quality improvements and broader social development initiatives to sustainably improve health outcomes.
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