Effect of integrated health system leading-managing-and-governing for results model on institutional delivery: Team-based quasi-experiment

Objective The objective of this study is to examine, based on theory of change, whether integrated leading-managing-and-governing for results model is plausible cause of improved institutional delivery.Methods A team-based quasi-experimental study was conducted. One-hundred-thirty-four health facility teams were enrolled in the study. Teams were allocated to intervention and control groups in a 1:1 ratio, non-randomly. End line institutional delivery was the dependent variable while the group (main predictor) and the baseline institutional delivery (covariate) were independent variables. The intervention that was given over six months was integrated leading-managing-and-governing for results model. The institutional deliveries were measured with percentages whilst the group was measured with exposure status (yes or no) to the intervention. Data, from both groups, were collected at baseline and end line. Data were analyzed using analysis of covariance. Statistical significance was determined at (p<.05). The main effect of the intervention was determined by 95% CI, presented in the contrast results.Results The adjusted mean institutional deliveries with 95% CI were 47.4 (46.2, 48.6) and 33.4 (32.2, 34.6) in the intervention and control groups, respectively. Contrast results showed that having an intervention group, p = .000, 95% CI (12.2, 15.8), of integrated leading-managing-and governing for results model significantly increased mean institutional delivery compared to having a control group.Conclusions This study provides some guidance regarding the plausible causation of integrated leading-managing-and-governing for results model on institutional delivery. It would serve as a baseline in identifying true causation using a randomized design.