# Health professionals’ competence for the provision of quality primary health care in Amhara region, Ethiopia

## TL;DR

This study assesses the competence of health professionals in providing quality primary health care in Ethiopia's Amhara region, finding significant gaps and identifying factors that influence professional competence.

## Contribution

The study provides new evidence on health professionals' competence in Ethiopia using a mixed-methods approach and identifies factors influencing their competency.

## Key findings

- Only 14% of health professionals were rated competent across all domains.
- Educational status, training, and salary positively affect self-rated competence.
- Qualitative findings confirm gaps in professional competence and suggest training and regulatory improvements.

## Abstract

Though competent health professionals are essential for building strong and resilient health systems; there is a dearth of evidence on whether health professionals possess core competencies for providing quality primary health care in Ethiopia. Therefore, the aim of this study was to examine health professionals’ competence in the provision of quality primary health care in Amhara region, Ethiopia.

A mixed methods study design with pragmatic philosophical paradigm was conducted on, 846 (for quantitative) and 12 (for qualitative) selected, health professionals from June 1–July 30/2023. Health professionals’ competence was measured through six domains, adapted from the World Health Organization (WHO) global competency framework for universal health coverage. Quantitative and qualitative data were collected. Logistic regression modeling and thematic analysis were carried out.

The response rate was 98%. As rated by themselves, only 116 (14%) health professionals were competent for all competencies. The rating for specific competency domains was slightly higher with a range of 21.7% (180) to 30.7% (255) of the professionals were competent in personal conduct and evidence informed practice domains, respectively. The qualitative findings support the competence gaps identified in health professionals’ survey. Educational status, training, taking licensure/ certificate of competence (COC) exam, training in public universities/colleges, high cumulative GPA and monthly salary above 10,000 ETB (177.84$) positively affected the rating of the competence.

The rate of health professional competence as judged by the health professionals themselves in the study area was very low. The qualitative findings also identified several competence problems. Progressive health professional development in the form of upward and in-service training, provision of licensure/COC exam, and learning in public universities/colleges positively impact professional competence. Therefore, the health and education systems together should strengthening upgrading and in-service training including CPD; licensure/COC exam; optimize the salary and strong regulation of private colleges.