IMPLEMENTATION PRACTICE AND ASSOCIATED FACTORS OF BALANCED SCORECARD IN CENTRAL GONDAR ZONE PUBLIC PRIMARY HOSPITALS NORTHWEST, ETHIOPIA, 2022

Abstract

Abstract Background: Low quality service and customer satisfaction of health facilities are mostly associated with poor implementation of balanced scorecard in the workplace, and the burden is dominant in developing countries like Ethiopia., there are studies done in Ethiopia where there is limited evidence in public primary hospitals as well as in mixed method approaches to the implementation practice of the balanced scorecard. Objective: The aim of the study was to assess the Balanced Scorecard implementation practice and associated factors in the central Gondar zone public primary hospitals, Northwest Ethiopia, in 2022. Method: A facility-based cross-sectional study using mixed concurrent qualitative approaches was conducted from May 25 - June 26, 2022, in Central Gondar zone primary hospitals. A computer generated simple random sampling technique was used to select the study subjects for the quantitative and purposive sampling techniques for the qualitative. Bivariable and multivariable logistic regression analyses were done. The strength of associations was measured using the adjusted odds ratio (AOR) with pvalue

of 0.05 in the multivariable analysis were considered significant. Thematic analysis was done for the qualitative part. Results 404 study participants were involved in the study, with a response rate of 95.28%. The overall balanced scorecard implementation practice was 48.5% (95% CI: 43.6%53.4%).Teamwork(AOR:2.68,95%CI;1.53,4.69)organizational communication (AOR:3.24,95% CI:1.79,5.89),availability of infrastructure(AOR:2.03,95% CI:1.14,3.64), , BSC evaluation (AOR:2.48,95%CI;1.32,4.67) were all significantly related to balanced scorecard implementation practice. Conclusions and Recommendations: The overall implementation of the balanced scorecard was poor. Therefore, organizational communication, balanced scorecard evaluation; team work, infrastructure, BSC training, human and financial resources, commitment and attitude towards BSC, job description, support and monitoring; need to be improved for balanced scorecard implementation practice. Key words BSC implementation, public primary hospital, central Gondar, Ethiopia