A majority of patients were managed at the clinic/health centre level (42.9%), followed by the referral hospital (38.9%) and the super-specialty hospital (18.2%) level.
We used random-effects multi-level regression models with centre-specific intercepts to allow for clustering on the study centre level (9 centres) and for year of birth (2000 – 2002; 2003 – 2005; 2005–2005).
The Trauma Model used GIS to calculate travel time from both rural and urban population areas to the nearest trauma centre (Level 1, 2 or 3) [ 24].
(OR: 0.55, 95% CI: 0.32 to 0.94, P = 0.03) Despite a longer out of hospital time, the organization SAMU/SMUR ameliorates delays to university hospital (trauma centre level 1) admission leading to a positive impact on survival.
This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective?
Three-level regression models were constructed to accommodate the inherent dependency structure of the data in the presence of both repeated observations from the same individuals (level 2 unit) and clusters within the same community health centre (level 3 unit) [ 22].
Currently, Kenya's health system for the public sector is organized around six levels which are the community (level 1), the dispensary (level 2), the health centre (level 3), the sub-county and county hospitals (level 4), the regional hospitals (level 5), and the national referral and teaching hospitals (level 6).
77 However, the provision of maternity care was still less than half of what was required 81 and additional recent data suggest that obstetric care services are still lacking in Malawi, especially at the peripheral health centre level, 33 82 and also that shortages of staff and supplies are still acute.
We conducted 27 key informant interviews with health officials and partners at national, district and health centre levels; 32 focus group discussions with community members and in-depth interviews with 32 community members and 32 community leaders.
The models were estimated taking the clustering of patients (level 1) within primary care centres (level 2) into account.
