Empirical evaluation of the Ethiopian Health Extension Program (HEP)

2021 ◽  
Author(s):  
Sebastian Bauhoff ◽  
Taye Tolera
Keyword(s):  
Empirical Evaluation ◽  
Health Extension Program ◽  
Extension Program

scholarly journals Utilization of Urban Health Extension Program Services and Associated Factors among Hosanna Dwellers, Hadiya Zone, southern Ethiopia: A Community Based Cross-Sectional Study

2019 ◽  
Author(s):  
Birhannu Jikamo ◽  
Temesegen Woelamo ◽  
Mekonen Samuel
Keyword(s):  
Urban Health ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Southern Ethiopia ◽  
Cross Sectional ◽  
Health Extension Program ◽  
Study Participants ◽  
Extension Program ◽  
Hadiya Zone ◽  
Model Family

Abstract Abstract Background: In 2009, in Hadiya zone reported that establishment of Urban Health Extension Program (UHEP) which is subsequent declaration of after the country of Ethiopia. Major contribution of the declared UHEP is to provide accessible service to the potentially vulnerable groups of <5children pregnant women. Therefore, the aim of this study was to assess the utilization and associated factors of the urban health extension program services in Hossana Town, Hadiya Zone, southern Ethiopia, 2018 Methods: we conducted community based cross-sectional study in Hossana town, Hadiya Zone southern Ethiopia. Households were recruited by using systematic random sampling technique and study participants also by using random sampling techniques. A total of 403 study participants were participated in this study. Strength of measure of association between explanatory variables with outcome variable reported using the Odds Ratio (OR) with 95% confidence interval. Bivariate and multivariate binary logistic regression analysis was performed to identify predictors. P-value < 0.05 used to identify factors significantly associated with outcome variable. Results: Out of 403 households, 397(98.5%) of response rate obtained. The mean score of community knowledge about the utilization of urban health extension program service (UHEP) was 2.352 (SD ±1.156. Regarding knowledge towards UHEP, of 166 (42%) of the respondents had good knowledge towards UHEP service while 231 (58%) had poor knowledge towards UHEP service utilization. The total number of households which graduated as a model family was 79 (19.9%). In the adjusted multivariate model, those respondents in the age group of 36-45 year were 3.73 times(AOR = 3.73; 95% CI:1.04-3.37) more likely to be utilized health extension program services as compared with those respondents in the age group of 18-24year. Those households which graduated as a model family were 2.2 times (AOR = 2.18; 95% CI: 1.36- 3.51) higher odds of utilized health extension program service as compared with those households which didn’t graduated as a model family. Conclusions: The coverage of utilization of urban health extension program service was low in the study setting compared with previous study. There were also identified predictors that were associated with utilization of urban health extension program service.

scholarly journals Use of Balanced Scorecard Methodology for Performance Measurement of the Health Extension Program in Ethiopia

2016 ◽  
Vol 94 (5) ◽  
pp. 1157-1169 ◽  
Author(s):  
Hailay D. Teklehaimanot ◽  
Mustofa Abdella ◽  
Awash Teklehaimanot ◽  
Aregawi A. Tedella
Keyword(s):  
Performance Measurement ◽  
Balanced Scorecard ◽  
Health Extension Program ◽  
Extension Program

scholarly journals Barriers and Facilitators to Implementing Mental Health Services into the Ethiopian Health Extension Program: A Qualitative Study

2020 ◽  
Author(s):  
Kiddus Yitbarek ◽  
Zewdie Birhanu ◽  
Gudina Terefe ◽  
Susan Anand ◽  
Liyew Agenagnew ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Health Problem ◽  
Mental Health Problems ◽  
Primary Health Care System ◽  
Political Commitment ◽  
Health Extension Program ◽  
Extension Program

Abstract Background: Mental health problem is the major health problem globally and nationally in Ethiopia. To address this problem the Ministry of health of Ethiopia integrated mental health services in to the community health service. However, the preliminary reports showed the service has not been implemented yet. Therefore, the aim of this study was to explore the barriers and facilitators of mental health service implementation in to the Ethiopian health extension program.Methods: A qualitative case study was conducted in the Ethiopian primary health care system from 12 August to 25 September 2019. We have conducted about ten purposively selected key informant interviews from the Ministry of Health and community level workers (i.e. health extension workers). All interviews were recorded using voice recorder and transcribed verbatim and translated for analysis. The data then analyzed manually in relevant themes. Results: Mental health problem currently is a major health issue in Ethiopia. However, the service is not ready to respond for the existing health service need. The recently designed integration of mental health services in to health extension program was not implemented so far. The basic identified barriers were, low political commitment, shortage of resources, non-functional referral system, lack of interest from private health service organizations, attitudinal problems from both the society and service providers, the lack of reporting system for mental health problems. On the contrary, there are also facilitators for the service like well-designed primary health care system, trained health extension workers, changing political commitment and attitude of the community.Conclusion: Although mental health problems are widely spread and increasing in alarming rate, in Ethiopia, the existing health system is not capable enough to respond. This problem is complex and intertwined. A series of activities to solve the major barriers are expected especially from the health system leaders to implement follow up and evaluate mental health services at the health extension programs.

scholarly journals Disparities in the implementation of the Health Extension Program in Ethiopia: doing more and better towards universal health coverage

2021 ◽  
Author(s):  
Tilahun Haregu ◽  
Yibeltal Kiflie Alemayehu ◽  
Yibeltal Assefa Alemu ◽  
Girmay Medhin ◽  
Mulu Abraha Woldegiorgis ◽  
...  
Keyword(s):  
Health Services ◽  
Child Nutrition ◽  
Large Scale ◽  
Maternal Health Services ◽  
Health Coverage ◽  
Health Extension Workers ◽  
Health Extension Program ◽  
Interregional Disparities ◽  
Rate Ratios ◽  
Extension Program

Abstract IntroductionLarge-scale implementation of the Health Extension Program (HEP) has enabled Ethiopia to make significant progress in health services coverage and health outcomes. However, evidence on equity and disparities in implementation of the HEP and its outputs is limited. The aim of this study was to examine disparities in the implementation of the HEP in Ethiopia.MethodsWe used data from the 2019 National HEP assessment conducted between Oct 2018 and Sept 2019 in nine regions in the country. Data was collected from 62 districts, 343 Health posts, 179 Health centres, 584 Health Extension Workers (HEWs), 7,043 women from 7,122 Households. This study focused on selected input, service delivery, and service coverage indicators. We used rate differences, rate ratios and index of disparity to assess disparities in HEP implementation across regions.ResultsWe found wide interregional disparities in HEP implementation. Developing regional states (DRS) had significantly availability of qualified HEWs (Rate Ratio (RR) = 0.54), proportion of households visited by Health Extension workers (RR = 0.40, and proportion of mothers who received education on child nutrition (RR = 0.45) as compared national average. There are also significant disparities in HEP implementation among DRS in proportion of household visited by HEWs in the past 12 months (Index of disparity = 1.58) and proportion of adolescents who interacted with HEWs (Index of disparity = 1.43). Despite low overall coverage of health services in DRS, the contribution of the HEP for maternal health services is relatively high.ConclusionThere exist significant interregional disparities in HEP implementation in Ethiopia. The level of disparity among DRS is also remarkable. If the country is to achieve UHC, it is important that these disparities are addressed systematically and strategically. This calls for further attention in all regions, in general, and a tailored approach in DRS, in particular.

scholarly journals Perspectives of the Health Extension Program Enhancing Contraceptive Provision in Southern Ethiopia: A Qualitative Exploration

2020 ◽  
pp. 65-75
Author(s):  
Abraham Alano
Keyword(s):  
Contraceptive Use ◽  
Community Organization ◽  
Study Data ◽  
Southern Ethiopia ◽  
Service Access ◽  
Health Extension Program ◽  
Contraceptive Service ◽  
The One ◽  
Qualitative Exploration ◽  
Extension Program

Aim: To uncover information gap on the health extension program contribution in improving access, the study explored the lived experiences towards creating enabling environments for contraceptive service provision and use in light of the health extension program. Methods: Interpretative phenomenological design was employed for the study. Data were collected using focus group discussions, individual in-depth interviews and key informant interviews. Analysis was done using an interpretive phenomenological analysis framework including phases of data immersion, transcribing, coding, theme development and phenomenological interpretation through the hermeneutic circle. Results: The finding captures the contribution of the health extension program in accelerating/decelerating contraceptive use in the study area. Contraceptive services organization, access and extension in the era of the health extension program were presented. Since the beginning of the program, contraceptive use has alarmingly improved as witnessed by both the service users and providers. The linkage of primary health care with the community organization, a women development army and the one-to-five network are among the major contributed factors for the outcomes. Conclusion and Recommendation: The study concludes that the health extension program has given a special momentum in shaping the principles of PHC. The study revealed that women witnessed encouraging involvements in contraceptive service access and use. Hence, the study recommends that the experiences of women development armies and other networks have to be strengthened. Moreover, the existing community networks should be strengthened through proper evaluation and feedback.

scholarly journals Economic evaluation of Health Extension Program packages in Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246207
Author(s):  
Lelisa Fekadu Assebe ◽  
Wondesen Nigatu Belete ◽  
Senait Alemayehu ◽  
Elias Asfaw ◽  
Kora Tushune Godana ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Prevention And Control ◽  
Unit Cost ◽  
Family Health ◽  
Cost Effective ◽  
Health Extension Program ◽  
Per Capita ◽  
The Cost ◽  
And Control ◽  
Extension Program

Background Ethiopia launched the Health Extension Program (HEP) in 2004, aimed at ensuring equitable community-level healthcare services through Health Extension Workers. Despite the program’s being a flagship initiative, there is limited evidence on whether investment in the program represents good value for money. This study assessed the cost and cost-effectiveness of HEP interventions to inform policy decisions for resource allocation and priority setting in Ethiopia. Methods Twenty-one health care interventions were selected under the hygiene and sanitation, family health services, and disease prevention and control sub-domains. The ingredient bottom-up and top-down costing method was employed. Cost and cost-effectiveness were assessed from the provider perspective. Health outcomes were measured using life years gained (LYG). Incremental cost per LYG in relation to the gross domestic product (GDP) per capita of Ethiopia (US$852.80) was used to ascertain the cost-effectiveness. All costs were collected in Ethiopian birr and converted to United States dollars (US$) using the average exchange rate for 2018 (US$1 = 27.67 birr). Both costs and health outcomes were discounted by 3%. Result The average unit cost of providing selected hygiene and sanitation, family health, and disease prevention and control services with the HEP was US$0.70, US$4.90, and US$7.40, respectively. The major cost driver was drugs and supplies, accounting for 53% and 68%, respectively, of the total cost. The average annual cost of delivering all the selected interventions was US$9,897. All interventions fall within 1 times GDP per capita per LYG, indicating that they are very cost-effective (ranges: US$22–$295 per LYG). Overall, the HEP is cost-effective by investing US$77.40 for every LYG. Conclusion The unit cost estimates of HEP interventions are crucial for priority-setting, resource mobilization, and program planning. This study found that the program is very cost-effective in delivering community health services.

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