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|Title: ||FUNCTIONING OF HEALTH EXTENSION PROGRAM WITH PARTICULA FOUCS ON CLIENT-PROVIDER INTERACTION IN GHIMBO WOREDA OF KAFFA ZONE, SNNPR|
|Authors: ||AMBACHEW, TEFERI|
|Advisors: ||Getnet Tadele|
|Copyright: ||Apr-2011 |
|Date Added: ||1-Nov-2012 |
|Abstract: ||As a core component of the broader health system, Health Extension program (HEP) focuses on the household and community that calls for coordinated action at all levels (FMOH, 2007). As a result, this study has focused on the interaction between clients and providers to understand how the HEP program is functioning. To be specific, the research tried to see accessibility, acceptability and cultural sensitivity of Health Extension Workers (HEWs); to understand the interaction of HEWs with VCHWs and other health care providers working at the various hierarchies; and to explore how incentives influence the implementation of HEP.
Four kebeles, two remote and two least remote, were purposively selected for the study. Although qualitative methods were the major source of data, quantitative methods were also used in the research. Accordingly, from the selected kebeles, in-depth interviews were conducted with twelve household heads, six HEWs and three key informants. Two FGD sessions, one with model households in a least remote kebele and the other with women in a most remote kebele, were also held. Quantitative data was obtained from a survey of 120 households and used to supplement the qualitative data.
The study revealed that limited knowhow about the community, and values and attitudes of HEWs had influenced these cadres to be less sensitive to cultural issues in health. Despite spatial variations in the amount of acceptance between more accessible and less accessible areas; the overall acceptability of HEWs in the community appeared very low. Inaccessibility at the work post was found to be high due to shift in place of residence and administrative inefficiencies.
The interaction between clients and providers, at all levels, was found to be not promising. Limited social participation, educational barriers, lack of social mobilization skill, social influences and networks; and limited support from the leadership were believed to have contributed to lack of meaningful interaction among stakeholders in HEP. Complaints about incentives by HEWs were continuously ignored by the government.
The combined effect of the aforementioned issues has significantly stifled the overall functioning of the program. Therefore, providers and clients are expected to create strong partnership so as to maximize the gain from HEP.|
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