Browsing by Author "Betre, Mulugeta(MD, MPH, Assitant Professor)"

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    Assessment of the extent and determinants of functionality of health extension workers in East Gojjam Zone, Amharra Regional State, Ethiopia.
    (Addis Abeba University, 2009-06) Hailu, Getachew; Betre, Mulugeta(MD, MPH, Assitant Professor)
    Background –Previous studies have identified factors affecting Health Service Extension Program implementation as well as working conditions of Health Extension Workers in Ethiopia. Most of the studies conducted were qualitative and none of them raised the question to what extent HEWs are functional and what are its determinants. The present matched case control study was conducted to evaluate risk factors for functionality of HEWs after a crosssectional census survey determination of extent of HEWs functionality. Objective- A study was undertaken to determine the extent of HEWs functionality and to evaluate determinants of functionality of HEWs in East Gojjam Zone, Amharra National Regional State. Method- A population based matched case control study after a cross sectional preliminary census survey was conducted in East Gojjam Zone from March to May 2009. A total of 632 health extension workers were included in the cross sectional census survey. All of the (n=25)eligible cases (nonfunctional HEWs) in the zone were included in the study. Two randomly selected controls [(n=50)(functional HEWs)] working from 2003 to 2008 in the same zone from which the cases were enrolled were matched for each case for age, service year, marital status and woreda of the case. Data collection instruments of separately designed self administered and interview based structured questionnaire were used for the cross sectional and matched case control studies respectively . Result- Over all non functional prevalence of HEWS in East Gojjam Zone was 4 %( n=25) The final multivariable model identified health institution support (adjusted matched odds ratio [Adj.mOR=40, 95% CI=4.5_360]), selection pattern [Adj.mOR=11.2, 95% CI=1.3_98.9], and Future aspiration,[Adj.mOR=2.1 95% CI=1.3_57], as independent determinants of functionality of HEWs after adjusting for other variables in the model. Conclusion- In general functionality of HEWs was found to be encouraging. The majority (96% n=607) were functional where as 4 %( n=25) were non-functional. HEWs are doing better the family health, personal hygiene and environmental sanitation and health education services but communicable disease prevention and control service needs more effort. Health institution support, selection pattern and future aspiration had been identified as independent determinants of HEWs functionality. The program need to employ many qualified HRH for training, supervision and support. Therefore, the real cost of scaling up HEP, including the additional qualified HRH for supervision and training, should not be neglected. Moreover the need for career structure for HEWs is a high concern.