Assessment of Factors Affecting Implimentation of Health Extention Program in Selected Subcities of Addis Ababa, Ethiopia
No Thumbnail Available
Date
2014-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Back ground;The Urban Health extension program (UHEP) is introduced in 2010 as a new initiative
community based health care delivery systems. The main objective of the program was to address
essential health services to the people at grass root level. Urban Health Extension Program
(UHEP) is expected to benefit approximately 2.6 million Ethiopians living in 19 cities and towns
in the Amhara, Oromia, SNNPR and Tigray regions, and was considered as the most important
institutional framework for achieving the Millennium Development Goals. In Ethiopia urban
health extension program UHEP is under studied, the present matched cross sectional study was
conducted to evaluate factors affecting program implementation.
Objective: - The overall objective is to assess factors affecting implementation of health
extension program in selected sub cities, Addis Ababa, Ethiopia.
Method and Materials: These HEWs based cross - sectional study was conducted from March
11/2014 to April 10/2014 in five sub-cities of Addis Ababa. A total of 235 HEWs were included
in the study by using self administered questionnaire.
Result :In the study area the main responsibility of the health extension workers is awareness
creation and social mobilization. 228 (97%) of HEWs are capable of doing their work
independently, while 7 (3%) of them need coaching support. Results indicate that antenatal care,
delivery service and curative treatment for mothers, children, and adults are not provided in the
study area. One hundred seven (45%) of the study participants implement postnatal care service
and 128(54.5) didn’t. Out of the total respondents 220(93.6%) gave counseling service on
essential nutrition action, family planning, treatment of anemia and others. Polio vaccination
service was delivered by 101(43%) during polio campaign alone. One hundred seventy five
(74.4%) of the HEWs give health education on essential nutrition action and 46(19.6%)
demonstrated vitamin A and iron complementation. Growth monitoring (only MUAC) is
performed by 157(66.8%) during home visit. Thirty seven percent (87) of the study participants
give only condom distribution service and created awareness on methods and types of
contraceptives; while 148(63%) of UHEWs gave only the education service. Adolescent and
reproductive health services were given by 64(27.7%) of the HEWs focusing mainly on sexuality,
HIV/AIDS counseling and condom provision.
Discussion In this study, it was found that the success of HEP in achieving its set goals and
objectives could be affected by a number of complex factors.Among which the capacity of HEWs
take the lion share in proper implementation of the HEP. To this end, more than 50% of the
HEWs should implement the packages independently was taken as a bench mark. This was
evidenced by the positive response of 228(97%) of the HEWs in selected sub-cities of Addis
Ababa that they commit independently. However the remaining 7(3%) did not materialize the
package independently and need technical backstopping or training. This proportion really should
not be undermined and neglected.
Conclusion :The overall implementation of HEP was found to be encouraging. The majority,
228(97%) of the HEWs implement the packages independently where as 7(3%) were not
implementing it independently. Health extension workers are doing better on HIV/AIDS related
services, hygiene and environmental sanitation and health education service. But, family health
service and disease prevention and control services needs more effort. Specifically, they have
limited contribution with respect to health promotion and preventive measures of major packages
such as family planning, TB, leprosy, and rabies management.
Recommendation The 3% of health extension workers not implementing the full packages
independently in Addis Ababa selected sub-cities should not be undermined. Therefore the Addis
Ababa region health bureau in collaboration with stakeholders should conduct need assessment
and respond accordingly to prevent non-functionality of the program and dropout rate of the
health extension workers.
Description
Keywords
Health extension program, job satisfaction, future aspiration, community involvement, refreshment training, referral linkage, Health institution support, selection, distance.