Implementation of urban health extension program: hygiene and environmental health packeges in Addis Ketema sub city, Ethiopia.

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Addis Ababa Universty


Introduction: Health Extension program is designed and implemented in recognition of the fact that the major factor underlying the poor health status of the country’s population is the lack of empowerment of households and communities to promote health and prevent disease. Although the government is trying to solve urban health problems through UHEP, still there are challenges and/or problems in waste management, access to sanitary facilities, safe and adequate water supply causing about 60-80 % of health problems. Objective: To assess the implementation status of urban health extension program of hygiene and environmental health packages in Addis Ketema Sub City, Addis Ababa. Methods: Community based cross-sectional study design using quantitative and qualitative methods was conducted from September, 2016 to June, 2017 in Addis Ketema Sub City, Addis Ababa. For quantitative data a total of 765 households was selected using multi stage sampling procedure and qualitative data obtained through key informant interview of purposively selected participants. The quantitative data entered and analyzed using SPSS version 20.0 and qualitative data analyzed by thematic method manually. Results: The overall level of implementation of hygiene and environmental health packages are 34.7 %. Age group with 36-45,46-55 and above 55 years old respondents were 99.7%,99% and 97% less likely implement [AOR=0.003,95%CI=0.001-0.057],[AOR=0.01,95%CI=0.00-0.041], [AOR=0.01,95%CI=0.009-0.15] compared to the age group 26-35 years. Female household respondents 7.3 times more likely to implement the hygiene and environmental health packages than the male respondents [AOR=7.3, 95%CI=3.211-6.157]. Monthly income between 501-1000 Eth Birr have 6.8 times more likely to implement than households income less than 501 Eth birr [AOR=6.80,95%CI=2.35-10.31]. Conclusion and recommendation: the level of implementation was low. There were variations in the level of implementation among the packages. Community resistance for the program, Governmental constraint and very poor supportive supervision are the main reasons for low implementation status of environmental health packages. Community ownership and involvement, continues supportive supervision and further study is important for better implementation.



Health Extension program