Abstract
BackgroundThe Health Extension Program (HEP) is one of the most innovative community based health program launched by the Ethiopian Federal Ministry of Health to make health services accessible to rural communities by setting-out women Health Extension Workers (HEWs) in rural Health Posts. The HEWs are premised to provide basic, largely preventive, primary health services to rural villages and the program gives special attention to children and mothers. The objective of the study was to assess the contribution made by the Health Extension Workers in maternal and child health care service delivery in Dale district, southern Ethiopia.MethodsUsing a community based cross-sectional data; the study assessed the status of mother’s health service utilization and estimated the role of HEWs in maternal and child health care delivery. Mothers of reproductive age (15–49), having at least one under-five age child, were eligible for the study. The total sample size was 617 and systemic random sampling method was used to select the study subjects from each randomly selected kebeles (lower administrative units). Structured questionnaire was applied to collect data through interviewing of the selected mothers and the data were analysed using SPSS version 16 statistical software.ResultsHealth Posts are important health care delivery settings and their share from the overall service delivery of ANC, Family planning and child treatment services were pivotal. However, overall service coverage of ANC (four and more visits), delivery and PNC services were low in the district as compared to the national status; and the input from the HEWs, in this regard, was unsatisfactory. The number of home visits was also inadequate for the necessary support of the mothers. The results of the multiple logistic regression indicated that mothers who listen to the radio (AOR 4.62; CI 1.66–12.85) and who had received information about the MCH services by HEWs (AOR 2.09; CI 1.06–4.14) were significantly associated with good MCH service utilization status.ConclusionHealth Extension Workers can improve their role in the MCH service delivery in the district by delivering appropriate information about the different available services to the mothers at the community and household level. All concerned bodies, including federal, regional and local governments should support the efforts of HEWs and need to address the challenges for poor performance areas of the HEWs in MCH service delivery.
Highlights
The Health Extension Program (HEP) is one of the most innovative community based health program launched by the Ethiopian Federal Ministry of Health to make health services accessible to rural communities by setting-out women Health Extension Workers (HEWs) in rural Health Posts
In order to identify predictors of good Maternal and child health (MCH) service utilization, the possible confounding effect was controlled using multiple logistic regression analysis; and found that mothers who listen to the radio (AOR 4.62; Confidence interval (CI) 1.66–12.85) and who had received information about MCH services by HEWs (AOR 2.09; CI 1.06–4.14) were more likely to use MCH services than mothers who had not (Table 7)
The primary purpose of the study was to assess the role of HEWs in promoting and expanding MCH services, which in turn helps to improve child and maternal health outcomes
Summary
The Health Extension Program (HEP) is one of the most innovative community based health program launched by the Ethiopian Federal Ministry of Health to make health services accessible to rural communities by setting-out women Health Extension Workers (HEWs) in rural Health Posts. The objective of the study was to assess the contribution made by the Health Extension Workers in maternal and child health care service delivery in Dale district, southern Ethiopia. In Ethiopia, pregnancy remains to be the leading cause of death of women in their reproductive years and the rate of under-5 and maternal mortality are among the highest in the world estimated at 67 deaths per 1000 live births and 412 deaths per 100,000 live births, respectively. Each year an estimated 22,000 women and 88,000 new-borns die from complications related to childbirth, mostly because of the large majority of the deliveries occur at home. Ethiopia is among the six countries that account for 50% of under-five child mortality globally, with 194,000 deaths every year. 68% of underfive deaths are attributed to pneumonia (21%); diarrhoea (14%); neonatal conditions such as prematurity (15%) and birth asphyxia (10%); measles (4%); malaria (2%) and HIV (2%) [3,4,5]
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