Abstract
Background: Health Extension Program (HEP) was launched-innovative community health service since 2002 in Ethiopia. Since then, families were graduated as models for the HEP. Maternal and child Health (MCH) was one of the major packages in HEP. This study intended to compare model and non-model families (MFs and NMFs) on MCH behaviors. Method: Correlational study was conducted between mothers' model status and MCH service use in Sebeta Hawas district, Oromia special zone surrounding Finfine. A total of 305 samples were involved in the study from both MFs and NMFs. We applied simple random sampling. A pretested and structured questionnaire adopted from literatures together with discussion guides was used. It mainly composed of utilization of Family Planning (FP), antenatal care (ANC), delivery care (DC), postnatal care (PNC) and immunization. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) version 16. We used frequency tables to describe model status. Odds Ratio (OR) was used to identify demarcations between MFs and NMFs. Finally, quantitative and qualitative findings was triangulated. Result: The study showed statistically significant key variations between MFs and NMFs over family size, knowledge of (ANC, delivery complications and PNC) and utilization of (FP and ANC visits). These variables were positively linked with being from MFs. For example, 114/201 (56.7%) current FP users, 120/222 (54.1%) any ANC visitors, and 56/82 (68.3%) repeated (>=4) ANC visitors were from MFs compared to NMFs (PV<0.001). However, mothers from MFs & NMFs had no variation on delivery, PNC & immunization utilization. Closure of health posts at work time, inaccessible institutional delivery service (for MFs) and perceived invulnerability to delivery complications (for NMFs) hampered the MCH behaviors. Conclusion: Though MFs and NMF were similar over some MCH service knowledge and utilization, they vary over FP and ANC. MFs can be advocate for enhancing adoption and diffusion of earlier stage MCH behaviors. However, beyond the control contexts hindered MFs from playing their role of modeling late stages MCH behaviors (DC/ PNC/immunization).Therefore, HEP designers and implementers shall work on system challenges and create separate models for those behaviors and assign new name.
Highlights
Since Alma-Ata declaration, nearly for the last four decades, primary Health care (PHC) services have become major global health and economic concern [1]
We considered the following assumptions: proportion of non-model families who use antenatal care (ANC) in rural Ethiopia (P1=0.34[Ethiopian DHS, 2011)(We assumed the ANC figure as reported by EDHS-2011 for rural areas represent non-model families, ANC yielded higher sample size compared to other maternal health indicators), proportion of model families who use ANC was unknown and assumed to be (P2=50%), level of significance (α=5%), standard reliability coefficient at 95% confidence level (Z 1α/2=1.96), the 80% power to detect significant difference when it happens (Zβ=0.84) and one to one ratio for MFs and NMFs
The production of the model families starts with training and through close support and follow-up it achieves the goal of modeling Maternal and child Health (MCH) behaviors: Family Planning (FP), ANC, delivery care (DC), postnatal care (PNC) and child immunization
Summary
Since Alma-Ata declaration, nearly for the last four decades, primary Health care (PHC) services have become major global health and economic concern [1]. A pretested and structured questionnaire adopted from literatures together with discussion guides was used It mainly composed of utilization of Family Planning (FP), antenatal care (ANC), delivery care (DC), postnatal care (PNC) and immunization. Result: The study showed statistically significant key variations between MFs and NMFs over family size, knowledge of (ANC, delivery complications and PNC) and utilization of (FP and ANC visits). These variables were positively linked with being from MFs. For example, 114/201 (56.7%) current FP users, 120/222 (54.1%) any ANC visitors, and 56/82 (68.3%) repeated (>=4) ANC visitors were from MFs compared to NMFs (PV
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