Study of the Working Conditions of Health Extension Workers in Ethiopia

Abstract

Background: Ethiopia is well placed as a potential candidate for the Millennium Development Goals (MDGs) fasttracking but the current 0.2/1000 human resource for health (HRH) clearly indicates the challenges ahead. However, there are also opportunities as the country has now launched an “Accelerated Expansion of Primary Health Care Coverage: 2005-2009” of which “The Health Extension Program (HEP)” is a major component”. Objective: The study focuses on the first batch of Health Extension Workers (HEWs) with the overall objective of assessing the working conditions of HEWs and their job satisfaction. Methods: An in-depth field study was carried out on 60 HEW in 50 health posts (HP) from six regions, 23 zones and 27 woredas. Results: There are challenges in harmonizing the staffing pattern at the HP level, guiding time-use, work schedule and relationship with the community. There are no clear guidelines on relationship with other health workers at the community level, on career structure, transfer, and leave of absences. Reporting and health management information system in general is weak. Conclusion: Placing HEW at community level is a commendable undertaking but fulfilling favorable working conditions is an important challenge which is compounded by long distances and poor transportation and communication facilities. These issues are elaborated and possible responses discussed.Ethiopian Journal of Health Development Vol. 21 (3) 2007: pp. 246-259