Is the role of Health Extension Workers in the delivery of maternal and child health care services a significant attribute? The case of Dale district, southern Ethiopia

Abstract

Background: 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 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.

Methods: Using 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.

Results: Health 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.

Conclusion: Health 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.

Keywords: Health Extension Workers; MCH service utilization; Southern Ethiopia.

Fig. 1

Availability of Health Extension Workers during mothers’ last Health Post visit in Dale district, southern Ethiopia, 2015. (Blue square) Availability of HEWs at HPs

Fig. 2

Home visits by Health Extension Workers (HEWs) during the last 6 months in Dale district, southern Ethiopia, 2015. (Red square) Home visits by HEWs