Abstract:
ackground: Since 2004, Ethiopia has been deploying specially trained new cadres of
community based health workers in rural areas of the country known as health extension
Workers. The modalities for HSEP implementation include an outreach programme run by
female health extension workers (HEWs), two per kebele serving 5000 people.
Objective: The objective of the study was to assess Implementation of health extension services
in Lalo Kile woreda, Qelem Wollega, Oromia regional state, West Ethiopia.
Methods: Community based cross sectional study was conducted using both quantitative and
qualitative data collection method from October14 to November14, 2013. Quantitative data was
collected using a pre-tested structured interviewer administered questionnaire by eight female
data collectors from a sample size of 422 households calculated with single population
proportion formula and selected by simple random method from household register found in
each kebele. All health posts were assessed using observation checklist. For qualitative data
focus group discussion and in-depth interview were conducted with Health extension workers
and Health developmemt army leaders. The quantitative data was analyzed using Statistical
Package for Social Science version 16.0 while qualitative data was analyzed thematically. Oral
informed consent was obtained from all participants.
Results: Of the 409 interviewed households, 75% of them had at least one service related contact
with Health Extension Workers in the previous six month. The mean frequency of service related
contact with Health Extension workers was found to be 2.9(±0.9). The mean frequency of home
visit a household received was 0.9(±1.02). The mean scores for individual attitude items range
from 3.4(±0.75) to 4.2(±0.59) while the mean score for the overall attitude scale was being 3.9
(±0.46). Qualitative study identified that Individual competencies of HEWs, availability of
supply and logistic system as well as the level of support from kebele leaders were reported to
influence the program implementation and utilization.
Conclusion: Health development army was found the most essential structure on maternal heath
related issues and the study showed that attitude on contribution of the program for the
community has shown significant association on affecting program implementation.
Recommendation: supportive supervision and intersectorial collaboration with sectors in the
kebele should be promoted to built positive attitude towards the implementation of the program.
