Assessment of Health Services Extension Program In Dawro zone, Southwest Ethiopia

Abstract

Background: Ethiopia, being one of the least developed countries, its people also suffers from many health problems, the major ones are infectious diseases, which emanate from poor sanitary conditions, nutritional deficiencies and harmful health practices. In response, the government has launched a Health Extension Program that aims for universal coverage of primary health care by 2009. Thus, assessing the progress made on heath extension program, factors affecting its achievement and the challenges faced by program implementers was the main intention of this study Objective: To assess health services extension program in Dawro zone, Southwest Ethiopia. Methods: a cross-sectional study design was used by applying a quantitative and qualitative method of data collection. The study was conducted in Dawro zone from March to April, 2010. The Study population comprised of all health extension workers and households in three randomly selected districts of rural kebeles. A pretested structured questionnaire was used to collect information from respondents after obtaining a verbal consent. Data were entered, cleaned, edited and analyzed using SPSS Version 16.0 statistical software package. Univariate, bivariate and multivariate analysis was carried out to identify the presence of association and the effect of independent variables on dependent variable. Results: A total of 755 respondents were interviewed and of whom 21.7% were in the age group of 25 to 29 years and about 688 (91.1%) had married. Among 599(79.3%) respondents who had heard about family health services, 560(74.2%) were informed by HEWs. Similarly, of 693(91.8%) who had awareness on how to dispose wastes, 651(93.9) reported HEWs as the main source of information. About, 587(77.7%) had reported that they knew at least one method of family planning. Those who had no model families in the neighbor were less likely to know as compared to their counter parts [OR=0.41, (0.28, 0.60)]. Of those that responded, 585(85.5%), to know how to prevent malaria, 362(61.9%) mentioned anti malaria drugs, 349(59.7%) bed net, and 253(43.2%) spraying DDT. As knowledge to HIV/AIDS, those who had been visited by HEWs in a weekly interval were 3.5 times more likely to know as compared to two months and above [95%CI (1.25, 9.64)]. Generally, about 61.8% respondents scored mean & above value and 38.2% scored below mean value on knowledge about disease prevention and control packages. About 435(57.6%) had reported as they had discussed about Tuberculosis prevention and control methods with HEWs in the past six months before the survey. In qualitative study, lack and shortage of some supplies and logistics, infrequent refresher training, weak supervision, and absence of water facilities at health post compound were identified as the major factors. Conclusions: Knowledge of respondents on disease prevention and control packages and hygiene and environmental sanitation was found to be consistent with practice. However, considerable gaps were observed in family health service packages. Thus, health extension workers should give a due attention to increase awareness of the community especially on family health services so as to use the available services.