Implementation of the Rural Health Extension Services in Lalo Kile Woreda, Qellem Wollega Zone, Oromia Regional State, West Ethiopia

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.