Implementation Evaluation of Rural HealthExtensionServices in Kersa Woreda, Jimma Zone, Oromia Regional State, south West Ethiopia ,2022

Abstract

Background The Health ExtensionService (HEP) is a main component ofprimary Health care units responsible for the delivery of family health, disease prevention and control, basic hygiene, and environmental sanitation services. The HEP was, to begin with, designed as a community health program providing 16 “packages” delivered by a team of two Health Extension Workers (HEWs), deployed to serve in community health posts with a catchment area of 5,000 populations. However, the program status and level of implementation are not indicated despite its long-term implementation in Kersa woreda. Therefore, this implementation evaluation was conducted to assess the implementation status of the program in the woreda. Objective: To Evaluate the Implementation Status of the Rural Health Extension Service in Kersa Woreda, Jimma Zone SouthWest Ethiopia. Methods:Acase study design withquantitative and qualitative data collection methods was employedat Kersa woreda from June 10- July 14, 2022.The evaluation was focused on the Implementation of the program with dimensions; of availability, compliance, and household Acceptability. Resource inventory, document review; key informant interviews, and observations were conducted;Households Acceptability was assessed through exit interview; with sample size of 403.The qualitative data were analyzed manually using thematic analysis and quantitative data were analyzed by using SPSS version 26 software. Bivariate and multivariate logistic regressions weredone to determine the predictor of client Acceptability,Attitude,awereness&perception of Households.The findings were compared with preset criteria for the final judgment. Result: Overall, the required resources were available in 76% of the health post studied. Service providers were complying with the guideline in 81% of the time. And 69% of the household were accepted with the service provided by the health extension workers. Conclusion and Recommendations:The overall Implementation Evaluation of the service as measured using the three dimensions (availability, compliance, and Acceptability) was found to be Medium, which requires improvement. The availability of program resources, compliance of health care providers to standards, and Acceptability of the community also showed a Medium performance.Therefore, we highly recommend that efforts should be made to improve the Implementation of the service in the Kersa District of Jimma Zone.