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Expanding or diluting? : a review of the health extension programme in Ethiopia

Document type: mthesis
Download file(s): 185327 (1967 KB)
Abstract: PROBLEM: The Ethiopian government launched a Primary Health Care (PHC) programme called ‘Health Extension Programme (HEP)’ in 2003 to bring essential preventive, promotive and basic curative services closer to the rural people. However, the programme has faced serious challenges that affect its full success. Several annual performance evaluations and midterm reviews have been carried out to assess the progress of the programme. Unfortunately, the evaluations and reviews are not comprehensive nor based on criteria commonly used to assess the performance of programmes. OBJECTIVES: To systematically review the HEP. METHODOLOGY: The review is based on EC evaluation criteria in order to answer questions that include: How relevant is the HEP? What are its achievements? Does HEP value for money? Is HEP a sustainable programme? To find appropriate answers for the above questions, relevant documents and literatures were reviewed. FINDINGS: The findings show that HEPs’ objectives and packages of services are relevant to the health problems of the country. Nevertheless, skilled care for women and newborn and treatment of pneumonia are not provided by the programme. The HEP has improved the coverage of latrine use, immunization, family planning and insecticide treated bed nets (ITNs). It has also achieved encouraging results with little financial investment (USD 5.5 per person). A strong government support and community-of-origin-based HEWs selection for employment are found to be very crucial for the sustainability of the programme. However, lack of active community participation and dependence of the HEP on donors’ support tend to affect its sustainability. CONCLUSIONS: From the findings, it is plausible to conclude that the HEP is a relevant, effective and efficient programme that needs to be sustained. RECOMMENDATIONS: For the HEP to be more successful, it is imperative to provide standard skill training on maternal and child care for HEWs, create a conducive working environment for the HEWs, strengthen community participation in planning, implementing, monitoring and evaluating the HEP and enhance Districts’ (Woreda) capacity to manage the HEP.
Authors: Guyallo, D.K.
Country: Ethiopia
Category: Research
Department: Development Policy & Practice
Institute: KIT (Royal Tropical Institute)
Keywords: health services , health , nutrition , aid programmes
Language: eng
PAGE: viii, 72
Year: 2009
Region: East Africa
Right: © 2009 Guyallo
Subject: Health and Nutrition
Title: Expanding or diluting? : a review of the health extension programme in Ethiopia
Training: Master of Public Health / International Course in Health Development (ICHD)