Community satisfaction with the urban health extension. Across the board, mortality is lower in urban than in rural areas in ethiopia. This guideline is a complement and a companion to the health extension packages prepared for health extension worker as a guidebook cookbook. The health extension program hep is one of the most innovative communitybased health programs launched by the ethiopian federal ministry of health fmoh to make health services accessible to rural communities by setting out women health extension workers hews in rural health posts. Family planning utilization among model and non model. Strengthening ethiopias urban health program funds for ngos. The program was later adapted for pastoralist and urban regions in 2010 3. These improvements are a result of the health extension program, a community based expansion of health facilities, launched in 2004. Rukiya, 23, is one of 4,600 uheps working as part of ethiopia s urban health extension program uhep, which aims to extend the reach and effectiveness of urban health care to the community through the provision of householdlevel services. The video is designed to bring the voices of ethiopian women and girls, as well as champions of family planning, into the u. Author unicef ethiopia posted on january 12, 2016 january 12, 2016 categories health, his, oromia tags child health, ethiopia, health, health extension programme, health extension workers, pneumonia, unicef leave a comment on in a quiet rural area of ethiopia, a three year old boy holds the promise of a healthy nation. In 2003, the government of ethiopia launched the health extension programme and introduced a new cadre, health extension workers hews, to improve access to care in rural communities. Ethiopia urban health extension program usaid uhep works to support at scale, the implementation and monitoring of the government of ethiopias uhep and to improve access to and demand for health services.
The program was originally launched in 2003 in the countrys four big agrarian regions. In 2003, the ethiopian ministry of health established the health extension program hep, with the goal of improving access to health care and health promotion activities in rural areas of the country. It was prepared by lucy mize, rebecca miles, mirgissa kaba, michael dejene, and kuleni berhanu through the gh tech bridge project. Program of severe acute malnutrition, federal ministry of health, 2010, addis ababa, ethiopia not printed. Research commentary poor access to health services. The impact of ethiopian health services extension program. Background primary health care services are fundamental to improving health and health equity, particularly in the context of low and middleincome settings where resources are scarce. How do health extension workers in ethiopia allocate their.
Usaid supports the ethiopian governments health extension program and works with local districts to provide training for health extension workers, who are then able to reach. Usaiduhep works to strengthen the capacity of uhe professionals to identify vulnerable groups and most atrisk populations in their catchment. Summary of concepts, progress, achievements and challenges. Urban health extension program model housing and household. Aster met with rukiya, an urban health extension professional uhep who serves in dessie town. Innovative strategies to improve household behaviors and coverage of basic health care. Finally the ministry of health gives its deepest appreciation for all those who dedicated. University hepcaps1 project team to work with ethiopia s federal ministry of health, and other relevant stakeholders, to create a platform of longterm strategies in line with ethiopia s vision for an effective, adaptable, and sustainable health extension program hep ethiopia s primary health care system. The usaidfunded ethiopia urban health extension program uhep cooperative agreement no. A central feature of the sector is the priority given to the health extension programme, which delivers costeffective basic services that enhance equity and provide care to millions of women, men and. Through the voices of rural women at health posts, health extension workers, and.
This initiative has been called the health extension program. Countrylevel programmes health extension workers in ethiopia delivering communitybased antenatal and. Family planning utilization among model and non model family women enrolled in urban health extension program in addis ababa, ethiopia, 2015. The ethiopian health extension program and variation in. Ethiopia strengthening urban health extension program in addis. Ethiopia strengthening urban health extension program in. Since 2003 the government of ethiopia has been deploying specially trained new cadres of community based health workers named health extension workers hews. Ethiopia health extension program open knowledge repository. We aimed to assess the successes and challenges of the hep over time, and develop a framework that may assist the implementation of the program toward universal primary healthcare services. Ethiopia has made substantial progress in improving health outcomes during the last decade and is on track to achieve some of the health millennium development goals. Pdf urban health extension service utilization and associated. Additionally, higherperforming and lowerperforming woredas shared concerns about hospitals being isolated from health centers and health posts.
Usaid efforts in ethiopia have contributed to this success. Blended learning module for the health extension programme. There were 119 hospitals 12 in addis ababa alone and 412 health. Ethiopia health extension program a s a lowincome country, ethiopia has made impressive progress in improving health outcomes. Effect of ethiopias health extension program on maternal. During the past decade, ethiopia undertook an ambitious investment in primary health care known as the ethiopian health extension program that recorded impressive gains in several health. Innovative strategies to improve household behaviors and coverage of basic health care services contributed to ethiopia s achievements, and the health extension program hep remains the core of such innovations and provides a model for countries struggling to improve health outcomes in a resourceconstrained setting. Community health workers are widely used to provide care for a broad range of health issues. Herbst, feng zhao, agnes soucat, and christophe lemiere in 2005 more than half of the population of ethiopia lived. The health extension program of ethiopia harvard health. Turning finance into services for 2015 and beyond significant human resource capacity challenges, in particular at woreda that is, district level, despite large but disparate programbased capacity building initiatives. According to the head of the world banks global hivaids program, in 2007 ethiopia had only 1 medical doctor per 100,000 people. Pdf background ethiopia has been deploying specially trained new cadres of community based health workers in urban areas of the country. A reference for health extension workers in ethiopia 2008, which was.
Innovative strategies to improve household behaviors and coverage of basic health care services contributed to ethiopias achievements, and the health extension program hep remains the core of such innovations and provides a model for countries struggling to improve health outcomes in a resourceconstrained setting. The health extension program hep, a flagship program of the government of, was ethiopia launched by the federal ministry of health in 2003 with the goal of improving health outcomes in ethiopia by targeting households and communities. Pdf the ethiopian health extension program and variation. Promoting urban health and laun ch of the strengthening. The federal ministry of health fmoh of ethiopia launched the health extension program hep in 2003 and it became operational with the 20042005 graduation of 76 health extension workers hew, trained to work mainly in disease prevention and health promotion in rural villages. Over the past decade, ethiopia has achieved dramatic progress in improving the health outcomes of its population. In addition to their formal of the health extension program, usually one of the health extension worker is member of the community kebele administrative cabinet. Health extension workers will use this guideline for their routine activities. Service delivery related lessons from implementation abstract context and purpose. This report examines how ethiopias health extension program hep has contributed to the countrys move toward univeral health coverage uhc, and to shed light on how other countries may learn from ethiopias experiences of hep when designing their own. During the past decade, ethiopia undertook an ambitious investment in primary health care known as the ethiopian health extension program that recorded impressive gains. In 2009, the government of ethiopia initiated the innovative urban health extension program. However, year after year, the system has becomestronger and stronger, presently deploying over 38,000 government salaried rural and urban health extension workers.
The center for urban health developmentethiopia is committed to advancing urban health in ethiopia and sharing lessons learned from global and national initiatives. In addis ababa, the capital of ethiopia, the urban health extension program was started in 2009. Executive summary improving health extension program in. Ethiopia urban health extension program usaiduhep home. Presidents emergency plan for aids relief pepfar, is a continuation of the previous usaid urban health extension program which supported governmentled efforts in expanding urban health from 2009 to 20. The urbanrural population breakdown cited above reflects the makeup of ethiopias economy. Participants from both woredas also highlighted a mismatch between the urban health extension program design and the urbandwelling communities expectations for primary health care. Health extension workers uhews has been identified as one of the critical strategies for early identification of. Pdf urban health extension services utilization in bishoftu town. The health extension program is one of the most innovative communitybased health programs in ethiopia. Public disclosure authorized program in ethiopia the. The hepcaps2 projects developing the longterm capability of ethiopias health extension program platform worked with ethiopias ministry of health to develop strategies to improve outcomes and sustainability in primary care service delivery and health financing. Packages of the rural health extension program of ethiopia.
Health extension program hep at nefas silk lafto sub city, addis ababa. The early years were challenging, because delivering services to more than 80 million people in a vast and diverse country is not an easy task. We also acknowledge the use of some illustrations from safe and clean birth and newborn care. University hepcaps1 project team to work with ethiopias federal ministry of health, and other relevant stakeholders, to create a platform of longterm strategies in line with ethiopias vision for an effective, adaptable, and sustainable health extension program hep ethiopias primary health care system. It was launched by the federal ministry of health in 2003 in the four big agrarian regions, and then expanded to pastoral communities in 2006, and to urban areas. As a lowincome country, ethiopia has made impressive progress in improving health outcomes. However, the world health organization in its 2006 world health report gives a figure of 1936 physicians for 2003, which is about 2. Health in ethiopia has improved markedly since the early 2000s, with government leadership playing a key role in mobilizing resources and ensuring that they are used effectively. In 2003, the ethiopian federal ministry of health fmoh launched a new health care plan, the accelerated expansion of primary health care coverage, through a comprehensive health. Us, ethiopia launch urban health program addis standard.
Ethiopia urban health extension program usaiduhep works to support at scale, the implementation and monitoring of the government of ethiopias uhep and to improve access to and demand for health services. Ethiopia the health extension program in ethiopia abstract. In 2009, the government of ethiopia has initiated the urban health extension program to expand the coverage of communitylevel health services to the urban population. This policy brief gives more information on rural health extension program than the other two programs urban and pastoral health extension program, so it is better to give further. Governments are increasingly reliant on community health workers to undertake health promotion and provide essential curative care. Ethiopia has been implementing a community health extension program hep since 2003. We report the effect of these interventions on changes in maternal and newborn health care practices between 2008 and 2010 in 101 districts, comprising 11. The same problem is observed in the urban health extension program implementation where heads of households and spouses are not interested in model family training ababor 2011. Strengthening ethiopias urban health program seuhp support the goes urban health extension program by improving the quality of communitylevel health services, strengthening referral linkages, building the institutional and technical capacity of regional health bureaus rhbs and promoting intersectoral collaboration to address urban health challenges. The urban health extension program uhep is an innovative government plan to ensure health equity by creating demand for essential health services through the provision of appropriate health information at a household level.
Does the ethiopian health extension programme improve. Usaidethiopia designed the strengthening ethiopias urban health seuh activity to support the government of ethiopias urban health extension program uhep by. An innovative solution to public health challenges of ethiopia a case study abstract the health extension program is a flagship of the ethiopian health sector development program. The health extension program and its association with. Urban health extension service utilization and associated factors in. In relation to these challenges, the following priority actions. Respondents odds of utilizing urban health extension services among those who participated in the planning of. The government of ethiopia launched an innovative program called urban health extension program uhep in 2009, intended to produce good.