In 2004, ethiopia launched its somali oromia southern nations, nationalities, and peoples gambela afar tigray amhara benishangulgumuz addis ababa dire dawa harari internationally acclaimed health extension program to bridge the gap between communities and health facilities through deployment of health extension workers. 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. Pdf the ethiopian health extension program and variation in. 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. In 2004, the government of ethiopia introduced the health extension programme hep, a free primary health care package with four components. 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 path to uhc. Usaid efforts in ethiopia have contributed to this success. May 26, 2016 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 outcomes. These are households which attend at least 75% of the training given by health extension workers and implement at least 75% of the health extension. Since 2004, the government of ethiopia has made a bo ld decision to strengthen and expand its primary health care system by launching the health extension program hep. Ethiopia the health extension program in ethiopia resumo. Ethiopia health extension program a s a lowincome country, ethiopia has made impressive progress in improving health outcomes. The health extension program and its association with change. Structure of the hep at the core of health extension program implementation is a sizeable cadre of new health extension workers hews, who are trained to implement a health extension package of 16 healthcare activities at the kebele village level.
Very few studies have investigated the role of these community health workers in. 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. Effect of ethiopias health extension program on maternal and newborn health care practices in 101 rural districts. A doseresponse study alimehryarkarim1,kesetebirhaneadmassu2,joannaschellenberg3,hibretalemu1,nebiyugetachew1. Over the past decade, ethiopia has achieved dramatic progress in improving the health outcomes of its population. Ethiopia urban health extension program usaiduhep our work. A primary implementation modality of the health sector development program hsdps third cycle program 200405 to 200910, which focused on povertyrelated health conditions, communicable diseases such as malaria and diarrhea, and health problems that affect mothers and children, is the health extension program hep. Urban health extension services utilization in bishoftu town. It was prepared by lucy mize, rebecca miles, mirgissa kaba, michael dejene, and kuleni berhanu through the gh tech bridge project. Ethiopias health facilities were in urban areas with over. 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 outcomes. Health extension program factors, frequency of household. The aim of the program is to increase public access to basic health services, mainly by producing model households.
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. Finally the ministry of health gives its deepest appreciation for all those who dedicated. The role of health extension workers in improving utilization. The ethiopian health extension program and variation in health systems performance. This guideline is a complement and a companion to the health extension packages prepared for health extension worker as a guidebook cookbook. 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. The lead now passed to the federal government of ethiopia, which took full ownership and. A qualitative assessment of health extension workers. With the introduction of the health extension program in 2003, 4 ethiopia prioritized increasing access to essential communitybased health services and education in rural areas where 80% of.
Community health workers are widely used to provide care for a broad range of health issues. 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. 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. Ethiopia has been implementing a community health extension program hep since 2003. 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. Muluemebet had contacted her to offer postnatal care for moges through the ethiopian governments health extension programme hep. Ethiopia health extension program open knowledge repository. Some documents the policy brief used as reference materials seems out dated, for example, the guide line which states health extension workers. Despite this progress, substantial disparities in health outcomes persist across the country. Weve partnered with ethiopias government and people since 2007 to take on malaria, tuberculosis, and other health threats.
Draft implementation guideline ethiopia population, health. However, there is no study on community satisfaction with the services provided by the uhep in ethiopia. Through the voices of rural women at health posts, health extension workers, and an orthodox priest, along with an official of the ministry of health and the first lady, the video vividly highlights the importance of family planning as a core component of ethiopias development. The urban health extension program uhep is an innovative. 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. 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. Ethiopia school health program framework 2 acknowledgements the federal democratic republic of ethiopia, ministry of health would like to acknowledge the leadership and commitment of the government of ethiopia in supporting the extension of the school health program shp to standardized service packages in schools.
Effect of ethiopias health extension program on maternal and. As a lowincome country, ethiopia has made impressive progress in improving health outcomes. These improvements are a result of the health extension program, a community based expansion of health facilities, launched in 2004. Ethiopia the health extension program in ethiopia the world. This initiative has been called the health extension program. 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. Pdf the ethiopian health extension program and variation. Together, we are improving health systems and services in this fastgrowing economy to create healthier futures for ethiopians. Federal democratic republic of ethiopia the wash implementation framework full document.
The health extension program uses taskshifting and community ownership to provide basic health services at the grassroots. Experiences, challenges, and lessons learned from an. Jun 04, 20 the national health extension program hep includes communitybased newborn survival interventions. Herbst, feng zhao, agnes soucat, and christophe lemiere in 2005 more than half of the population of ethiopia lived more than 10 kilometers from health services. How do health extension workers in ethiopia allocate their. Improved access and coverage for the rural poor nejmudin kedir bilal, christopher h. The impact of ethiopian health services extension program on. Ethiopia undertook an ambitious investment in primary health care known as the ethiopian. Research articleefficiency of the health extension programme. Community satisfaction with the urban health extension service in. Research articleefficiency of the health extension programme in tigray, ethiopia. 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 rural communities with basic health services. 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 health extension program of ethiopia harvard health.
The health extension program is one of the most innovative communitybased health programs in ethiopia. Community health extension program of ethiopia, 20032018. A female cadre of salaried community health workers. Service delivery related lessons from implementation abstract context and purpose. Muluemebet balcha, one of the health extension workers hew that helped save moges life, remembers how distraught his mother was.
The ethiopian health extension program and variation in. Kesetebirhan admasu,minister of health,ethiopia visited johns hopkins bloomberg school of public health on february 8, 20 and talk. Pmc improves health extension program in ethiopia on the air since june 2010 with 80 episodes broadcast to date, mieraf is addressing numerous health issues, including maternal and child health, use of family planning, malaria prevention, hivaids prevention, and hygiene and sanitation. Health extension program hep ethiopias primary health care system. Federal democratic republic of ethiopia ministry of health. Ethiopia has been implementing a community health extension. For example, at the results chain of reducing wasting, chapter 3 documents increase of improved sanitation facilities, increase in womens knowledge of properly. Ethiopia has implemented a nationwide primary health program the health extension program at the grassroots level since 2003.
Kesetebirhan admasu,minister of health, ethiopia visited johns hopkins bloomberg school of public health on february 8, 20 and talk about the successes and challenges of ethiopia s. The urban health extension program is organized as a component of other urban health. The ethiopian health extension program and variation in health. 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. It is based on the assumption that access to and quality of primary health care in rural. Health extension workers will use this guideline for their routine activities. Governments are increasingly reliant on community health workers to undertake health promotion and provide essential curative care. Ethiopia urban health extension program usaiduhep works to support at scale, the implementation and monitoring of the government of ethiopia s uhep and to improve access to and demand for health services. Community satisfaction with the urban health extension.
Pehsp pastoralist extension health service program phast participatory hygiene and sanitation transformation. Since 2003 the government of ethiopia has been deploying specially trained new cadres of community based health workers named health extension workers hews. For health extension workers desta workneh jimma university in collaboration with the ethiopia public health training initiative, the carter center, the ethiopia ministry of health, and the ethiopia ministry of education november 2004. The ethiopian health extension program and variation in health systems.
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