ArticlePloS one2013
Effect of ethiopia's health extension program on maternal and newborn health care practices in 101 rural districts: a dose-response study.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 4 of them syntheses that pooled it.
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Who cites it
88 citing papers in PubMed, 4 syntheses or guidelines pooled it, 138 citations in OpenAlex.
- Conceptualisation and application of implementation strength in public health programmes within health systems: a systematic review.BMC health services research · 2026Pooled it
- Interventions to improve infant and young child feeding practices in Ethiopia: a systematic review.BMJ open · 2021Pooled it
- Evaluating implementation strategies for essential newborn care interventions in low- and low middle-income countries: a systematic review.Health policy and planning · 2020Pooled it
- The effect of antenatal care on use of institutional delivery service and postnatal care in Ethiopia: a systematic review and meta-analysis.BMC health services research · 2018Pooled it
- Evaluation of a community-based intervention package to improve knowledge of obstetric danger signs, birth preparedness, and institutional delivery care utilization in Arba Minch Zuria District, Ethiopia: a cluster-randomized trial.Reproductive health · 2023Trial
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- Progress in family planning in Sierra Leone: a mixed-methods case study.BMJ global health · 2026Article
- Inequalities in the completion of maternal continuum of care in Ethiopia using the 2019 mini-Ethiopian demographic and health survey.Scientific reports · 2026Article
- Article
- Effective coverage of maternal and newborn health services across the antepartum and peripartum continuum in primary health care in Ethiopia.Reproductive health · 2025Article
- Insights to optimizing health extension workers' time use and efficiency in Ethiopia: a qualitative study.Global health action · 2025Article
- Facility readiness and experience of women and health care providers in receiving and delivering obstetric care in comprehensive health posts in Ethiopia: a mixed method study.BMC health services research · 2025Article
- Measuring the strength of maternal, newborn and child health care implementation and its association with childhood mortality risk in three rural districts of Tanzania.PLOS global public health · 2025Article
- Networks of care for optimizing Primary Health Care Service Delivery in Ethiopia: Enhancing relational linkages and care coordination.PloS one · 2025Article
- Healthcare-Seeking Behaviour for Obstetric Complications in Ethiopia: A Multilevel Mixed-Effect Analysis.Health services insights · 2025Article
- Neonatal transport practices and effectiveness of the use of low-cost interventions on outcomes of transported neonates in Sub-Saharan Africa: A systematic review and narrative synthesis.Health science reports · 2024Article
- Health extension workers' level of job satisfaction in western Hararghe Zone, eastern Ethiopia: an institutional-based cross-sectional study.Frontiers in health services · 2024Article
- Challenges and experience of the Ethiopian rural health extension program: implications for reform and revitalization.BMC health services research · 2023Article
- Home-based optimal newborn care practice and associated factors among mothers in Ethiopia: a community-based longitudinal panel survey.BMJ open · 2023Article
28 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImproving newborn survival is essential if Ethiopia is to achieve Millennium Development Goal 4. The national Health Extension Program (HEP) includes community-based newborn survival interventions. We report the effect of these interventions on changes in maternal and newborn health care practices between 2008 and 2010 in 101 districts, comprising 11.6 million people, or 16% of Ethiopia's population. METHODS AND
findingsUsing data from cross-sectional surveys in December 2008 and December 2010 from a representative sample of 117 communities (kebeles), we estimated the prevalence of maternal and newborn care practices, and a program intensity score in each community. Women with children aged 0 to 11 months reported care practices for their most recent pregnancy and childbirth. The program intensity score ranged between zero and ten and was derived from four outreach activities of the HEP front-line health workers. Dose-response relationships between changes in program intensity and the changes in maternal and newborn health were investigated using regression methods, controlling for secular trend, respondents' background characteristics, and community-level factors. Between 2008 and 2010, median program intensity score increased 2.4-fold. For every unit increase in the score, the odds of receiving antenatal care increased by 1.13 times (95% CI 1.03-1.23); the odds of birth preparedness increased by 1.31 times (1.19-1.44); the odds of receiving postnatal care increased by 1.60 times (1.34-1.91); and the odds of initiating breastfeeding immediately after birth increased by 1.10 times (1.02-1.20). Program intensity score was not associated with skilled deliveries, nor with some of the other newborn health care indicators.
conclusionsThe results of our analysis suggest that Ethiopia's HEP platform has improved maternal and newborn health care practices at scale. However, implementation research will be required to address the maternal and newborn care practices that were not influenced by the HEP outreach activities.
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