ArticleBMJ global health2022
Exploring complementary and competitive relations between non-communicable disease services and other health extension programme services in Ethiopia: a multilevel analysis.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- Addressing priority gaps in access and quality of NCD services in primary care settings in Rural Kenya: a participatory approach to intervention development.BMC primary care · 2026Article
- Assessing the capacity of primary healthcare facilities and healthcare workers in managing diabetes and hypertension in Kisumu county, Kenya.BMC health services research · 2025Article
- Task-sharing for non-communicable disease prevention and control in low- and middle-income countries in the context of health worker shortages: A systematic review.PLOS global public health · 2025Article
- Readiness for non-communicable disease service delivery in Ethiopia: an empirical analysis.BMC health services research · 2024Article
- The role of community health workers in non-communicable diseases in Cape Town, South Africa: descriptive exploratory qualitative study.BMC primary care · 2024Article
- A Study on Communication Practices in Reducing Non-Communicable Diseases in Bahir Dar City, Ethiopia.Risk management and healthcare policy · 2024Article
- An Evaluation of Community Health Workers' Knowledge, Attitude and Personal Lifestyle Behaviour in Non-Communicable Disease Health Promotion and Their Association with Self-Efficacy and NCD-Risk Perception.International journal of environmental research and public health · 2023Article
- National Assessment of the Health Extension Program in Ethiopia: Study Protocol and Key Outputs.Ethiopian journal of health sciences · 2023Article
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7 authors.
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Abstract
backgroundEthiopia has recently revitalised its health extension programme (HEP) to address the rising burden of non-communicable diseases (NCDs). We examined the effects of existing essential HEP services on the uptake of NCD preventive services.
methodsWe applied a mixed-effect non-linear model with a logit link function to identify factors associated with a community resident's probability of receiving NCD prevention services through the HEP. The data were drawn from the Ethiopian HEP assessment Survey conducted in all regions. The analysis included 9680 community residents, 261 health extension workers (HEWs), 153 health posts, 119 health centres, 55 districts and 9 regions, which we combined hierarchically into a single database.
resultsIn the 12 months before the survey, 22% of the sample population reported receiving NCD preventive service at least once. The probability of receiving NCD prevention service increased by up to 25% (OR=1.25, CI 1.01 to 1.53) if health centres routinely gathered NCD data from health posts and by up to 48% (OR=.48, CI 1.24 to 1.78) if they provided general (ie, non-NCD specific) training to HEWs. NCD preventive service uptake also increased if the HEW held level IV qualification (OR=1.32, CI 1.06 to 1.65) and lived in the community (OR=1.24, CI 1.03 to 1.49). Conversely, if facilities delayed general performance reviews of HEWs by a month, uptake of NCD prevention services decreased by 6% (OR=0.94, CI 0.91 to 0.97). We observed that better HIV/AIDS programme performance was associated with a lower uptake of NCD preventive services (OR=0.15, CI 0.03 to 0.85).
conclusionDespite efforts to improve NCD services through the HEP, the coverage remains limited. A strong HEP is good for the uptake of NCD preventive services. However, integration requires a careful balance, so that the success already recorded for some existing programmes is not lost.
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