ArticleDialogues in health2022
Disparities in the implementation of the Health Extension Program in Ethiopia: Doing more and better towards universal health coverage.
Article in Dialogues in 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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Who cites it
8 citing papers in PubMed, 7 citations in OpenAlex.
- Spatial variation of correct knowledge of the ovulatory cycle and its associated factors among reproductive age women in Ethiopia: geographically weighted regression analysis.Frontiers in reproductive health · 2025Article
- Article
- Prevalence and predictors of anemia among HIV-positive women in Ethiopia: findings from the Ethiopian demographic and health survey.Frontiers in medicine · 2025Article
- Educational inequalities and decomposition of the urban-rural disparities in maternal health care utilization in Ethiopia: further analysis of 2019 intermediate Ethiopian demography and health survey.BMC public health · 2024Article
- Intention to Use an Electronic Community Health Information System Among Health Extension Workers in Rural Northwest Ethiopia: Cross-Sectional Study Using the Unified Theory of Acceptance and Use of Technology 2 Model.JMIR human factors · 2024Article
- Article
- Individual and contextual level enablers and barriers determining electronic community health information system implementation in northwest Ethiopia.BMC health services research · 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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8 authors at 5 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
Introduction: Large-scale implementation of the Health Extension Program (HEP) has enabled Ethiopia to make significant progress in health services coverage and health outcomes. However, evidence on equity and disparities in the implementation of the HEP is limited. The aim of this study was to examine disparities in the implementation of the HEP in Ethiopia. Methods: We used data from the 2019 National HEP assessment which was conducted between Oct 2018 and Sept 2019 in nine regions in the country. Data were collected from 62 districts, 343 Health posts, 179 Health centres, 584 Health Extension Workers (HEWs), and 7043 women from 7122 Households. This study focused on selected input, service delivery, and coverage indicators. We used rate differences, rate ratios and index of disparity to assess disparities in HEP implementation across regions. Results: We found wide inter-regional disparities in HEP implementation. Developing regional states (DRS) had significantly lower availability of qualified HEWs (Rate Ratio (RR) = 0.54), proportion of households visited by Health Extension workers (RR = 0.40), and proportion of mothers who received education on child nutrition (RR = 0.45) as compared national average. There were also significant disparities in HEP implementation among DRS in the proportion of households visited by HEWs in the past 12 months (Index of disparity = 1.58) and proportion of adolescents who interacted with HEWs (Index of disparity = 1.43). Despite low overall coverage of health services in DRS, the contribution of the HEP for maternal health services was relatively high. Conclusion: There were significant inter-regional disparities in the implementation HEP in Ethiopia. The level of disparity among DRS was also remarkable. To achieve Universal Health Coverage, it is important that these disparities are addressed systematically and strategically. We recommend a tailored approach in HEP implementation in DRS.
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