Impact evaluation of the Ethiopian Health Services Extension Programme

Abstract

Ethiopia has launched a pro-poor health services extension programme since 2003 to deliver preventive and basic curative health services to its inhabitants. Despite the massive support and recognition the programme has received, there has not been proper evaluation of its impact. This study has applied propensity score matching and regression adjustment techniques to evaluate the short-term and intermediate-term impacts of the programme on child and maternal health indicators in the programme villages. Empirical data for the study were collected from 3095 households from both programme and non-programme villages in rural Ethiopia. The estimated results indicate that the programme has significantly increased the proportion of children fully and individually vaccinated against tuberculosis, polio, diphtheria-pertussis-tetanus, and measles. The study finds heterogeneity in childhood immunisation coverage as a result of differences in terms of the number of health extension workers, in the quality of health posts and in terms of the educational achievement of mothers across programme villages. The proportions of children and women using insecticide-treated bednets for malaria protection are significantly larger in programme villages than in non-programme villages. The effect on preventive maternal care is rather limited. Whereas women in the programme villages appeared to make their first contact with a skilled health service provider significantly earlier during pregnancy, very little effect is detected on other prenatal and postnatal care services. Moreover, the programme has not reduced the incidence and duration of diarrhoea and cough diseases among under-five children.impact evaluation, health services extension, propensity scores, regression adjustment, Ethiopia,

The Status of Desired Maternal and Child Health Practices and Service Utilizations of Model Families of the Health Extension Program in SNNPR, Ethiopia

“…This may be due to the fact that access is nearly universal and some vaccines are also provided through well-coordinated national campaigns that create access to all children, be it in model or non-model families. But in another study, contrary to our findings, improvements have been seen in the proportion of children that are vaccinated against diphtheria, polio and tetanus (DPT), measles and tuberculosis in villages where the HEWs were deployed as compared to villages where such did not happen [18]. The 2011 EDHS also indicates a 19% increment in the proportion of fully immunized children as compared to the 2005 report.…”

Socio-Economic Determinants of Child Immunization in Rural Ethiopia

“…Thus, specific studies are needed in order to draw valid inferences in different contexts. Yet, previous socio‐economic studies of immunization are very few in Ethiopia (Kiros & White, ; Admassie et al ., ). Moreover, the existing studies do not differentiate, for instance, between different types of immunization such as partial immunization and non‐immunization.…”

Effect of Ethiopia’s Health Extension Program on Maternal and Newborn Health Care Practices in 101 Rural Districts: A Dose-Response Study

“…To the best of our knowledge, previous published evaluations of HEP have been cross sectional studies and have not included community-based essential newborn care [6], [15]–[19]. Using cross-sectional data collected in December 2008, we reported on the association between HEP outreach activities and maternal healthcare seeking behaviors [16].…”