Dataset Information

The Health Extension Program and Its Association with Change in Utilization of Selected Maternal Health Services in Tigray Region, Ethiopia: A Segmented Linear Regression Analysis.

ABSTRACT:

Background

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. This paper aims to assess the association of the HEP with improved utilization of maternal health services in Northern Ethiopia using institution-based retrospective data.

Methods

Average quarterly total attendances for antenatal care (ANC), delivery care (DC) and post-natal care (PNC) at health posts and health care centres were studied from 2002 to 2012. Regression analysis was applied to two models to assess whether trends were statistically significant. One model was used to estimate the level and trend changes associated with the immediate period of intervention, while changes related to the post-intervention period were estimated by the other.

Results

The total number of consultations for ANC, DC and PNC increased constantly, particularly after the late-intervention period. Increases were higher for ANC and PNC at health post level and for DC at health centres. A positive statistically significant upward trend was found for DC and PNC in all facilities (p<0.01). The positive trend was also present in ANC at health centres (p = 0.04), but not at health posts.

Conclusion

Our findings revealed an increase in the use of antenatal, delivery and post-natal care after the introduction of the HEP. We are aware that other factors, that we could not control for, might be explaining that increase. The figures for DC and PNC are however low and more needs to be done in order to increase the access to the health care system as well as the demand for these services by the population. Strengthening of the health information system in the region needs also to be prioritized.

SUBMITTER: Gebrehiwot TG

PROVIDER: S-EPMC4517769 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

The Health Extension Program and Its Association with Change in Utilization of Selected Maternal Health Services in Tigray Region, Ethiopia: A Segmented Linear Regression Analysis.

Gebrehiwot Tesfay Gebregzabher TG San Sebastian Miguel M Edin Kerstin K Goicolea Isabel I

PloS one 20150728 7

<h4>Background</h4>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. This paper aims to assess the association of the HEP with improved utilization of maternal health services in Northern Ethiopia using institution-based retrospective data.<h4>Methods</h4>Average quarterly total attendances for antenatal care (ANC), delivery care (DC) and post-na ...[more]

PMID: 26218074

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Project description:BackgroundBirth registration establishes the existence of a child under law and provides the foundation for ensuring many of his/her rights. Despite its significance, a continuous, effective and comprehensive birth registration system has not been established in Ethiopia until the recent past. This paper examines the status of child's birth registration and its associated factors in selected districts of Tigray Region, Ethiopia.MethodA community-based cross-sectional study was conducted from April to May 2018 among 383 randomly selected mothers who had given birth to at least one child since August 2016. A structured questionnaire was used to gather the quantitative data. Qualitative data were collected using key informant interviews and focus group discussions. To analyze the data, SPSS version 20 was used. Logistic regression analysis was employed to assess the association between dependent and independent variables.ResultsFindings reveal that significant number of the respondents did not have knowhow about birth registration and its uses. As a result, only 117(30%) of them registered the birth of their children and secured certificates. Inaccessibility of the registrar offices, lack of relevant manpower and political will of the government were reported as major reasons for such a gap. Mother's education was identified to be positively associated with the likelihood of a child being registered. Children born from mothers living in urban areas were found more likely to be registered compared to their rural counterpart [AOR = 1.46, 95% CI = 0.76, 2.76]. In light of Religion, children from the Muslim community had better opportunity for birth registration and owning birth certificate compared to children from Orthodox Christian parents. Compared to those who have possessed own birth certificates, the likelihood of mothers who did not possess own birth certificates to register the birth of their children was found lower by the factor of 86% [AOR = 0.14, 95%CI = 0.07, 0.26].ConclusionBirth registration of a child and subsequent issuance of certificate should be pursued as a right issue. To make this a reality, extensive awareness raising programs that underscore the need for a birth registration and its significance for rural communities is needless to say critical.

Project description:Low levels of neonatal health services utilization and high neonatal deaths are often concentrated among socially and economically disadvantaged groups, especially in low-income countries. Therefore the aim of this study was to assess inequity in the use of neonatal health services in Southwest Ethiopia. A community-based cross-sectional study was conducted in 8 districts located in Jimma Zone, Southwest Ethiopia from 19 March to 28 April 2018. A total of 835 mothers were included in the study with systematic random sampling. Principal component analysis was conducted to develop wealth quintiles of the households. Equity in neonatal health services was measured using rate-ratio, concentration curve, concentration index, and analyzed by binary logistic regression. Neonates from richer families were 1.25 times more likely to use neonatal health services than the poorer households with a concentration index value of 0.07. Neonates from highly educated mothers have better used the services and the corresponding concentration index value of 0.03. Neonatal service utilization was 1.32 times higher in the highest wealth quintile in rural settings. Similarly, services delivered at health posts and hospitals were used 2.4 and 2 times more by the wealthy, whereas services given at health centers are more utilized by the poorest. Outputs of binary logistic regression analysis indicated that neonates from middle quintile wealth households were found to be better neonatal health service users [AOR_1.72, 95% CI: 1.04, 2.82]. Neonate born from a secondary school attended mother [AOR_3.56, 95% CI: 1.90, 6.69] were more likely to use neonatal health services. Neonatal health service utilization in Southwest Ethiopia is more common among neonates from richer households and more educated mothers. There is a big difference among the wealthy and poorer in a rural setting and among those who used health posts. Working on the social-determinants of health will facilitate eliminating inequity.

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Project description:BACKGROUND:Providing compassionate and respectful maternity services in order to bring satisfaction to service users is one of the health extension services packages in Ethiopia. Though the service utilization and its associated factors have been well documented so far, yet there is a dearth of information on client satisfaction; particularly among rural women who are mostly the target groups of health extension services within the Ethiopia. Thus, this study aimed to assess mothers' satisfaction with health extension services and the associated factors in the Gamo Goffa Zone, of Southern Ethiopia. METHODS:A community based cross sectional study was conducted among 478 women from February 1st to February 28th of 2018. A pre-tested and interviewer administered questionnaire was used to collect the data. The study participants were selected using a systematic random sampling technique by allocating a proportion to each rural kebeles. Both bivariate and multivariate logistic regression analysis were performed to identify associated factors. Odds ratio with its 95% confidence interval was used to determine the degree of association. Level of statistical significance was set at a p-value of less than 0.05. RESULT:The overall proportion of mothers who were satisfied with health extension services was 37.4% with 95% CI (33-44%). Mothers who had good family monthly income [AOR = 4.66 (95% CI: 1.1, 20.6)], whose husbands participated in the health extension program [AOR = 4.02 (95% CI: 2.0, 8.1)], who had recent participation in planning of health extension programs [AOR = 5.75 (95% CI: 2.0, 16.5)], who were recognized as a model family [AOR = 2.23 (95% CI: 1.1, 4.6)] had higher odds of satisfaction with health extension services. CONCLUSION:Satisfaction with the health extension services was low among women in the study area. A better household monthly income, women's and their husbands' participation in health extension services and being a member of a model family were positively associated with their satisfaction. Interventions to enhance women's satisfaction in the health extension service need to focus on household-based involvement of them and their husbands in planning and implementing the services. Likewise, expansion of experiences of model families in the community would raise satisfaction levels.

Dataset Information

The Health Extension Program and Its Association with Change in Utilization of Selected Maternal Health Services in Tigray Region, Ethiopia: A Segmented Linear Regression Analysis.

Background

Methods

Results

Conclusion

Publications

The Health Extension Program and Its Association with Change in Utilization of Selected Maternal Health Services in Tigray Region, Ethiopia: A Segmented Linear Regression Analysis.

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