ヘルスケアと予防ジャーナル

抽象的な

Implementation, Experience and Challenges of Urban Health Extension Program: A Case Study from Ethiopia

Abraham Tamirat

Background: Ethiopia has been deploying specially trained community based health workers in urban areas of the country known as urban health extension professionals since 2009 to provide health service under Urban Health Extension Program to community members. Therefore, this study was aimed in assessing the implementation, experience and challenges of urban health extension program in Ethiopia. Methods: A qualitative case study was conducted at Addis Ababa from November 15 – December 29, 2017. Data were collected through focused group discussions, in-depth and key informant interviews. A total of 4 focus group discussions and 31 in-depth and key informant interviews were conducted and several techniques were used to ensure that data analysis was systematic and verifiable. Interviews and Focus Group were audio-recorded, transcribed, translated, coded and thematically analyzed. Result: This study found that there were 15 health service packages of the Urban Health Extension Program provided to the communities by the Health Extension Professionals. Home visitation and model family training continued providing focusing on the household needs and gap. The health development army leaders are playing great role in the program. Model family graduation was not happened as per the plan. Lack of coordination between the health extension program and other sectors, poor supplies management system, having no clearly defined career and education path and lack of motivation and incentives were some of the challenges posed in the program implementation. Conclusions: Although having many challenges, Urban Health Extension Program has made a significant contribution to the health of Addis Ababa community through increasing access to public health services in urban settings, strengthening referral between community and the health facilities, supportive supervision, and creating demand for health services. All stakeholders, governmental and non-