Title:
The challenges of the Ethiopian Health Extension Workers to reduce Maternal Mortality
Authors:
Nafkot, Abafita
Year:
2013
PAGE:
viii, 41
Language:
En
Subject:
Maternal Health – Lessons Learned
Keywords:
Health Extension Program, Health Extension Workers, Maternal Health, Institutional Delivery, Skilled Birth Attendant, Safe and Clean Delivery, Health Development Army and Ethiopia.
Abstract:
The Ethiopian Health Extension Program (HEP) has successfully improved the health of the majority of the rural population, but Ethiopia’s maternal mortality reduction still delays the country’s achievement of the Millennium Development Goal (MDG) 5. The 2011 Maternal Mortality Rate (MMR) was 676 per 100,000 live births, which was not an improvement over 673 per 100,000 live births in the 2005 NDHS of five years before. The health extension program was aimed to contribute to reduction of the MMR by 2/3rd by attending normal delivery, promoting institutional delivery and referring to the health center in case of complicated labor in order to achieve MDG 5 by 2015. However, there is no much improvement in institutional delivery coverage after the implementation of HEP. This study analyzes those factors preventing Health Extension Workers (HEW)s to achieve this goal, mainly in rural Ethiopia. Objectives: The aim of the study is to describe and analyze factors that hinder the HEP from improving institutional delivery service coverage in rural Ethiopian communities and to make recommendations to government and stakeholders so that the country will be able to achieve MDG 5 and save mothers lives. Methods: A literature review on maternal health was undertaken. The adopted three delays model is used to critically explore factors. Literatures conducted in relation to HEP/HEWs and maternal health in Ethiopia was used by using different key words from PubMED, Google scholar, Google, VU and KIT library. I also used Ethiopian FMoH , WHO website. Results: Most women in Ethiopia prefer to give birth at home with the assistance of a Traditional Birth Attendant (TBA), rather than by HEWs. The study found a number of factors contributing to the low coverage. Seeking care, delay 1, was linked with individual factors such as age, income, education, marital status and place of residence, and with social factors such as deep routed traditional, cultural norms and beliefs. Reaching care, delay 2, was caused by transport unavailability or costs. Receiving appropriate care, delay 3, was hindered by unavailability of competent staff, unavailability of adequate facilities providing emergency obstetric care (EmOC) and week referral system for complicated pregnancies. Conclusion: The HEP in Ethiopia has shown significant positive impacts on the health of communities. However, HEW have not improved the low coverage of institutional delivery. The three delays model show the obstacles for achieving safe delivery. Solving only the challenge of one of the delays cannot bring improvement in coverage of institution delivery so that the country can achieve MDG 5. Thus to attack all three delays the government need to work with other sectors using a multi-sectoral approach. Recommendations: To address delay one by strengthening HEP using the new FMoH strategy called Health Development Army (HAD), delay 2 by procuring and distribution of Ambulance, delay 3 by training and monitoring the quality of the training of staff at HC/HP, ensuring sustainable and adequate supply, expanding facilities to provide EmOC. In addition and very important inter-sectorial collaboration to manage challenges beyond the scoop of the health sector.
Organization:
KIT - Royal Tropical Institute
,
VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institue)
Department:
Development Policy & Practice
Country:
Ethiopia, Federal Democratic Republic of
Region:
Horn of Africa
Training:
Master of Public Health / International Course in Health Development (ICHD)
Category:
Research
Right:
© 2013 Nafkot
Document type:
Thesis/dissertation
File:
eChECW5Xpm_20161026124258232.pdf