Contribution of the Health Services Extension Program to Improve Coverage and Comprehensiveness of Primary Health Care Services in Jimma Zone, Southwest Ethiopia

Background: Improving access to health care services through efforts to provide services closer to people where they live and work has been advocated widely since the Declaration of Alma-Ata. Despite the efforts to realize this in Ethiopia, in 2003 that the intention to take a package of essential health services to the kebele (village) level was realized. This was done through the introduction of the Health Services Extension Program (HSEP).

Objective: To explore whether HSEP in Jimma Zone has improved coverage and comprehensiveness of primary health care services delivered to the population in the rural areas.

Methods: A cross sectional study was conducted in three randomly selected Woredas (districts). Data was collected in May to July 2009. A structured questionnaire was used to interview female heads of sampled households of nine kebeles randomly selected from the three Woredas. Data was analysed using SPSS 16.0 package.

Results: Only 64.0% of the kebeles had functional health posts. 93.7%  kebeles had two HEWs. Vaccination coverage for DPT3 was 67.9%. 10% of under two years children had diarrhea. 53% of the women use family planning methods, 72% of pregnant women received at least one ANC, 8 % of women delivered at health institutions, and 15% of the mothers were visited by the HEWs. Assessment of environmental and personal hygiene showed that only 10.2% of households dispose excreta on the open field and only 13.2% and 10.4% of the households members do not practice hand washing with soap after using the latrine and before main meals, respectively.

Conclusions: Physical access to primary health care services including family planning, antenatal care, environmental and personal hygiene, and provision of health information on the prevention of common health problems were remarkably improved in the study kebeles as per the time of introduction of the HSEP.