Volunteer Community Health Workers' Role in Promoting Healthy Actions: An Impact Evaluation of the Essential Services for Health in Ethiopia Project

Introduction

The USAID funded Essential Services for Health in Ethiopia (ESHE) project supported the training of 20-30 volunteer community health promoters (CHP) to complement the government’s Health Extension Worker (HEW) initiative to place two HEWs) in each village.  CHPs were trained to assist HEWs to promote healthy actions.  This initiative trained over 54,000 volunteers.

Methodology

Quasi-experimental pre and post household surveys were conducted in 2003 and 2008, respectively. A total of 180 clusters representative of a total population of 55 million were sampled across three regions. The post survey included 4293 households, yielding robust coverage estimates of key evidence-based health interventions. This analysis focuses on data collected from the Southern Nations, Nationalities and People’s (SNNP) Region.

Efforts have been made to ensure that the control group looks like the intervention group along socio-demographic characteristics. A Difference-in-Difference model has been applied to test the impact of the ESHE program on three outcomes.

Results

Preliminary results demonstrate significant increases across many key evidence-based child health interventions. High coverage is needed if countries are to reach MDG 4.  Significant region-wide results documented in the post household survey include: exclusive breastfeeding- 57% to 77%, complementary feeding- 49% to 68%, modern contraceptive prevalence rate- 15% to 29%, insecticide-treated bednets- 2% to 52%, Vitamin A supplementation- 35% to 65%, and DPT3- 46% to 57%. A more in-depth analysis of these data is underway to validate the initial results.

Impact

The regional health officials became convinced of the added value of having this large volume of volunteers to help mobilize the community for positive health changes.  They requested new NGOs and partners who came to the region to assist to adapt and spread the USAID/ESHE approach. The RHB wanted one harmonious approach at community level that they could own.

292 words exclusive of title and keywords