Ethiopias Health Extension Programs: Maternal and Child Health Extension Program

A poor country like Ethiopia has many challenges; among these health problems is the major one. Ethiopias population lacks access to basic health services, health care delivery systems are weak, and more than 80% of the population lives in rural areas which has shortage of facilities such as roads, telecommunication, and electricity. Moreover, the problem of health mainly recognized to preventable (communicable) infectious diseases. The Ethiopian government has formulated a health sector extension programs in order to provide access to basic health services and achieve the health related Millennium Development Goals (MDGs). It focuses on availability and accessibility of essential health services by sufficiently reducing distance between health services and users. Primarily, its target is to achieve the Millennium Development Goals (MDGs). The health extension program is community-based health programs. Its basic assumption is that access to and quality of primarily health care in rural communities which improved through the extension program contains around sixteen packages in to four areas; Diseases prevention and control, Family health, Hygiene and environment sanitation, and Health education and communication. Under family services packages, maternal and child health (MCH) is one of the extension programs which given the highest concern and still the big problem in the health sector. The country-wide community based health extension program (HEP) is having an important impact in terms of providing services directly to women and developing an effective referral system for maternal care. The child survival program, on the other way, is centered on the health extension program which designed as a community based child and maternal health system. Its primarily goal is to increase the access to primarily health services to the majority of the population living across the country side and rural areas. Community informants and district and regional program coordinators reported that mothers and children are regularly monitored by the health extension workers. Maternal and childhood disease incentives have decreased as a result of family planning and health care services has improved. Maternal and childhood health deaths care also reduced and the community has started to use family planning programs effectively; the number of women using contraceptives

and accessing pre- and postnatal care services is increasing. Infant feeding habits such as breast feeding and use of supplements have improved; the number of children and mothers immunized has increased, and practices in reporting sick children to health extension workers has shown improvements. The government has also made major investments in strengthen its health logistics and management information systems; this sect of major commitments is expected to continue improvements in child survival and begin to improve maternal survival and health, as well. To meet the maternal health needs of Ethiopias rural population, primary emphasis must be placed on delivering basic community-based maternal and neonatal services, most notably through HEWs and mid-level service providers. Community-based health care workers must be able to refer complications to appropriate facilities; and hospitals must be adequately equipped and staffed to provide health services.

Major constraints (disadvantage) of the maternal and child health extension program
Utilization of maternal and child health services remains low for a number of reasons which includes; Limitations in the services of maternal and child health program, Limitations in the delivery capacities both materially and trained human resources, The quality of the services is not as expected (planned), Shortage and uneven distribution of trained health professionals, Poor skill of trained health professionals, The infrastructure in the rural and across country side is not adequate. The financial system is very limited, Use of voluntary community health workers appears hard to sustain without some material compensation for extra services rendered to communities. Supervision, monitoring and evaluation are very weak Regional and Woreda health offices are short of staff and management capacity. Decentralisation is in progress but there are widespread problems of information flow, inadequate management and accountability.

 Health information system is weak, making planning, monitoring and response difficult at all levels. The role of women in the society is underestimated, and women are not fully empowered to take responsibility Basic and undergraduate training of health staff contains too little practical experience

Major opportunities (advantages) of the maternal and child health extension program Ongoing reform of the health system, Continuing national effort to realize the health extension program goals. Solid national and international commitment to achieving the child survival MDGs, The
issue of child survival is seen as unfinished business that must be tackled without delay.

Decentralization of authority for planning and implementation of health services to the

Woreda Health Office

Recent introduction of the Health Extension Programme as an innovative health Delivery system to reach the grass roots level. Present plans see this programme
expanding fast and achieving not only important changes in community health behavior on a large scale but also almost universal access to basic services over the coming 5 years.

Availability of and experience with high impact, low cost interventions to address the
major causes of child mortality

Existence in-country of experienced programmes relevant to child health, including

EPI/plus, IMCI, Nutrition and Malaria Control

Plans for expansion of higher education and the training of large numbers of health
professionals.

Conclusion
Ethiopias health extension program has shown tangible positive impact on preventable (communicable) health, in disease prevention, family health, and environmental hygiene and sanitation. Together with the health extension workers and communities that they serve should be able to achieve the vision of Ethiopia where children can grow and develop without dying to preventable (communicable) killers. What is more important is that health extension program has shown population behavior patterns can be changed to be more favorable to good health and achieve primarily health care.