Effect of Ethiopia's Health Development Army on maternal and newborn
                        health care practices: A multi-level cross-sectional analysis

Betemariam, Wuleta; Damtew, Zufan Abera; Tesfaye, Chala; Fesseha, Nebreed; Karim, Ali Mehryar

doi:10.1016/j.aogh.2017.03.051

Cited by 6 publications

(3 citation statements)

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“…Communities with one health development army (HDA) team leader for at least every 40 households were associated with 12.4, 10.0, 8.4 and 7.9 percentage-points higher ( p < 0.05) coverage of ANC, institutional deliveries, clean cord care and thermal care than those in communities with one HDA team leader for every 60 or more households in 2017 [ 43 ]. Identification of pregnant women through Women’s Development Groups (WDGs), and referral by ambulance to health facilities were facilitators to skilled birth attendance.…”

Section: Resultsmentioning

confidence: 99%

Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services

et al. 2019

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BackgroundEthiopia has been implementing a community health extension program (HEP) since 2003. We aimed to assess the successes and challenges of the HEP over time, and develop a framework that may assist the implementation of the program toward universal primary healthcare services.MethodsWe conducted a systematic review and synthesis of the literature on the HEP in Ethiopia between 2003 and 2018. Literature search was accomplished in PubMed, Embase and Google scholar databases. Literature search strategies were developed using medical subject headings (MeSH) and text words related to the aim of the review. We used a three-stage screening process to select the publications. Data extraction was conducted by three reviewers using pre-prepared data extraction form. We conducted an interpretive (not aggregative) synthesis of studies.FindingsThe HEP enabled Ethiopia to achieve significant improvements in maternal and child health, communicable diseases, hygiene and sanitation, knowledge and health care seeking. The HEP has been a learning organization that adapts itself to community demands. The program is also dynamic enough to shift tasks between health centers and community. The community has been a key player in the successful implementation of the HEP. In spite of these successes, the program is currently facing challenges that remain to be addressed. These challenges are related to productivity and efficiency of health extension workers (HEWs); working and living conditions of HEWs; capacity of health posts; and, social determinants of health. These require a systemic approach that involves the wider health system, community, and sectors responsible for social determinants of health. We developed a framework that may assist in the implementation of the HEP.ConclusionThe HEP has enabled Ethiopia to achieve significant improvements. However, several challenges remain to be addressed. The framework can be utilized to improve community health programs toward universal coverage for primary healthcare services.

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Section: Resultsmentioning

confidence: 99%

Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services

et al. 2019

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“…Despite the fact that the Ethiopian female community health intervention has special features, unpaid community health intervention has been used in various countries to improve population’s health 15. As various findings indicated, it is a cost-effective measure, especially in low-income countries with low access to health services.…”

Section: Discussionmentioning

confidence: 99%

Contribution of women’s development army to maternal and child health in Ethiopia: a systematic review of evidence

2019

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ObjectiveThe aim of this review was to identify, appraise and synthesise studies that reported on the contribution of women’s development army (WDA) to maternal and child health development.SettingStudies conducted in Ethiopia 2010 onwards and published in English were considered.Data sourcesEvidence were searched in MEDLINE, CINAHL and EBSCOhost from 25 March to 10 April 2018.Eligibility criteriaBoth quantitative and qualitative studies assessing the contribution of WDA to maternal and child health were considered.Data extraction and synthesisTwo independent reviewers have extracted data using pre-planned data extraction tool separately for each study design. Findings were synthesised using tables and narrative summary.OutcomeMaternal and child health services; maternal and child mortality.ResultsNine studies met the inclusion criteria and were used for synthesis. The results revealed that participation and membership in women’s development teams (WDTs) have a positive effect on minimising maternal death and improving child immunisation service use. Skilled delivery and antenatal care service use were higher in WDTs located within a radius of 2 km from health facilities. Women’s development teams were also the main sources of information for mothers to prepare themselves for birth and related complications. Moreover, well-established groups have strengthened the linkage of the health facility to the community so that delays in maternal health service use were minimised; health extension workers could effectively refer women to a health facility for birth and utilisation of skilled birth service was improved.ConclusionVoluntary health service intervention in Ethiopia has improved maternal and child health services’ outcome. A decrease in maternal deaths, increase in antenatal and delivery service use and improved child immunisation service uptake are attributable to this intervention. The linkage between community members and the primary healthcare system served as an effective and efficient mechanism to share information.

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“…In contrast, inter-sectoral and multisectoral collaboration is promoted for the improvement of the health status of the population at large. 30 This implies that there was a poor inter-sectoral collaboration in the district and which underscores the necessity of putting into practice the principles and strategies in supporting the health extension workers to reorganize, monitor and supervise HDAs for successful implementation of HEP. Similarly, the finding from other qualitative study conducted in Ethiopia supports this finding.…”

Section: Discussionmentioning

confidence: 99%

Barriers for the Functional Implementation of Community Health Volunteers in Health Developmental Army in Debre Libanos District, Oromia, Ethiopia: A Descriptive Qualitative Study

Tareke¹,

Solomon²,

Teshome³

2022

JMDH

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Background: Although the existing evidence suggests that the implementation of the health, developmental army (HDA) brought promising successes towards the delivery of Health Extension Programs (HEPs), pieces of evidence have shown that there are problems related to its functionality. Therefore, this study explored barriers to the functionality of HDAs. Methods: A descriptive qualitative study was conducted from March 11 to April 7, 2019, in the Debre Libanos District, Oromia, Ethiopia. The study participants were purposively recruited from six kebeles. They were recently delivered mothers, pregnant women, other reproductive age group community members, health workers, kebele chairman, HDA team leaders, and religious leaders. Five in-depth interviews, seven key informant interviews, and four focus group discussions were conducted with a total of 52 participants. Data were audio-recorded, transcribed verbatim, and translated. The inductive thematic analysis approach was used and the data were coded, categorized, and themes were developed using Atlas ti.7.1. software package. Results:The barriers to the functionality of HDAs were organized into four major themes. First, it was affected by structure, monitoring, or supervision-related challenges. Second, communityrelated barriers such as perceptions and attitudes towards HDAs, and the need for incentives or compensation from the HDAs affected the functionality. Third, it was affected by the lack of multisectoral collaboration to strengthen, monitor, or supervise the HDAs. Lastly, behavior, residence, or shortage of health extension workers affected its implementation. In addition, the study found that, as a result of poor functionality of HDAs, service utilization was decreased, especially antenatal care, postnatal care, sick newborn treatment, etc. Conclusion:The functionality of HDAs was affected by a variety of barriers. Therefore, there is a need to develop different strategies and take action to address the explored barriers to improve their capacity and implementation status for increasing health care service utilization.

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Effect of Ethiopia's Health Development Army on maternal and newborn health care practices: A multi-level cross-sectional analysis

Cited by 6 publications

References 0 publications

Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services

Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services

Contribution of women’s development army to maternal and child health in Ethiopia: a systematic review of evidence

Barriers for the Functional Implementation of Community Health Volunteers in Health Developmental Army in Debre Libanos District, Oromia, Ethiopia: A Descriptive Qualitative Study

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