Qualitative assessment of factors that are affecting the implementation of urban health extension program in Jimma city, South-west Ethiopia

Abstract

Background: Ethiopia has made remarkable progress in health services coverage to improve the health status of the population. Despite the progresses that have been made, the populations still face a high rate of morbidity and mortality. In response to the country urban health problem, the Government has launched Urban Health Extension Program in 2009. The goal of the this program is to improve access and equity to basic health services and address major health problems and other issues in urban areas such as HIV, food security, and poor sanitation, among many other health and non-health issues. Since it has launched in urban settings, no or little is known about factors related with the implementation of this program in national or regional level. So this study may give baseline information on the current situation of the program. Objective: To assess factors that affects the implementation of urban health extension program in Jimma city. Methods: This assessment used cross-sectional design with qualitative methods. The study was conducted from August 5 to August 9, 2012. Purposive sampling technique was used to select 13 urban health extension workers, four health extension supervisors, and 13 kebele representative for in-depth interview, and 12 women representatives for focus-group discussion. The data collection methods were in-depth interview, focus-group discussion, and resource inventory. Qualitative data were analyzed thematically and resource inventory results were described. Result: All urban health extension workers were selected by woreda health offices and have taken 3months pre service training. All most all of urban health extension workers who were interviewed reported that pre service and in-service training on urban health extension program was sufficient. The program implemented through home to home visit, training of model families and front runner health collaborators. Currently the program stills not start the implementation in schools and youth centers. Most health extension professionals said there was community resistance to participate in urban health extension program. Most resources needed for the program available except material and drugs needed for emergency services. Conclusion and Recommendation: there were encouraging efforts of urban health extension workers to implement the program based on the guideline. But the program still was not implemented in school and youth centers, and there was community resistance on the program. So the Jimma Woreda health office should be scaling up and benchmarking best practices such as selection and training of model family and front runner health collaborators. Urban health extension professionals and supervisors should start the implementation of the program in school and youth center settings. The kebele administrators should promote the program through available channels to increase awareness about the program among the community.