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Background: Tigray is one of the first regions in Ethiopia that implementing health extension package program at household level. In 2002/2003 EC this program strengthened and expanded in all woredas of the Region. Kola Tembien woreda, which is our study area, has 4000 households which are graduated and involved in the program for the last 3 years. Objective: To assess the impact of having HEP on active trachoma prevalence, and identify challenges, achievements and factors for sustainable implementation of the program. Methodology: This is a quasi-experimental study conducted in Kola Tembien District. Using systematic random sampling 310 households from intervention and 621 households from non-intervention households were interviewed in 31 randomly selected villages. Ophthalmic nurses use a simplified clinical grading to assess stages of trachoma while environmental technicians assessed risk factors of trachoma. Qualitative data were also collected through FGDs to identify community perception on household HEP program and the relation within all stakeholders, major achievements and challenges, and mechanisms used to sustain the program. Results: Prevalence of active trachoma in under ten years in household with HEP is 17% and in households without HEP is 35.5%. Prevalence of active trachoma is lower among households with HEP [OR: 0.37 95% CI, 0.22-0.63]; who have latrine and used properly [OR:0.62 95%CI, 0.38-0.95]. who washed face frequently [OR:0.10 95%CI, 0.05-0.18], who used soap to wash face [OR:0.37 95%CI, 0.15-0.94]; and clean face [OR:0.40 95%CI, 0.29-0.57] but higher in those who dispose waste to disposal pit [OR:1.43 95%CI, 1.04- 1.95] and distance to fetch water less than one kilometers [OR:1.47 95%CI, 1.00-2.15]. The FGDs suggested that households who implement the HEP program prevented eye diseases and eye irritation and they internalize importance of the HEP program. Conclusion: Health extension package has significant effect in prevention of active trachoma and has to be expanded to households who have not implemented the HEP program. Further sensitization and training of woreda and kebele councils, health workers and CHW and make understanding with stakeholders like Agriculture, Education, Water development and Cooperatives is necessary to enhance expansion of the program.
Key words: Health extension package, Active trachoma, quasi-experimental study |
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