Abstract:
Background: Health extension program (HEP) is an innovative community based strategy to deliver preventive and promotive services. It brings community participation through creation of awareness, behavioral change, community organization and mobilization. It also improves the utilization of health services by bridging the gap between the community and health facilities. Objectives:-Assessing attitude and participation level of households towards health extension program in Nefas Silk Lafto Sub-city, Addis Ababa, Ethiopia. Method:- Community based cross-sectional study design was used to assess the attitude and participation level of households with the sample size 423, which was determined by single proportion formula (P) of 0.5 and 95% confidence interval. Households were included in the study using systematic sampling method. Health extension workers were randomly selected first and households under health extension workers were included into the study by calculating the interval between the households. Structured pre-tested questionnaire was used to collect data. Frequencies, proportions, odds ratio (95% CI), adjusted odds ratio(95% CI) and logistic regression were used for description of the study population, to determine dependent and independent variables association strength and relative effect of independent variables on dependent variables. Result:- Participation level of households in health extension program was 42% (95% C.I= 0.37-0.47) and attitude of households on the change HEP implementation brought, satisfaction of HHs on HEP services, communication skill of HEW, believing HEW skillful and satisfaction of HHs on HEW service provision were associated with participation level of households in HEP [AOR(95%C.I):0.15(0.04-0.54),21.08(2.32-191.38),0.06(0.01-0.64),0.11(0.03-0.35)and 2.67(1.01-7.09) respectively. Conclusion:- Majority of the respondents have poor attitude and low participation level in HEP. This is due to household’s attitude towards change that the program has brought was very low and their satisfaction on the program was low. Households’ attitude on the technical competence of HEW and communication skill of health extension worker was unfavorable and influence participation in the program.