Programmatic correlates of maternal healthcare seeking behaviors in Ethiopia

Abstract

Background: Considerable improvement in maternal healthcare use has been observed since the inception of the health extension program (HEP) in Ethiopia in 2003.Objective: This paper evaluates the influence of HEP outreach strategies on maternal healthcare use.Method: Cross-sectional survey of 2,916 women with children 0 to 11 months from Amhara, Oromiya, Southern Nations, Nationalities and People’s, and Tigray regions, obtained between December 2008 and January 2009, were analyzed using regression models to assess the impacts of HEP strategies on maternal health outcomes.Result: The analyses found that communities (i.e., kebeles) with relatively high prevalence of model families, higher rate of household visits by health extension workers, and higher rate of household visits by voluntary community health workers were associated with improved antenatal care use, tetanus toxoid vaccination coverage, and receiving postnatal care visits; but the strategies were not associated with deliveries attended by health professionals.Conclusion: Although the impacts of HEP strategies on maternal healthcare use were statistically significant, they were not optimum to reach the maternal mortality reduction targets of the government of Ethiopia. The HEP needs to review and strengthen its community based strategies in order to reach its goals. [Ethiop. J. Health Dev. 2010;24 Special Issue 1:92-99]