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Background: Health Extension Program (HEP) is innovative community based program. The aim of the program is to improve access to basic essential health service in severely under served rural and remote communities with the goal of achieving universal primary health care. There are some studies on HEP; most of them are evaluation of the program and its implementation process. This study on its side focus on assessing extent of Health Extension Workers functionality and its determinants again this study is the pioneer to address the issues of Health Extension workers competence. Objectives: The study was designed to assess Health extension workers level of functionality and competence on family health package components of health extension program in East Shoa zone of Oromia region. Methodology: A cross sectional study was conducted from January2010 –April2010. In the study 381 HEWs were participated in the functionality assessment after this functionality assessment 42 Health Extension Workers were selected by simple random sampling from functional HEWs and observed during their performance of Ante natal care(ANC),post natal care(PNC) and delivery and new born care to study their competence by using observational checklist and written examination. Logistic regression was used to identify factors associated with Health Extension workers functionality. Result: Functionality- Overall prevalence of HEWs functionality on family health package was 92.9%. 98.2% of HEWs were functional on family planning service while only 43% of them on delivery and new born care. Supervision (p-value, 0.015), and refresher training (p-value0.016) was found highly associated factors with functionality of HEWs. In school training on family health package lacks both theoretical and practical training. Competence- HEWs were more competent on PNC (78.6%) followed by ANC (76.2%) and delivery and new born care (66.7%).HEWs were highly competent on interpersonal and routine activity than technical skill during performing the activities. Health Extension Workers (HEWs) scored more on theoretical knowledge (written examination) than practical skill (observation) in case of ANC& delivery and new born care but in PNC the reverse. Stretcher and examination beds were found scarce equipment while contraceptives were highly supplied drugs to health posts. Conclusions and recommendation Generally level of functionality of HEWs were encouraging in all service under family health package except delivery service, again competence level of HEWs was satisfactory on ANC and PNC but delivery service need especial attention to maximize their competence and functionality. The program need attention at school training level and also in service refresher trainings, on job supervision and timely supply of recommended medical equipment and supplies are mandatory for HEWs functionality and competence. |
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