Caregivers’ and Health Extension Workers’ Perceptions and Experiences of Outreach Management of Childhood Illnesses in Ethiopia: A Qualitative Study

Atkure Defar, Kassahun Alemu, Zemene Tigabu, Lars Åke Persson and Yemisrach B. Okwaraji
Additional contact information
Atkure Defar: Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia
Kassahun Alemu: Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
Zemene Tigabu: Department of Paediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
Lars Åke Persson: Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia
Yemisrach B. Okwaraji: Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia

IJERPH, 2021, vol. 18, issue 7, 1-11

Abstract: Introduction: Ethiopian Health Extension Workers provide facility-based and outreach services, including home visits to manage sick children, aiming to increase equity in service coverage. Little is known about the scope of the outreach services and caregivers’ and health workers’ perceptions of these services. We aimed at exploring mothers’ and health extension workers’ perceptions and experiences of the outreach services provided for the management of childhood illnesses. Methods: Four focus groups and eight key informant interviews were conducted. A total of 45 community members participated. Interviews were recorded, transcribed verbatim, and translated into English. We applied thematic content analysis, identified challenges in providing outreach services, and suggestions for improvement. We balanced the data collection by selecting half of the participants for interview and focus group discussions from remote areas and the other half from areas closer to the health posts. Results: Mothers reported that health extension workers visited their homes for preventive services but not for managing childhood illnesses. They showed lack of trust in the health workers’ ability to treat children at home. The health extension workers reported that they provide sick children treatment during outreach services but also stated that in most cases, mothers visit the health posts when their child is sick. On the other hand, mothers considered distance from home to health post not to be a problem if the quality of services improved. Workload, long distances, and lack of incentives were perceived as demotivating factors for outreach services. The health workers called for support, incentives, and capacity development activities. Conclusions: Mothers and health extension workers had partly divergent perceptions of whether outreach curative services for children were available. Mothers wanted improvements in the quality of services while health workers requested capacity development and more support for providing effective community-based child health services.

Keywords: outreach services; home-based services; sick child; focus group discussion; key informant interview; Ethiopia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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