The Ethiopian Health Extension Program (HEP) is Still Relevant After 15 Years of Implementation Although Major Transformation is Essential to Sustain Its Gains and Relevance
Universal health coverage is one of the global agendas (1) and different counties have been following diverse modalities to address this agenda (2). The HEP is one of the modalities Ethiopia has followed and launched in 2003 to deliver 16 packages (latter increased to 18 packages) of essential health services organized under 4 major areas, including hygiene and environmental sanitation, disease prevention and control, family health services, and health education and communication (3). The program involves more than 40 thousand health extension workers (HEWs) serving from more than 17 thousand health posts (their work stations within the community). The program has contributed to the major gains registered in the country over the past two decades.
From 2015 to 2017, dissenting ideas about the program started to emerge. Some groups said the program is maturing, while others claimed it was showing signs of decay. The lack of consensus on the status of the program was becoming clearer by the day. The existing studies related to the program did not examine it comprehensively. The paucity of the evidence was overt when the existing evidence proved to be insufficient to make major decisions, even when the government wanted to do so. The national HEP assessment (4) conducted by MERQ from March to May 2019 was the timely response to the understanding of the status of the program
The findings of this major assessment were put into use immediately after completion, informed several government decisions and have been the main sources for the 15-year roadmap that the Ministry of Health developed and endorsed (5).
The seven papers in this special issue are among the many that are in the pipeline and developed using data from the national HEP assessment. In this special issue, the study protocol, relevance of HEP, mental health and burnout of HEWs, logistics status at the health post, community health information system, current status of HEWs training Institutions and quality of service delivery modality are addressed. From the findings of these papers you will learn that:
