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Perception and Experience of Health Extension Workers on Facilitators and Barriers to Maternal and Newborn Health Service Utilization in Ethiopia: A Qualitative Study

Author

Listed:
  • Alemayehu Hunduma Higi

    (Department of Population and Family Health, Institute of Health, Jimma University, Jimma P.O. Box 378, Ethiopia)

  • Gurmesa Tura Debelew

    (Department of Population and Family Health, Institute of Health, Jimma University, Jimma P.O. Box 378, Ethiopia)

  • Lelisa Sena Dadi

    (Department of Epidemiology, Institute of Health, Jimma University, Jimma P.O. Box 937, Ethiopia)

Abstract

Background : Health extension workers (HEWs) have substantial inputs to reduce maternal and newborn morbidity and mortality in Ethiopia. However, their perceptions and experiences were not well understood. Therefore, this study aimed to explore their perceptions and experiences on facilitators and barriers to maternal and newborn health services in Ethiopia. Methods : A descriptive qualitative study was conducted from 8–28 April 2021 in Oromia, Amhara and Southern Nation, Nationality, and People’s Regional State of Ethiopia. Focused group discussions were made with purposively selected 60 HEWs. The data were transcribed verbatim and translated into English. An inductive thematic analysis was carried out using Atlas ti.7.1. The findings were presented in major themes, categories, and sub-categories with supporting quote(s). Results : The findings were categorized into two major themes (i.e., facilitators and barriers) and seven sub-themes. Community-related facilitators encompass awareness and behavior at the individual, family, and community. Significant others such as traditional birth attendants, religious leaders, women developmental armies, and kebele chairman substantially contributed to service utilization. Availability/access to infrastructures such as telephone, transportation services, and solar energy systems facilitated the service utilization. Furthermore, health facility-related facilitators include the availability of HEWs; free services; supervision and monitoring; maternity waiting rooms; and access to ambulance services. Maternal and newborn health services were affected by community-related barriers (i.e., distance, topography, religious and socio-cultural beliefs/practices, unpleasant rumors, etc.,), health facility-related barriers (i.e., health worker’s behaviors; lack of logistics; lack of adequate ambulance service, and placement and quality of health post), and infrastructure (i.e., lack or poor quality of road and lack of water). Conclusions : The HEWs perceived and experienced a wide range of facilitators and barriers that affected maternal and newborn health services. The study findings warrant that there was a disparity in behavioral factors (awareness, beliefs, and behaviors) among community members, including pregnant women. This underscores the need to design health education programs and conduct social and behavioral change communication interventions to address individuals, families, and the broader community to enhance maternal and newborn health service utilization. On the other hand, the health sector should put into practice the available strategies, and health workers provide services with empathy, compassion, and respect.

Suggested Citation

  • Alemayehu Hunduma Higi & Gurmesa Tura Debelew & Lelisa Sena Dadi, 2021. "Perception and Experience of Health Extension Workers on Facilitators and Barriers to Maternal and Newborn Health Service Utilization in Ethiopia: A Qualitative Study," IJERPH, MDPI, vol. 18(19), pages 1-26, October.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10467-:d:650212
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    References listed on IDEAS

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    1. Legesse Tesfaye & Yohannes Kebede Lemu & Kasahun Girma Tareke & Mulugeta Chaka & Garumma Tolu Feyissa, 2020. "Exploration of barriers and facilitators to household contact tracing of index tuberculosis cases in Anlemo district, Hadiya zone, Southern Ethiopia: Qualitative study," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-16, May.
    2. Mulu Ftwi & Gebremedhin Gebre-egziabher Gebretsadik & Haftu Berhe & Mebrahtom Haftu & Gebrehiwot Gebremariam & Yemane Berhane Tesfau, 2020. "Coverage of completion of four ANC visits based on recommended time schedule in Northern Ethiopia: A community-based cross-sectional study design," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-14, August.
    3. Yemisrach B. Okwaraji & Zelee Hill & Atkure Defar & Della Berhanu & Desta Wolassa & Lars Åke Persson & Geremew Gonfa & Joanna A. Schellenberg, 2020. "Implementation of the ‘Optimising the Health Extension Program’ Intervention in Ethiopia: A Process Evaluation Using Mixed Methods," IJERPH, MDPI, vol. 17(16), pages 1-20, August.
    4. Rekiku Fikre & Kidist Eshetu & Muntasha Berhanu & Akalewold Alemayehu, 2021. "What determines client satisfaction on labor and delivery service in Ethiopia? systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-15, April.
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    Cited by:

    1. Daniel Badell & Jesica de Armas & Albert Julià, 2022. "Impact of Socioeconomic Environment on Home Social Care Service Demand and Dependent Users," IJERPH, MDPI, vol. 19(4), pages 1-21, February.

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