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Impact evaluation of the Ethiopian Health Services Extension Programme

Author

Listed:
  • Assefa Admassie
  • Degnet Abebaw
  • Andinet Woldemichael

Abstract

Ethiopia has launched a pro-poor health services extension programme since 2003 to deliver preventive and basic curative health services to its inhabitants. Despite the massive support and recognition the programme has received, there has not been proper evaluation of its impact. This study has applied propensity score matching and regression adjustment techniques to evaluate the short-term and intermediate-term impacts of the programme on child and maternal health indicators in the programme villages. Empirical data for the study were collected from 3095 households from both programme and non-programme villages in rural Ethiopia. The estimated results indicate that the programme has significantly increased the proportion of children fully and individually vaccinated against tuberculosis, polio, diphtheria-pertussis-tetanus, and measles. The study finds heterogeneity in childhood immunisation coverage as a result of differences in terms of the number of health extension workers, in the quality of health posts and in terms of the educational achievement of mothers across programme villages. The proportions of children and women using insecticide-treated bednets for malaria protection are significantly larger in programme villages than in non-programme villages. The effect on preventive maternal care is rather limited. Whereas women in the programme villages appeared to make their first contact with a skilled health service provider significantly earlier during pregnancy, very little effect is detected on other prenatal and postnatal care services. Moreover, the programme has not reduced the incidence and duration of diarrhoea and cough diseases among under-five children.

Suggested Citation

  • Assefa Admassie & Degnet Abebaw & Andinet Woldemichael, 2009. "Impact evaluation of the Ethiopian Health Services Extension Programme," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 1(4), pages 430-449.
    • Handle: RePEc:taf:jdevef:v:1:y:2009:i:4:p:430-449
    DOI: 10.1080/19439340903375724
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    References listed on IDEAS

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    1. Marco Caliendo & Sabine Kopeinig, 2008. "Some Practical Guidance For The Implementation Of Propensity Score Matching," Journal of Economic Surveys, Wiley Blackwell, vol. 22(1), pages 31-72, February.
    2. Alejandro Gaviria & Carlos Medina & Carolina Mejía, 2006. "Evaluating The Impact Of Health Care Reform In Colombia: From Theory To Practice," Documentos CEDE 2647, Universidad de los Andes, Facultad de Economía, CEDE.
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    Cited by:

    1. Monica Jain & Shannon Shisler & Charlotte Lane & Avantika Bagai & Elizabeth Brown & Mark Engelbert & Yoav Vardy & John Eyers & Daniela Anda Leon & Shradha S. Parsekar, 2022. "Use of community engagement interventions to improve child immunisation in low‐ and middle‐income countries: A systematic review and meta‐analysis," Campbell Systematic Reviews, John Wiley & Sons, vol. 18(3), September.
    2. Mebratie, A.D. & Van de Poel, E. & Debebe, Z.Y. & Abebaw, D. & Alemu, G. & Bedi, A.S., 2013. "Self-reported health care seeking behavior in rural Ethiopia: Evidence from clinical vignettes," ISS Working Papers - General Series 551, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    3. Bethlehem A. Argaw, 2017. "Regional inequality of economic outcomes and opportunities in Ethiopia: A tale of two periods," WIDER Working Paper Series 118, World Institute for Development Economic Research (UNU-WIDER).
    4. Thomas, Ranjeeta & Jones, Andrew M & Squire, Lyn, 2010. "Methods for Evaluating Innovative Health Programs (EIHP): A Multi-Country Study," MPRA Paper 29402, University Library of Munich, Germany.
    5. Squire, Lyn & Jones, Andrew M & Thomas, Ranjeeta, 2010. "Evaluating Innovative Health Programs: Lessons for Health Policy," MPRA Paper 29205, University Library of Munich, Germany.
    6. Lelisa Fekadu Assebe & Wondesen Nigatu Belete & Senait Alemayehu & Elias Asfaw & Kora Tushune Godana & Yibeltal Kiflie Alemayehu & Alula M Teklu & Amanuel Yigezu, 2021. "Economic evaluation of Health Extension Program packages in Ethiopia," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-16, February.
    7. Zelalem Yilma & Anagaw Mebratie & Robert Sparrow & Marleen Dekker & Getnet Alemu & Arjun S. Bedi, 2015. "Impact of Ethiopia's Community Based Health Insurance on Household Economic Welfare," The World Bank Economic Review, World Bank, vol. 29(suppl_1), pages 164-173.
    8. Yohannes Dibaba Wado & Eshetu Gurmu & Tizta Tilahun & Martin Bangha, 2019. "Contextual influences on the choice of long-acting reversible and permanent contraception in Ethiopia: A multilevel analysis," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-17, January.
    9. UN Economic Commission for Africa & United Nations Development Programme Regional Bureau for Africa & African Union & African Development Bank, 2016. "MDGs to Agenda 2063/SDGs Transition Report 2016: 2016Towards an integrated and coherent approach to sustainable development in Africa," UNDP Africa Reports 267640, United Nations Development Programme (UNDP).
    10. Eirin Krüger Skaftun & Merima Ali & Ole Frithjof Norheim, 2014. "Understanding Inequalities in Child Health in Ethiopia: Health Achievements Are Improving in the Period 2000–2011," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-10, August.
    11. Bethlehem A. Argaw, 2017. "Regional inequality of economic outcomes and opportunities in Ethiopia: A tale of two periods," WIDER Working Paper Series wp-2017-118, World Institute for Development Economic Research (UNU-WIDER).

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