The government is investing 360 million Br to construct 100 health posts across nine regional states and in one city administration.
The Ministry of Health will undertake the project with financing from the government’s budget and pledges from development partners. The ministry will also invest 7.41 million Br on 136 existing health posts by upgrading, equipping and providing medicine supplies.
Under the new project 100 new posts will be built, replacing an equal number out of the existing 17,187 health posts spread throughout the country. The posts designated for replacement were constructed poorly and provide inadequate facilities and services, according to ministry officials. Another 136 posts will be upgraded, equipped and supplied with medicine, while the remaining old posts are planned to be rebuilt by regional health bureaus over the next ten years.
The pilot project is part of the second generation health extension programme launched in 2015, which includes: upgrades of health extension packages by adding mental health and non-communicable diseases, such as diabetics and hypertension, to the list of 16 other services; upgrading health extension workers’ skills from level three to level four nurses; two-year courses for workers on health extension packages and a Certificate of Competence; and the replacement of the rest of the posts located in different parts of the country by new facilities.
This second generation program aims to increase health-related awareness in the community, makes provisions for quality and equitable health care services, treats patients for non-communicable diseases and provides emergency medical services according to Temesgen Ayehu, director of the Health Extension Programme and Primary Healthcare at the ministry.
“Locations of the new health posts are based on formula made by the parliamentary body, House of Federation,” said Temesgen.
The largest shares will go to Oromia Regional State with 34 posts, Amhara Regional State with 22, and Southern Nations, Nationalities, and Peoples’ Region (SNNPR) will receive 20. In addition, Ethiopia Somali Regional State will get 10, Tigray six, Afar Regional States three, and Benishangul Gumuz two. Harari, Gambella, Afar Regional States and Dire Dawa city will each get one.
Each of the new 100 health posts is expected to cost the government about 3.6 million Br. The buildings were designed by in-house architects of the ministry and will include maternity wards, vaccination and outpatient rooms, restrooms, storage facilities and living quarters for health extension workers.
In addition, 54,480 Br will be allocated for upgrading, procurement of medical equipment and supplies and worker training for each of the 136 existing posts.
Currently, there are close to 40,000 health extension workers in rural areas of the country. The tuition fee for each worker will be 8,316 Br a year and is covered by the regional health bureaus.
“The design of the new posts will enable them to provide delivery and post-delivery services for women,” said Netsanet Sorri, senior architect of the Ministry, “this was previously offered at the health centre levels only.”
The first generation health extension programme was launched in 2003 in rural areas and was later expanded to urban and pastoral areas. It focused on hygiene, sanitation, family health, disease prevention and health education.
The health extension programme has played a significant role in the health status of women and children in the past decades, according to a report by the Demographic Health Survey, where child mortality was reduced to 88 per 1,000 from 123 per 1,000. The contraceptive acceptance rate has increased from 15pc in 2005 to 29pc by 2011, according to the survey.
Ansha Nega (PhD), a lecturer and researcher at Addis Abeba University, School of Public Health for the last 16 years, also recognises the positive outcomes of the health extension programme. Hence, she believes the project has lacked some additional packages.
“The package should be more inclusive, integrating the unseen rural as well as urban communities,” she said.
Community-Based Rehabilitation, a basic rehabilitation service for disabled persons, occupational safety, employee workplace health and safety packages for the informal sector has to be included in the extension packages, according to Ansha.