Initial community perspectives on the Health Service Extension Programme in Welkait, Ethiopia

<p>Abstract</p> <p>Background</p> <p>The Health Service Extension Programme (HSEP) is an innovative approach to addressing the shortfall in health human resources in Ethiopia. It has developed a new cadre of Health Extension Workers (HEWs), who are charged with providing the health and hygiene promotion and some treatment services, which together constitute the bedrock of Ethiopia's community health system.</p> <p>Methods</p> <p>This study seeks to explore the experience of the HSEP from the perspective of the community who received the service. A random sample of 60 female heads-of-household in a remote area of Tigray participated in a structured interview survey.</p> <p>Results</p> <p>Although Health Extension Workers (HEWs) had visited them less frequently than planned, participants generally found the programme to be helpful. Despite this, their basic health knowledge was still quite poor regarding the major communicable diseases and their vectors. Participants felt the new HESP represented an improvement on previous health provision. HEWs were preferred over Traditional Birth Attendants for assistance with labour</p> <p>Conclusion</p> <p>While the introduction of HEWs has been a positive experience for women living at the study site, the frequency of visits, extent of effectively imparted health knowledge and affects of HEWs on other health providers needs to be further explored.</p

Personnel planning in general practices: development and testing of a skill mix analysis method

Background: General practitioners (GPs) have to match patients’ demands with the mix of their practice staff’s competencies. However, apart from some general principles, there is little guidance on recruiting new staff. The purpose of this study was to develop and test a method which would allow GPs or practice managers to perform a skill mix analysis which would take into account developments in local demand. Methods: The method was designed with a stepwise method using different research strategies. Literature review took place to detect available methods that map, predict, or measure patients’ demands or needs and to fill the contents of the skill mix analysis. Focus groups and expert interviews were held both during the design process and in the first test stage. Both secondary data analysis as primary data collection took place to fill the contents of the tool. A pilot study in general practices tested the feasibility of the newly-developed method. Results: The skill mix analysis contains both a quantitative and a qualitative part which includes the following sections: i) an analysis of the current and the expected future demand; ii) an analysis of the need to adjust skill mix; iii) an overview about the functions of different provider disciplines; and iv) a system to assess the input, assumed or otherwise, of each function concerning the ‘catching up demand’, the connection between supply and demand, and the introduction of new opportunities. The skill mix analysis shows an acceptable face and content validity and appears feasible in practice. Conclusions: The skill mix analysis method can be used as a basis to analyze and match, systematically, the demand for care and the supply of practice staff. (aut. ref.