Bryan Shaw|Agbessi Amouzou|Nathan P Miller|Amy O. Tsui|Jennifer Bryce|Mengistu Tafesse|Pamela J. Surkan
Determinants of Utilization of Health Extension Workers in the Context of Scale-Up of Integrated Community Case Management of Childhood Illnesses in Ethiopia
Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University|Johns Hopkins University
ethiopia invested significant resources integrated community case management iccm childhood illness oromia region iccm scaleup phased allowing comparisons districts providing iccm routine services assessed determinants utilization health extension workers hews delivering iccm services rural health posts caregivers sick underfive children crosssectional survey found low utilization hews 93 caregivers child sick diarrhea fever andor pneumonia previous 2 weeks taking child hews iccm routine areas higher likelihood utilization hews iccm areas 144 95 ci 097212 p 007 effect disappeared accounting confounders iccm areas maternal education illness type distance associated utilization perceptions illness severity service quality primary reasons given utilizing health post findings suggest though iccm reaching vulnerable populations remain significant barriers use hews delivering iccm services efforts demand generation minimization remaining barriers urgently needed sustained success iccm strategy ethiopia