THE TRAINING AND USE OF COMMUNITY HEALTH AGENTS IN ETHIOPIA

Abstract

ABSTRACT The training of community health agents (CHAs) started in Ethiopia in 1978. Thus far, 4218 CH4s have been trained and deployed. A study covering 58 CHAs out of 1122 (5%) in three regions was conducted to evaluate the work of the CHAs before unidentified and/or unresolved problems arose which could jeopardize their future effectiveness. The study showed that the size of the population covered per CHA varied considerably among the three types of mass organizations. Support in the form of cash remuneration was most frequent in service cooperatives. Three-quarters of the peasants' associations provided no remuneration at all. Service cooperatives were most often able to supply drugs. Supervision by health units was high, although what that meant was not clear. Of the CHAs investigated, '62% had continued unbroken service, 17% of those initially selected as CHAs had not started work, and 21% discontinued work which gave a total attrition rate of 38%. The lack of full support by communities for community health services is noted, and some reasons are suggested.