Degree of adherence of the urban health extension service delivery process to the standards set nationally


  • Mesfin Addisie
  • Adiam Nega
  • Berhan Tassew
  • Demeke Assefa
  • Dawit Siraw
  • Yibeltal Tebekaw
  • Hibret Alemu
  • Damen Haile Mariam


Background: The Urban Health Extension Program (UHEP) is an innovative Ethiopian government plan to ensure health service equity by creating demand for essential health services through the provision of appropriate health information at the household level. Even though the HEP was launched in Ethiopia in 2003 as the flagship program for the implementation of primary health care in the country, studies looking at its quality are limited. Adherence to set standards within a program is one of the parameters that indicates process quality. This paper, part of a larger survey to assess the quality of services provided by the UHEP in Ethiopia, looks at the degree of adherence of the service delivery process to the standards set nationally. Methodology: The study included an assessment of the degree of adherence of the urban health services delivery process to the national standards in selected urban health extension facilities within the catchment areas of sampled institutions. Assessment was made using observation checklists of the routine service provision of the health professionals. Data collection for the survey included the assessment of the service delivery practices of 330urban health extension professionals (UHE-ps) in five major regions. Results: When compared with the standards set in the national program implementation manual, environmental sanitation and counseling of mothers (99.4%), essential nutrition action (in terms of growth monitoring and provision of vitamin A and iron supplementation) (95.4%), HIV/AIDS and STI-related services (95.1%), antenatal care (87.6%), adolescent reproductive health(RH) services (82.1%), family planning services (81%) and facilitating immunization (63.7%) were reported to have good performance. On the other hand, childhood curative services (22%), curative care for pregnant mothers (24.2%), delivery care (25.4%) and follow-up of treatment for leprosy cases (25.5%) were reported to have comparatively low performance. Conclusions: Overall, the comparison of adherence to standards set by the UHE-ps implementation manual showed that the most preventive and health promotive services (including HIV/AIDS and STI) were regularly provided, while low performance of UHEps were reported in delivery-related and curative services (including those given to pregnant women and children. [Ethiop. J. Health Dev. 2020; 34(Special issue 2):62-69] Key words: Adherence to standards; Urban Health Extension Program; Urban Health Extension Professionals.




How to Cite

Addisie, M., Nega, A., Tassew, B., Assefa, D., Siraw, D., Tebekaw, Y., Alemu, H., & Haile Mariam, D. (2020). Degree of adherence of the urban health extension service delivery process to the standards set nationally. The Ethiopian Journal of Health Development, 34(2). Retrieved from



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