The Contribution of a Health Extension Programme in the Utilisation of Maternal Healthcare Services in the Mecha District of the Amhara Region, Ethiopia

The purpose of this study was to identify the contributions made by the Health Extension Programme (HEP) to influence the utilisation of maternal healthcare services at primary healthcare units in the Mecha district, Ethiopia. A non-experimental quantitative descriptive research design was conducted. This was structured into four phases. In phase one the continuum of care and quality of documentation was audited from 975 antenatal cards documented in three health centres from 1 July 2010 to 30 June 2013. In phase two 304 women were interviewed about their knowledge on the available services, the quality of maternal healthcare provision and factors that hinder the utilisation of maternal healthcare services. In phase three the opinions of all midwives and health extension workers (HEWs) were obtained with self-administered questionnaires from three health centres and 15 health posts respectively. In phase four the guidelines were developed.The findings revealed that the continuum care of maternal healthcare services was ineffective; the quality of documentation was poor. The majority of respondents were more knowledgeable about other HEP packages than maternal healthcare services. The advocacy and dissemination of information about the maternal healthcare services proved to be inadequate. The relations between the clients and the healthcare providers at the healthcentres were unsatisfactory.The study developed guidelines based on the findings. The study recommended that a strong antenatal care follow-up tracking mechanism be urgently provided, that providers be knowledgeable, that community midwives be trained and accredited to give skilled delivery at the health posts, and that the recording tools at the health post be reviewed and developed