Table 1 Logic framework for the Optimizing Health Extension Program intervention in selected districts of Ethiopia
Assumptions | • Local stakeholders committed to coordinate and support the interventions • Traditional leaders will promote the maternal, newborn and child health services • The government health sector and supply chain partners will ensure drug and service availability | ||
Strategies | COMMUNITY ENGAGEMENT | CAPACITY BUILDING | OWNERSHIP, ACCOUNTABILITY |
Interventions | • Health post open house • Group discussions led by Women’s Development Army (WDA) members • Reaching male partners • Engaging schools • Engaging religious and traditional leaders • Health films • Radio spots and dramas | • WDA level one training • Community-based data for decision making • Health Extension Worker (HEW) gap filling training and job aids • Supportive supervision of HEWs • Performance review and mentorship meetings with HEWs • Provision of job aids and tools | • Advocacy for the integration of Community-Based Newborn Care (CBNC) and integrated community case management (iCCM) into planning, budgeting, management, and information systems of the district and sub-district levels. • Management standard for health post opening hours • Ambulance service for children’s referral • Engage Kebele (sub-district) command post in the efforts Establish community feedback mechanism |
Output | • Awareness of childhood illness and availability of CBNC and iCCM • Acceptance of health post care • Evidence-based social and behavioural change communication | • WDA members capacitated • HEWs gained skills • Supportive supervision and performance review and mentorship meetings with HEWs done | • CBNC and iCCM integrated in the planning, management and information systems at district and sub-district levels • Standard set for health post opening hours • Sub-district level local administration engaged in demand creation and support to primary health service provision • Community feedback mechanisms created • Advocacy to decision makers and influential bodies |
Intermediate outcomes | • Improved child health practice at household and community levels Data source: Household module • Improved availability of high quality community-based newborn care and integrated community case management of childhood diseases Data source: Health post, health extension worker and health provider assessment module • Improved ownership and accountability of community-based newborn care and integrated management of childhood illnesses Data source: woreda contextual factors module | ||
Outcome | • Increased utilisation of good quality community-based newborn care and integrated management of childhood illnesses Data source: household module | ||
Impact | • Reduction of under-five mortality | ||