Community-based health extension policy implementation in Ethiopia: a policy experience to scale-up

Submitted: 29 October 2021
Accepted: 25 April 2022
Published: 14 October 2022
Abstract Views: 68
PDF: 63
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


Ethiopia has launched innovative community-based health policy in 2003. It was designed to accelerate the expansion of community-based health facilities and basic health services. The program established a health post at the lowest administrative unit level to serve in the villages. The policy implementation was supported by many stakeholders to improve the health indicators of the country. All the concerted efforts and public participation has helped the implementation of the policy and improvement of primary health services in rural communities. Thus, participating communities through grassroots mobilization in similar resource limited settings as experienced in this policy review could be scaled up to other health policies for its successful implementation.

Federal Ministry of Health. Health and Health Related Indicators 2005 E.C (2012/2013). 2014. p. 68.

Assefa Y, Gelaw YA, Hill PS, Taye BW, Van Damme W. Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services. Globalization and Health. 2019;15(1):1-11. DOI:

World Bank Group. Population total in Ethiopia [Internet]. 2019 [cited May 08, 2021]. Available from:

You D, Hug L, Ejdemyr S, Idele P, Hogan D, Mathers C, et al. Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Interagency Group for Child Mortality Estimation. The Lancet. 2015;386(10010):2275-86. DOI:

World Health Organization. Trends in maternal mortality: 1990-2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and

the United Nations Population Division: World Health Organization; 2015.

Jembere GB, Cho Y, Jung M. Decomposition of Ethiopian life expectancy by age and cause of mortality; 1990-2015. PloS one. 2018;13(10):e0204395. DOI:

Federal Democratic Republic of Ethiopia. Health policy of the transitional government of Ethiopia. The Federal Democratic Republic of Ethiopia Addis Ababa, Ethiopia; 1993.

Wamai RG. Reviewing Ethiopia’s health system development. Population (mil). 2004;75.

Federal Ministry of Health. Health Sector Strategic Plan (HSDP-III) 2005/6-2009/10. Ethiopia Federal Ministry of Health Addis Ababa; 2005.

Sebhatu A. The implementation of Ethiopia’s Health Extension Program: an overview. Addis Ababa, Ethiopia. 2008.

Stratton IM, Adler AI, Neil HAW, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular

complications of type 2 diabetes (UKPDS 35): prospective observational study. Bmj. 2000;321(7258):405-12. DOI:

Wang H, Tesfaye R, NV Ramana G, Chekagn CT. Ethiopia health extension program: an institutionalized community approach for universal health coverage: The World Bank; 2016. DOI:

Damtew ZA, Chekagn CT, Moges AS. The Health Extension Program of Ethiopia: strengthening the community health system. Harvard Health Policy Review. 2016.

Alebachew A, Waddington C. Improving health system efficiency. Human resource for health reforms, Ethiopia. 2015.

Teklehaimanot HD, Teklehaimanot A. Human resource development for a communitybased health extension program: a case study from Ethiopia. Human resources for health. 2013;11(1):1-12. DOI:

Bilal NK, Herbst CH, Zhao F, Soucat A, Lemiere C. Health extension workers in Ethiopia: improved access and coverage for the rural poor. Yes Africa Can: Success Stiroes from a Dynamic Continent. 2011:433-43.

Becerra-Posada F, Berwick D, Bhutta Z, Chowdhury M, de Savigny D, Haines A, et al. The Millennium Development Goals will not be attained without new research addressing health system constraints to delivering effective interventions.

Report of the Task Force on Health Systems Research. 2005. World Health Organization. The Global Fund strategic approach to health systems strengthening: report from WHO to the Global Fund Secretariat, September 2007. World Health Organization; 2007.

Workie NW, Ramana GN. The health extension program in Ethiopia. 2013.

Ababor S, Hadis M, Dibaba A, Assefa Y. Improving health extension program in Ethiopia (SURE policy brief). In: Institute EPH, editor. Addis Ababa Ethiopia:2014.

Kingdon JW. Agendas, Alternatives, and Public Policies, Update Edition, with an Epilogue on Health Care: Pearson Education Limited; 2014. 240 p.

Hall P. Change, choice, and conflict in social policy: London: Heinemann; 1975.

Nejmudin bilal. Health extension program: An innovative solution to public health challenges of Ethiopia case study: Reviewed by USAID Abt associate inc. 2012.

Declaration of Alma Ata: International conference on primary health care. Alma Ata, USSR: International Conference on Primary Health Care; 1978.

Getaye Tefera, Y. (2022). Community-based health extension policy implementation in Ethiopia: a policy experience to scale-up. Journal of Public Health in Africa, 13(3).


Download data is not yet available.