title: The community-based Health Extension Program significantly improved contraceptive utilization in West Gojjam Zone, Ethiopia.
abstract: BACKGROUND
  Ethiopia has implemented a nationwide primary health program at grassroots level (known as the Health Extension Program) since 2003 to increase public access to basic health services. This study was conducted to assess whether households that fully implemented the Health Extension Program have improved current contraceptive use.
  
  
  METHODS
  A cross-sectional community-based survey was conducted to collect data from 1,320 mothers using a structured questionnaire. A multivariate logistic regression was used to identify the predictors of current contraceptive utilization. A propensity score analysis was used to determine the contribution of the Health Extension Program "model households" on current contraceptive utilization.
  
  
  RESULTS
  Mothers from households which fully benefited from the Health Extension Program ("model households") were 3.97 (adjusted odds ratio, 3.97; 95% confidence interval, 3.01-5.23) times more likely to use contraceptives compared with mothers from non-model households. Model household status contributed to 29.3% (t=7.08) of the increase in current contraceptive utilization.
  
  
  CONCLUSIONS
  The Health Extension Program when implemented fully could help to increase the utilization of contraceptives in the rural community and improve family planning.
authors.affiliation: University of Gondar, Gondar, Ethiopia.
authors.forename: Mezgebu
authors.initials: M
authors.lastname: Yitayal
authors.affiliation: Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
authors.forename: Yemane
authors.initials: Y
authors.lastname: Berhane
authors.affiliation: Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Alemayehu
authors.initials: A
authors.lastname: Worku
authors.affiliation: University of Gondar, Gondar, Ethiopia.
authors.forename: Yigzaw
authors.initials: Y
authors.lastname: Kebede
keywords: Health Extension Program; current contraceptive utilization