title: Effect of the health extension program and other accessibility factors on care-seeking behaviors for common childhood illnesses in rural Ethiopia.
abstract: BACKGROUND
  In January 2011, Health Extension Workers (HEWs) of Ethiopia's Health Extension Program (HEP) began providing pneumonia case management for children less than five years of age through the integrated Community Case Management (iCCM) strategy.
  
  
  OBJECTIVE
  To report the effect of HEP, following the introduction of iCCM, and other accessibility factors on care-seeking behaviors for common childhood illnesses (acute respiratory infection [ARI], diarrhea, and fever).
  
  
  METHODS
  Three possible care-seeking outcomes for childhood illnesses were considered: not seeking appropriate care, seeking care from HEP sources, or seeking care from other appropriate sources. The baseline care-seeking outcomes from the Ethiopian Demographic and Health Survey, 2011, were compared with the care-seeking outcomes in a follow-up iCCM survey in December 2012. The effects of the HEP intensity and other factors on care-seeking outcomes were estimated using regression analyses.
  
  
  RESULTS
  Appropriate care-seeking for children with acute respiratory infection, ARI, diarrhea, or fever increased two-fold, from 19% at baseline to 38% at follow-up, mainly due to an increase in seeking care for common child- hood illnesses from HEWs. Higher intensity of the HEP and other accessibility factors were associated with higher care-seeking for childhood illnesses from HEP sources.
  
  
  CONCLUSIONS
  Incorporating iCCM within the HEP service package significantly improved the appropriate care-seeking behaviors for childhood illnesses in rural Ethiopia.
authors.forename: Addis
authors.initials: A
authors.lastname: Ashenafi
authors.forename: Ali Mehryar
authors.initials: AM
authors.lastname: Karim
authors.forename: Agazi
authors.initials: A
authors.lastname: Ameha
authors.forename: Amano
authors.initials: A
authors.lastname: Erbo
authors.forename: Nebiyu
authors.initials: N
authors.lastname: Getachew
authors.forename: Wuleta
authors.initials: W
authors.lastname: Betemariam
mesh_terms: D019090:Case Management / Q000706:statistics & numerical data*; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003153:Community Health Services / Q000706:statistics & numerical data*; D003967:Diarrhea / Q000628:therapy; D005002:Ethiopia; D005260:Female; D005334:Fever / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000628:therapy; D012424:Rural Population / Q000706:statistics & numerical data