Assessment of Urban Health Extension Package Utilization and Healthcare Seeking Behavior Among Model and Non-model Households in Addis Ababa, Ethiopia: A Comparative Community Based Study

Abstract

BACKGROUND: Ethiopia has been implementing the Urban Health Extension Program (UHEP) at the community level since 2009. The program was a pro-poor and cost-effective approach that aimed to enhance the utilization of urban health extension program packages and empower community healthcare-seeking behavior. This study was conducted to compare the utilization and healthcare-seeking behaviors of urban health extension program packages and the healthcare-seeking behaviors of model and non-model households. METHODS: A community-based comparative cross-sectional study was conducted among 594 female household heads (297 models and 297 non-models) using a structured face-to-face interview. A bivariate and multivariable logistic regression analysis was employed to identify associated factors. A p-value less than 0.05 and an adjusted odds ratio (AOR) with a 95% confidence interval were carried out to identify significant factors. RESULTS: Urban health extension program package utilization was 78% among model and 64.2% among non-model female households. A total of 75.5% of model and 65.2% of non-model female household heads had appropriate healthcare-seeking behavior. Moreover, having information about UHEPs (AOR = 2.35, 95% CI = 1.08 - 3.42), the frequency of home visits by UHEWs (AOR = 2.12, 95% CI = 1.01 - 3.13), knowledge about UHEPs (AOR = 3.14, 95% CI = 2.43 - 4.47), and household graduation status (AOR = 3.052, 95% CI = 2.024 to 5.113) were significantly associated with urban health extension program package utilization and healthcare-seeking behaviors. CONCLUSION: In terms of utilization, the overall urban health extension package favors model female household heads over the non-model female household heads. As a result, raising awareness, frequent home visits, and focusing more on disease prevention and control packages will boost the adoption of urban health extension packages.