Workie, Netsanet W.Ramana, Gandham NV2013-05-012013-05-012013-01https://hdl.handle.net/10986/13280Ethiopia has made substantial progress in improving health outcomes during the last decade and is on track to achieve some of the health Millennium Development Goals. Innovative strategies to improve household behaviors and coverage of basic health care services contributed to Ethiopia's achievements, and the Health Extension Program (HEP) remains the core of such innovations and provides a model for countries struggling to improve health outcomes in a resource-constrained setting. The program rests on an accelerated expansion of basic health infrastructure and local human resources with required skills to scale-up delivery of high-impact interventions focusing on improving the supply of and enhancing demand for a well-defined package of essential promotive, preventive, and curative health services. The objectives of the case study are to provide a detailed description of (a) the context for the introduction of the program; (b) the scope of the service package delivered under the program; and (c) the institutional arrangements and the links with the rest of the health system. The case study also summarizes and discusses the evidence of the program's achievements and the challenges to achieving universal primary health care coverage. The study also discusses the importance of political will and commitment in introducing such large-scale innovations in improving service delivery and mobilizing the community in a resource-constrained setting.en-USCC BY 3.0 IGOaccess to health servicesaccess to primary health careAdolescent reproductive healthagedaggressiveagricultural developmentbasic health carebasic health servicesbirth attendantsbreastfeedingburden of diseasecaesarean sectionscapacity buildingcenter for healthcertificationchild healthchild morbiditychild mortalityclinicscold chainsCommunicable diseasesCommunity Healthcommunity participationcompetenciesContraceptive Prevalencecontraceptive usecontraceptivescounselingdecision makingdeveloping countriesdisabilitydisseminationdrugseconomic growthessential commoditiesessential health servicesessential medicinesexpendituresfamiliesfamily healthfamily planningfertilityfertility rateGeneral Health Systemgovernment leadershipgross domestic producthealth carehealth care coveragehealth care facilitieshealth care serviceshealth centershealth clinicshealth educationHealth ExpenditureHealth Extensionhealth facilitiesHealth FinancingHealth IndicatorsHealth Infrastructurehealth initiativesHealth Insurancehealth interventionshealth managementhealth messageshealth outcomeshealth policyhealth postshealth problemshealth professionalshealth sectorhealth sector reformhealth servicehealth service providershealth serviceshealth statusHealth Systemhealth system strengtheninghealth systemsHealth Workershealth workforcehealthy lifeHIVHIV/AIDShome visitshospitalHospital bedshospitalshousehold levelhuman capitalhuman resourceshygieneill healthillnessesimmunizationincomeInfantInfant mortalityInfant mortality rateinfantsinformation systemInformation systemsinjuriesintegrationinterpersonal communicationlarge populationleprosyLife expectancylimited resourceslive birthslocal communitymalariamanagement of healthmarried womenmaternal healthmaternal mortalitymaternal mortality ratiomedical equipmentmedical servicesmedical suppliesmedicinesMillennium Development GoalsMinistry of EducationMinistry of Healthmodern contraceptive methodsmodern familymodern family planningmodern family planning methodsmorbiditymortalitymothermother-to-childmother-to-child transmissionnational levelNeeds Assessmentnewbornnewborn carenormal deliveriesnumber of childrennursesnutritionnutritional deficienciesoccupational healthoral rehydration therapypatientpatientspersonal hygienePharmaciesPhysicianPhysiciansplan of actionpopulation indicatorspopulous countrypostnatal carepregnancypregnant womenprenatal careprimary careprimary health careprimary health care facilitiesprimary health care servicesprimary health facilitiesprimary health servicesProgresspromoting gender equalityprovision of careprovision of servicesPublic Healthpublic health programspublic servicequality of healthquality of servicesreferral servicesreferral systemreferral systemsregional hospitalreligious institutionsreproductive healthreproductive health servicesresource constraintsresource mobilizationrespectrole modelsrural areasrural communitiesrural populationsafe drinking watersafe motherhoodsafety measuressanitationscreeningservice deliveryservice delivery pointsservice provisionsexually transmitted infectionssocial networkssocioeconomic differencesSustainable Developmenttechnical skillstetanustraditional birth attendantstuberculosistuberculosis preventionunder-five mortalityUNFPAuniversal accessurban areasurban communitiesuser feesvaccinationvaccinesvocational educationwastewaste disposalWorkersWorld Bank10.1596/13280