Abstract:
Background: - The lowest health tier system of Ethiopia is Primary level health care, with one Primary Hospital, 5 health centers and twenty-five health posts at rural level, that one health post serves 3000-5,000 population. Two Health Extension Workers (HEWs) are trained and deployed in each health post at the village/kebele level to improve access and equity to basic health services, targeting households particularly women/mothers focusing on sustained preventive health actions and increased health awareness. Objective: - To assess the magnitude of attrition, explore the whereabouts of the HEWs who have left their jobs and the possible factors related to those among Health Extension Workers deployed in Oromia Regional State. Methods: - It is an exploratory cross sectional study done in Oromia Regional State. Data for the number of HEWs graduated, by the years of graduations from TVETs commission, number of HEWs who have left their jobs, and the whereabouts of HEWs who have left their jobs since 1997 EFY until 2001 EFY assessed and collected from all eighteen Zones of Oromia. Three Zones (Guji, West Harerge and Nannewa Finfinne) from the Region and again three Woredas/Districts from each Zone were selected by the highest number of HEWs left their jobs/services, for the assessment of factors /reasons associated with attrition among HEWs deployed in Oromia Regional State. Systematic random sampling method used to select Health Extension Workers in each Woreda/District, using the payroll list of HEWs in each District/Woreda Heath Offices as a sample frame. The total sample size of 118 respondents were selected from each Zone/District, based on proportion to size of the current number of Health Extension Workers or key informants in each Zone/District. Results: - There were multiple reasons associated with the attrition of HEWs in the region, of which 87.4% of key informants mentioned low salary payment. One hundred ninety (20.7%) and 141 (15.3%) of HEWs that have left their jobs changed their jobs to other non-health category & left because of marriage respectively. Conclusion: - In general, 12,766 HEWs were trained and deployed that fulfilled 99.2% of the need during the five years (1997 to 2001 EFY) period in Oromia Region, and the finding of this study showed that attrition rate of HEWs was 7.2% which is not high.