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EFFECTIVENESS OF SCALING UP THE THREE PILLARS APPROACH TO ACCELERATING MDG 4 PROGRESS IN ETHIOPIA

Friday, 13th of February 2015

EFFECTIVENESS OF SCALING UP THE THREE PILLARS APPROACH TO ACCELERATING MDG 4 PROGRESS IN ETHIOPIA

Mary A. Carnell1, Leanne Dougherty1, Amanda M. Pomeroy1 Ali M. Karim1,Yared M. Mekonnen2, Brian E. Mulligan3

 

1John Snow, Inc., Arlington, VA, USA;

2Mela Research, PLC, Addis Ababa, Ethiopia;

3Bill & Melinda Gates Foundation, Seattle, WA, USA

 

ABSTRACT BELOW; FULL TEXT IS AT http://www.jhpn.net/index.php/jhpn/article/view/3010/1062

 

This paper describes the integrated approach taken by the Government of Ethiopia with support from the Essential Services for Health in Ethiopia (ESHE) Project and assesses its effect on the coverage of six child health practices associated with reducing child mortality. The ESHE Project was designed to contribute to reducing high child mortality rates at scale among 14.5 million people through the three pillars approach.

 

This approach aimed to (i) strengthen health systems, (ii) improve health workers performance, and (iii) engage the community. The intervention was designed with national

and subnational stakeholders input.

 

To measure the Projects effect on the coverage of child health practices, we used a quasi-experimental design, with representative household survey data from the three most populous regions of Ethiopia, collected at the 2003-2004 baseline and 2008 endline surveys of the Project. A difference-in-differences analysis model detected an absolute effect of the ESHE intervention of 8.4% points for DTP3 coverage (p=0.007), 12.9% points for measles vaccination coverage (p<0.001), 12.6% points for latrines (p=0.002), and 9.8%

points for vitamin A supplementation (p<0.001) across the ESHE-intervention districts (

woredas) compared to all non-ESHE districts of the same three regions. Improvements in the use of modern family planning methods and exclusive breastfeeding were not significant. Important regional variations are discussed.

 

ESHE was one of several partners of the Ministry of Health whose combined efforts led to accelerated progress in the coverage of child health practices.