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Global Health Econ Sustain Clinician’s attitude toward health extension program

Table 2. (Continued)
Code Questions Factors
F1 F2 F3
ARW14 HEWs can successfully provide vaccination for children and mothers 0.66
ARW15 Adolescent health needs such as behavioral change and family planning can be addressed through HEW 0.54
ARW16 Clinicians have to give value and respect for the works done by HEWs 0.64
ARW17 I would be happy to work with HEWs in any health-related activity 0.63
ARW18 I do not have doubt on the competence of rural HEW to run their daily activities 0.42
ARW19 HEWs are well trained and qualified to the level their job demands
ARW20 HEWs are playing their role in improving community health needs
ARW21 Generally, I support the existence and continuity of HEWs activity in the community 0.63
ARP01 HEP has been promoting community health needs well 0.60
ARP02 HEP has been meeting Health care needs of hard-to-reach communities 0.58
ARP03 Health seeking behavior of rural community has increased after the implementation of HEP 0.63
ARP04 HEP has contributed to decreased maternal and under five mortality in rural community 0.66
ARP05 HEP is a necessary and desirable for improvement of community health needs 0.64
ARP06 HEP has an efficient planning, follow up, monitoring and evaluation 0.45
ARP07 In my view, primary healthcare delivery coverage is improved since the implementation of HEP 0.64
ARP08 Adolescent health needs such as sexual behavior, STI prevention, FP provision, and behavioral change can effectively be 0.47
addressed through HEP
ARP09 Overall, HEP has a significant impact on improvement of community health in rural Ethiopia 0.68
ARP10 Generally, I support the existence and continuity of HEP activity in the community 0.65
** Cronbach’s alpha 0.93 0.91 0.89
Abbreviations: HEP: Hospital extension program; HEW: Hospital extension worker; ANC: Antenatal care; PNC: Postnatal care.

However, we decided to exclude F4 from further analysis good correlation. Even though all items showed a good
because this factor was only constructed by one item. item-total correlation score (>0.30), one item (ARW09)
One item, ARW20, which was cross-loaded in F1 and F3, received a relatively low item-total score correlation (0.29).
as well as weakly loaded items (0.4), were eliminated. 42 The 54 items’ Cronbach’s alpha value was reported at 0.96.
items were therefore kept in the final model. The sampling The model was re-tested after dropping ARW09 from
adequacy measure for the remaining 42 items was 0.96, the analysis to see if Cronbach’s alpha would be changed
with an inter-item range of 0.93 – 0.98. For F1, F2, and substantially. However, dropping this item did not result in
F3, the sampling adequacy was 0.96, 0.93, and 0.93, an increase beyond 0.961. As a result, the final Cronbach’s
respectively, showing that the factors have been sufficiently alpha was reported at 0.96. Cronbach’s alpha was examined
sampled. The percentage of variance was the same (91%) for items retained in each of the three factors and reported
for both item extraction and rotation sums. However, the as: F1 = 0.93, F2 = 0.91, and F3 = 0.89.
varimax rotation resulted in changes in the percentage of
variance across factors: F1 changed from 67.9 % to 31.1%, 3.5. Knowledge and attitude of clinicians
F2 changed from 11.3% to 27.2%, and F3 changed from Clinicians’ perceived attitudes toward HEWs’ skill
7.1% to 25.6%. (F1), Clinicians’ knowledge of HEP activities (F2), and
Clinicians’ perceived attitudes toward the impact of
3.4. Internal consistency HEP (F3) are the three outcome variables created from
The average inter-item variance and covariance were EFA. The F1 composite score has a value between 0 and
determined to be 0.05 and 0.31, respectively. The 17, with a mean score of 12.9 (SD = 4.7). As shown in
correlation between an item’s score and the sum of all Table 3, 75.5% of respondents had a favorable attitude
the other items was calculated to determine how well an toward F1. Activities of the HEP should continue as a
item correlated with the overall scale, with a value of <0.3 community health intervention, according to 87.9% of
being considered poor. Except for one item, the item-total respondents. The majority of clinicians (86.6%) thought
correlation scores ranged from 0.38 to 0.70, indicating a that HEWs could successfully administer vaccination

Volume 1 Issue 1 (2023) 7 https://doi.org/10.36922/ghes.0887