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

For the F2, eight out of ten predictors were statistically (Ababa, 2020). The quality of care provided to the large
significant (r = 11%, F [15, 1185] = 10.8, and P = 0.001). community in Ethiopia can be improved by improving
2
F2 decreased by −0.013 as age increased (95% CI [−0.02, the technical proficiency of HEW, who forms the second-
−0.002], P = 0.02). For females, the average value of F2 was largest group of health professionals. There is evidence that
0.20 lower (95% CI [−0.31, −0.09], P = 0.001). Clinicians the expanded HEP necessitates abilities far beyond what
who were married had an F2 that was 0.16 higher than those HEWs are currently capable of (Ameha et al., 2014; Fetene
who were not married (95% CI [0.05, 0.27], P = 0.005). In et al., 2016; Tilahun et al., 2017). Strong competency
comparison to MDs, the value of F2 increased for nurses, standards and ongoing in-service training must therefore
midwives, and HOs by 0.33 (95% CI [0.05, 0.62], P = 0.02), be a part of technical and vocational education and
0.41 (95% CI [0.11, 0.70], P = 0.007), and 0.51 (95% CI training to boost HEWs’ confidence levels. In a previous
[0.20, 0.82], P = 0.00), respectively. In addition, there was study, it was found that 95.7% of HEWs believed they
a linear relationship between education level and F2, with were competent in performing their job duties (Desta
degree holders having an average F2 value of -0.19 (95% et al., 2017). However, in the current study, there was a
CI [−0.32, −0.07], P = 0.002) lower than diploma holders. contrasting finding, with only 75.5% of clinicians agreeing
As participation in HEP review meetings and home that HEWs possessed the necessary skills to carry out the
visits increased, F2 also rose by 0.27 (95% CI [0.15, 0.38], HEP program. This discrepancy in perceptions could be
P = 0.000), and 0.17 (95% CI [0.05, 0.29], P = 0.006), explained by social desirability bias, where HEWs might
respectively. For the clinicians who were willing to support exaggerate their skills to present a positive self-image.
HEP as opposed to those who were not, the value of F2
decreased on average by -0.44 (95% CI [−0.60, −0.28], A clinician’s familiarity with the system is manifested
P = 0.000). by their understanding of the tasks carried out by the
HEP. In the study, the EFA yielded a dimension that
4. Discussion measured clinicians’ familiarity with HEP activities (F2).
The results indicated that clinicians are well-versed in
To achieve universal access to primary healthcare in the HEP activities, highlighting the extent of interconnection
most underserved communities, HEP, a well-known
government initiative, continues to be a top priority for among the contributors, including clinicians, in the
health officials (Bilal, 2009; Wang et al., 2016). It is also a program. According to the present study, 70.2% of
crucial component of the healthcare system in Ethiopia clinicians demonstrated a good understanding of and
(Republic, 2019). Despite clinicians actively participating support for HEP activities. The interaction between HEWs
in the program and significantly contributing to its and clinicians, as well as the presence of clearly defined
success, neither their comprehension of the program nor roles, ultimately contributed to the program’s success and
their attitudes toward its effects have ever been evaluated HEW satisfaction (Kok et al., 2015b). However, due to the
(Ameha et al., 2014; Jakovljevic et al., 2017). Hence, the methodological flaw, it is challenging to determine whether
objective of this study was to assess clinicians’ knowledge clinicians acquired their understanding of HEP activities
of and attitudes toward the HEP as well as to analyze through direct participation in HEP or through training.
factors associated with latent scales. Three crucial elements The HEP establishment guideline primarily aimed to
that impact clinician perception and knowledge of the enhance the capacity of local communities to improve
HEP were produced by the EFA after performing several their health and bridge the healthcare access gap between
procedures to confirm the measurement reliability. The urban and rural populations (Mangham-Jefferies et al.,
ability of HEWs, the impact of HEP on community health, 2014; Waddington & Waddington, 2015). The results of
and clinicians’ perspectives on HEP activities – all of which this study aligned with the goals of HEP, as the perceived
are top priorities for the healthcare system – were presented attitude toward the impact of HEP (F3) emerged as the
as key findings, and the authors draw the conclusion that third factor. This finding is consistent with the objective
these findings are beneficial to policymakers, program of optimizing the HEP roadmap, which aims to accelerate
implementers, and health leaders in the Ethiopian health access to essential health services (Ababa, 2020). Health
sector. However, due to the fact that the data only comes professionals hold diverse opinions regarding the effect
from public facilities, the lack of generalizability is a major of HEP on community health. While many believe in
limitation. its positive impact, some argue that the effects are not

One factor, the perceived clinicians’ attitude toward easily noticeable. Due to insufficient supporting data,
the HEW’s skill, was identified. This supports the strategic such debatable issues remain unresolved. However,
objectives of optimizing the HEP road map, which demands other researchers have identified these issues as crucial
that HEW capacity be strengthened to increase their skill factors to consider when evaluating the effectiveness

Volume 1 Issue 1 (2023) 9 https://doi.org/10.36922/ghes.0887