Integration of mother and child health services in Ethiopia
Walley, J.D.; McDonald, M.
Tropical Doctor 21(1): 32-35
1991
ISSN/ISBN: 0049-4755 PMID: 1998221 DOI: 10.1177/004947559102100113Document Number: 314171
Maternal-child health services in the Wollo region of Ethiopia, south of Eritrea and Tigray, were reorganized into an integrated format by several non-governmental health officers in 1987-1988, replacing separate clinics and service records. Originally mothers had to attend on separate days for curative care, growth monitoring, vaccination, antenatal care and family planning. As a result they rarely came except for curative care. Daily integrated clinics were held combining growth monitoring, nutrition, prenatal or postnatal care, vaccination, family planning and health education, starting with the presenting problem and going through the other services. 5 patient registers and 11 record cards were replaced by 3 attendance and clinic records, 3 medical records, and patient identification and take-home cards. Staff were trained in use of oral contraceptive and prenatal check lists, vaccination graphs, and maintenance of sterilizers and refrigerators. An integrated check-list was made up for supervision and inventory supplies. After the new program was instituted, attendance increased and clients more readily accepted vaccination and oral contraceptives. Nevertheless, health workers later generally did not offer prenatal care unless requested, because there were few referral services available. Other problems with the system were staff difficulty in interpreting growth monitoring graphs and failure to record services rendered on new forms. This integrated system was extended to the remaining 9 districts in Wollo in 1988. In 1989 11 district courses were conducted to train 420 new staff.