Child health service provision in Ethiopia: Outpatient, growth monitoring and immunization

Background: Ethiopia has made tremendous effort by cutting under five mortality by two third from the 167 in 1999 to 68 in 2012. Nevertheless, nearly 277,186 under five children die each year mostly from diseases which can be prevented or treated. Sound information on the supply and quality of health services is necessary for health systems management, monitoring, and evaluation. Objective: The objectives of this study are to assess the availability of child health services and how often these services are available in Ethiopian health facilities. Method: The assessment is part of the 2014 Ethiopia Service Provision Assessment Plus (ESPA+) Survey which was designed to be a cross-sectional study, which combines MEASURE DHS SPA, World Health Organization’s service Availability and Readiness Assessment (SARA) and the World Bank’s Service Delivery Indicator (SDI). A total of 1,327 health facilities were assessed. All hospitals, selected health centres, private clinics (Higher, Lower, & Medium), and health posts were assessed using a facility inventory questionnaire. . Results: Among all facilities, 62 % of them provide all three basic child health services (out-patient curative care for sick children, routine childhood vaccination services (EPI), and routine growth monitoring services) as a package. Seventy three percent of government facilities provide all three basic child health services. While 68 % of rural facilities provide all the services, in urban settings, 32 % of the facilities provide all the three basic child health services while majority of Health centres (82 %) provide all the services, only 1 % of lower clinics provide all three basic services. Out-patient curative care for sick children is the most commonly provided (95 %) service of all the three basic services. These services are almost universally available across all facility types, except in higher clinics which are less than 80 %. Among all facilities offering outpatient curative care for sick children, majority (78 %) of them offer the service 5 or more days per week at the facility. Conclusion: Majority of facilities provide all three basic child health services (Outpatient Curative Care, Child Vaccination, and Child Growth Monitoring). Out-patient curative care for sick children is the most commonly provided service. Government facilities mostly provide all three basic child health services. Among all facilities offering outpatient curative care for sick children, majority of them of