Volume 1 Issue 1 (2023) 1 https://doi.org/10.36922/ghes.0887
ORIGINAL RESEARCH ARTICLE
Assessment of clinician’s knowledge and
attitude toward health extension program in
Ethiopia: An exploratory factor analysis
Merhawi Gebremedhin Tekle
1
*, Esie Gebrewahd Gebre
2
, Girmay
Medhin
3,4
, Alula M. Teklu
4
, Daniel Tadesse
4
, Genet Gebrehiwot
5
, Sentayehu
Tsegaye
6
, Eskinder Wolka
7
, Gebrehiwot Gebretsadik
8
, Ciara DeGraf
9
, and
Mihajlo Jakovljevic
10,11,12
1
School of Public Health, Haramaya University, Harar, Ethiopia
2
School of Geography and Environmental Studies, Haramaya University, Harar, Ethiopia
3
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
4
MERQ Consultancy PLC, Addis Ababa, Ethiopia
5
Department of Gender and Development Studies, Haramaya University, Harar, Ethiopia
6
Federal Ministry of Health, Addis Ababa, Ethiopia
7
International Institute for Primary Health Care-Ethiopia, Addis Ababa, Ethiopia
8
Department of Biomedical Sciences, College of Health Sciences and Comprehensive Specialized
Hospital, Aksum University, Axum, Ethiopia
9
Department of Psychological and Brain Sciences, Colgate University, New York, United States
10
Institute of Advanced Manufacturing Technologies, Peter the Great St. Petersburg Polytechnic
University, St. Petersburg, Russia
11
Institute of Comparative Economic Studies, Hosei University, Tokyo, Japan
12
Department of Global Health Economics and Policy, University of Kragujevac, Serbia
Abstract
Health extension workers (HEWs) are the primary implementers of the health
extension program (HEP) – a government-led community-based health-care
program, but clinicians are anticipated to play a critical part in providing extensive
support, thus, this study aimed to assess clinicians’ knowledge and perceptions of
HEP, a cross-sectional study was conducted with 1239 clinicians. A set of 54-item
questions was created based on HEP guidelines and relevant literature. Exploratory
factor analysis (EFA) identifed latent variables with Eigenvalues matrix >1. Cluster
variables were derived through orthogonal varimax factor rotation, and internal
reliability was evaluated using Cronbach’s alpha coefcient. A composite score was
generated for each constructed factor, and the associations between variables were
determined using a one-way analysis of variance. Multiple linear regression analysis
was conducted to eliminate confounders, with statistical signifcance set at P < 0.05.
EFA provides three factors explaining 91% of the total variance and labeled as
“clinician-perceived attitude towards the skill of HEWs” (F1), “clinician knowledge on
HEP activities” (F2), and “clinician-perceived attitude towards the impact of HEP” (F3).
Internal reliability for the 54 items was 0.96, and it was 0.93, 0.90, and 0.89 for F1, F2,
and F3, respectively. 75.5% and 76.2% of clinicians had favorable attitudes toward
F1 and F3, respectively, and 70.2% had good knowledge of F2. F1 was positively
correlated with participation in HEP review meetings, home visits, HEP outreach, and
willingness to work in HEP but negatively correlated with degree holders. F2 was
*Corresponding author:
Merhawi Gebremedhin
(meriget12@gmail.com)
Citation: Tekle, M.G., Gebre, E.G.,
Medhin, G., Teklu, A.M., Tadesse, D,
Gebrehiwot, G., et al. (2023).
Assessment of clinician’s
knowledge and attitude toward
health extension program in
Ethiopia: An exploratory factor
analysis. Global Health Econ
Sustain, 1(1): 0887.
https://doi.org/10.36922/ghes.0887
Received: May 1, 2023
Accepted: July 10, 2023
Published Online: July 25, 2023
Copyright: © 2023 Author(s).
This is an Open Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with
regard to jurisdictional claims in
published maps and institutional
afliations.
Global Health Econ Sustain