RESUMO
BACKGROUND: Primary healthcare (PHC) is a crucial strategy for achieving universal health coverage. Ethiopia is working to improve its primary healthcare system through the Optimization of Health Extension Program (OHEP), which aims to increase accessibility, availability and performance of health professionals and services. Measuring current accessibility of healthcare facilities and workforce availability is essential for the success of the OHEP and achieving universal health coverage in the country. METHODS: In this study we use an innovative mixed geospatial approach to assess the accessibility and availability of health professionals and services to provide evidence-based recommendations for the implementation of the OHEP. We examined travel times to health facilities, referral times between health posts and health centers, geographical coverage, and the availability and density of health workers relative to the population. RESULTS: Our findings show that the accessibility and availability of health services in Somali region of Ethiopia is generally low, with 65% of the population being unable to reach a health center or a health post within 1 h walking and referral times exceeding 4 h walking on average. The density of the health workforce is low across Somali region, with no health center being adequately staffed as per national guidelines. CONCLUSIONS: Improving accessibility and addressing healthcare worker scarcity are challenges for implementing the primary care roadmap in Ethiopia. Upgrading health posts and centers, providing comprehensive services, and training healthcare workers are crucial. Effective outreach strategies are also needed to bridge the gap and improve accessibility and availability.
Access to primary healthcare, which encompasses essential healthcare services and often the initial point of contact between individuals and the healthcare system, is crucial for addressing the health needs of a population. In Ethiopia, ongoing efforts to reform the primary healthcare system aim to increase geographic access to health services and improve the availability of healthcare workers. This study focuses on the Somali region of Ethiopia and finds that 65% of the population is unable to reach a health center within 1 h of walking, and none of the health centers meet national and international staffing guidelines. These results play an important role in identifying areas where mobile outreach, involving trained service providers traveling to communities with limited access to healthcare facilities, can bridge gaps in healthcare accessibility and availability. Furthermore, the findings inform the implementation of primary healthcare reforms.