Health Service Extension Program

Health Extension Program (HEP) is an innovative community based health care delivery system aimed at providing essential promotional and preventive health care services.  It was introduced in recognition of failure of essential services to reach communities in remote parts of Ethiopia.

HEP services have been customized to meet the needs, demands and expectations of the pastoralist, agrarian and urban population.  It is considered as the most important institutional framework for achieving the Millennium Development Goals (MDGs).  

Objective of HSEP

  • Shift health care resources from predominantly urban to rural areas, where the majority of the country's population resides;
  • Improve access and equity of essential health services at the village and household levels in line with the decentralization goal;
  • Ensure ownership and participation by increasing health awareness, knowledge and skills among community members;
  • Promote gender equality in accessing health services;
  • Improve the utilization of peripheral health services by bridging the gap between communities and health facilities through Health Extension Workers (HEWs);
  • Reduce maternal and child mortality and
  • Promote an overall healthy lifestyle. 


HEP provides a package of basic and essential promotional, preventive health intervention services in three primary areas:

  • Hygiene and Environmental Sanitation
  • Diseases Prevention and Control
  • Family Health Services

  These three packages include various intervention services such as:

  • Prevention of HIV/AIDS, STDs and TB; malaria prevention and control; first aid emergency measures; maternal, new born and child health; family planning; immunization, nutrition, adolescent reproductive health; excreta disposal; solid and liquid waste disposal water supply; food hygiene and safety measures; healthy home environment; control of insects and rodents; personal hygiene; health education and communication.


Pilot implementation was launched in 5 regions in 2002/2003 (G.C.) and encouraging results were seen in terms of community's acceptance and demand for services provided through HEP.  By mid-2008/09, the FMoH has successfully deployed over 30,190 health extension workers throughout Ethiopia.  As a result, improvements were seen in the construction and utilization of latrines, acceptance rate of contraceptives and vaccination services in areas where the program has been implemented. 

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