Ethiopia DHS 2016
        •  Will be conducted by
            – Central Statistical Agency (CSA)
            – Ethiopian Public Health Institute (EPHI)
        •  Data collection teams will visit each Enumeration 
           Area (EA) selected for the survey
        •  A separate team (health facility team) will visit health 
           centers or posts with names of children without 
           vaccination cards identified during data collection.
   Health care system in Ethiopia 
    Health Centers
     – Found at the regional, zonal and wareda level. 
     Staffed with Health officers, Midwives, Nurses. A 
     higher level of care with in-patients care;
     – Unclear how many health personnel per health 
     centers because of variations within the regions, 
     zones, and waredas;
     – A Wareda is responsible for a population of 15,000 
     to 25,000 individuals depending on the area.
   Health care system in Ethiopia (Cont.)
    Health Posts
     – Health Extension Workers (HEW) are responsible 
     for providing very specific care in health posts at 
     the kebele level (smallest administrative unit in 
     Ethiopia). 
     – Two HEWs per Kebele, formally trained by MoH.
     – Focus on immunization, family planning, and 
     sometimes with delivery. Also responsible for 
     referring patients to health centers.
   Data collection
   • Home-based records:
     – Immunization cards/ child care cards;
     – Polio0 and BCG cards (given at health centers);
   • Mother’s recall:
   • Health centers and posts records:
     – Child care cards (started in 2014)
     – Family health book (started in 2014)
     – Small registration book (older)
     – Registration book (IGMRB)
      Visits to four health centers 
    Positive aspects                 Challenges
    Information on vaccination is    Information recorded in the 
    routinely recorded in the        registry book by the date of 
    registry book                    first visit
    All vaccination data recorded in  Children’s names are not 
    a single line in the register    always recorded
    Family book available since      The mother’s name is not 
    2014                             always recorded
    HEWs are the source of           System is not standardized 
    information for the community    across health centers or posts