Multiple Impacts of Ethiopia’s Health Extension Program on Adolescent Health and Well-Being: A Quasi-Experimental Study 2002e2013
Objectives
The study aimed to assess whether Ethiopia’s Health Extension Program improves key adolescent health and social outcomes, including child marriage, pregnancy, education, and health-seeking behaviors. It examined exposure to heath extension workers and model households to determine how community health platforms influence the wellbeing of adolescent girls and boys
Findings
Adolescents with higher exposure to the Health Extension Program had better outcomes across several domains. Girls showed greater odds of avoiding child marriage and delaying pregnancy. Both boys and girls had improved school attendance, enhanced knowledge of HIV prevention, and higher use of modern contraception. Communities with model households demonstrated stronger effects, suggesting that social diffusion and household-level engagement strengthened program impact. Overall, the program was associated with meaningful shifts in behaviors and norms that protect adolescent health.
Recommendations
Scaling the Health Extension Program should include deeper engagement with households and stronger community diffusion mechanisms, since these elements amplified improvements in adolescent outcomes. Future implementation should incorporate adolescent-focused components within routine primary health care, including tailored messaging and follow-up. Integrating the program with education and social protection platforms may further reduce child marriage and early pregnancy. Continued monitoring is needed to understand long-term effects and to guide investments in community-based health systems that reach adolescents effectively.
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