Published in PLOS One on 2026-05-28, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Gizachew Tadele Tiruneh, Girma Tadesse, Alemnesh Mirkuzie Hailemariam, Yared Kifle, Tsegaye Shewangzaw, Bezawit Mesfin Hunegnaw, Getnet Alem, Nebreed Fesseha, Biruk Bogale, Gete Mekuria, Alemayehu Hunduma, Dessalew Emaway
Source: PLOS One • DOI 10.1371/journal.pone.0350270
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
In 2018, Ethiopia’s government digitized its Community Health Information System (eCHIS) to enhance Health Extension Program service delivery. However, the impact of eCHIS on health outcomes remains unclear. This study, therefore, examined the effects of eCHIS on the uptake of maternal and child health services.
A post-test-only, non-equivalent group household survey design was used, collecting data from July to August 2024 in rural communities with and without eCHIS. A stratified multistage sampling technique was employed to recruit respondents. A sample of 1,728 women of reproductive age (271 in eCHIS and 1,457 in non-eCHIS woredas), 1,118 women with children ages 0–11 months (188 in eCHIS and 930 in non-eCHIS), and 569 women with children ages 12–23 months (301 in eCHIS and 268 in non-eCHIS) were included in this study.
Propensity scores were used to match intervention and comparison communities based on women’s age, religion, parity, education, household wealth, distance to health facilities, and autonomy. A modified Poisson regression analysis, adjusting for covariates, was conducted to estimate the adjusted prevalence ratios (PR) for maternal and child health outcomes.
Modern contraceptive use was 66% in intervention areas versus 56% in comparison areas. Institutional delivery rates were 95% in intervention and 79% in comparison areas. In intervention areas, 94% of children received the first dose of the Pentavalent vaccine compared to 83% in comparison areas, while 85% and 68%, respectively, received the third dose. Adjusted analyses showed that eCHIS intervention areas had statistically significant increases in contraceptive use (13.0 percentage points; PR: 1.25; p-value < 0.01) and institutional deliveries (8.9 percentage points; PR: 1.18; p-value < 0.01) compared to comparison areas. Similarly, the average treatment effect of eCHIS on Pentavalent 1, Pentavalent 3, and full vaccination coverage showed significant increases of 10.3 (PR: 1.13; p-value < 0.01), 13.6 (PR: 1.26; p-value < 0.01), and 14.6 (PR: 1.36; p-value < 0.01) percentage points, respectively.
This study underscores the transformative potential of eCHIS in improving maternal and child health outcomes in Ethiopia. Sustained investment in digital health systems can help scale effective health care services to rural and underserved communities.
Background
Since 2003, the Health Extension Program (HEP) in Ethiopia has aimed to improve access to health services in rural communities by deploying trained Health Extension Workers (HEWs) to provide essential health services at the community level. The program has significantly increased access to maternal and child health services, particularly in rural and underserved areas [1,2], and has contributed to a decline in maternal and child mortality rates in Ethiopia [3,4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Gizachew Tadele Tiruneh, Girma Tadesse, Alemnesh Mirkuzie Hailemariam, Yared Kifle, Tsegaye Shewangzaw, Bezawit Mesfin Hunegnaw, Getnet Alem, Nebreed Fesseha, Biruk Bogale, Gete Mekuria, Alemayehu Hunduma, Dessalew Emaway. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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