The HSEP is an approach that brings healthcare down to the household level. It has been designed to provide a number of health packages which are categorised under four main topics: Disease Prevention, Family Health Service, Hygiene and Environmental Sanitation, and Health Education and Communication. These packages (Box 1.3) have been developed to tackle the main health problems of the country, such as TB, HIV/AIDS, malaria, and maternal and child health, in order to be able to achieve the Millennium Development Goals which the country aspires to achieve by the year 2015 (the year 2008 in the Ethiopian calendar).

Box 1.3 Health Service Packages for the Health Service Extension Programme

Disease Prevention and Control. Under this component the most dominant communicable diseases are addressed.
1. TB, HIV/AIDS and other STI prevention and control.
2. Malaria prevention and control.
3. First aid and emergency measures.
Family Health Service.
1. Maternal and child health.
2. Family planning.
3. Immunization.
4. Adolescent reproductive health.
5. Nutrition.
Hygiene and Environmental Sanitation.
1. Excreta disposal.
2. Solid and liquid waste disposal.
3. Water supply and safety measures.
4. Food hygiene and safety measures.
5. Healthy home environment.
6. Control of insects and rodents.
7. Personal hygiene.
Health Education and Communication. This is part of all the packages.

Have a look at the packages that are part of the HSEP and which are set out in Box 1.3. If you are a Health Extension Practitioner working in a rural area, on which of these packages do you think you should concentrate most of your time and resources?

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The whole idea of HSEP is that all these packages are of importance. In any particular area the balance of resources that are put into different packages will be slightly different. The priorities for each area will be decided by the health problems that are found in that area and will be determined after discussion with the local community (Figure 1.5).