araya-thesis

Introduction
Map 2 The Tigray region and its districts. mHealth Study districts are shaded in yellow.
Health
The major health problems of the country largely remain preventable communicable
diseases and nutritional disorders. Despite major progress in the health status of the
population in the last decade, Ethiopia’s population still faces a high rate of morbidity
and mortality and the health status remains relatively poor. Figures on vital health
indicators show a life expectancy of 54 years (53.4 years for males and 55.4 for
females), an infant mortality rate (IMR) of 59/1000, and an under‐five mortality rate
(U5MR) of 88/1000 in 2011, with more than 90% of child deaths due to pneumonia,
diarrhoea, malaria, neonatal problems, malnutrition or HIV/AIDS, and often a
combination of these conditions. In terms of women’s health, MMR has not shown any
decline and remains to be among the highest figures in the world, with 676 maternal
deaths for every 100,000 live births recorded in 2011 [11,12,16].
Health system
Since 2003, Ethiopia has been rigorously accelerating access to PHC through its
community based health extension program (HEP) and primary health centers. The
four‐level health system of Ethiopia is characterized by a primary health care unit
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