Determinant of Health Professional Participation in Rural Health Extension Service at Nyinenyang Primary Hospital, Makuey District, Gambella Region, Ethiopia

Abstract Background Health extension services are vital components of primary healthcare systems in rural and underserved areas where access to medical facilities is limited. Therefore, this study aimed to determine health workers’ participation in rural health extension services in the study area. Methods This study was conducted at Nyinenyang Primary Hospital using a purposive sampling technique. The participants were selected via a stratified sampling method with both primary and secondary data sources. The study used structured questionnaires, focus group discussions, and interview guides for data collection. Data were analyzed via frequency, percentage, mean, and standard deviation as descriptive statistics. The chi-square test and independent sample t test were used to examine the relationships between health professional participation and the independent variables as inferential statistics. In addition, a binary logit model was used to analyze the factors influencing the participation of health workers via an econometric model. Results This study identified the major challenges that hinder health worker participation, such as a shortage of skilled workers (20.7%), inadequate infrastructure (16.1%), limited access to medical equipment and supplies (16.1%), low financial incentives (13.8%), and weak support and supervision (12.6%). The results of the binary logistic regression revealed a significant and positive influence of education level (p = 0.001), training received (p = 0.070), and professional cadres (p = 0.010), whereas workload was significant and negatively influenced health workers’ participation in rural health extension services (p = 0.033). Conclusion This study highlights the major challenges facing the involvement of health workers in rural health extension services, including shortages of skilled personnel, inadequate infrastructure, limited availability of basic medical equipment and supplies, absence of financial incentives, and inadequate support and supervision systems. The binary analysis results indicated that education level, relevant training, and professional cadre significantly and positively influenced participation. In contrast, an increased workload had a significant negative effect on health worker participation. These insights underscore the need for targeted interventions that address both systemic and individual-level barriers to enhance health professionals’ engagement in rural health programs.