Study setting
The baseline data used in this analysis were collected from Ana Lemo and Gibe districts of Hadiya Zone of southern Ethiopia from September 15 to October 30, 2022. The two districts were purposefully selected based on the availability of functional MWHs. Based on the information we obtained from the Zonal health department, the total estimated population of the two districts was 265,000 in 2021. The two districts were divided into 52 clusters/kebeles (the smallest administrative units). One cluster has an average of 5000 population. There was one primary hospital, 10 health centers, 10 MWHs and 42 health posts in the two districts including two health centers and MWHs added from an adjacent district (Misha district). The livelihood of the population mainly depends on agriculture.