Title

Emergency SRH interventions in droughtaffected and food-insecure areas, Ethiopia

From Relief to Self-Reliance

IAWG annual meeting,

Kuala Lumpur, May 31-June 01, 2013

Tenaw Bawoke – IMC Ethiopia

Presentation outline

•Background

•Introduction

•Program Objective

•Program approaches

•Program findings/outcomes

•Limitations

•Next steps

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1. Background

•Main RMNCH indicators of Ethiopia (2011 DHS)

–MMR (per 100,000 live births) - 676

–ANC (4+) – 19 %

– ANC (1+) – 43 %

–TFR – 4.4

–Institutional delivery (per 1,000 live births) – 10

–CPR – 29 %

–U5MR (per 1,000 live births) – 88

–IMR (per 1,000 live births) - 59

–NMR (per 1,000 live births) – 37

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1. Background ….

•Backgrounds of E & S Ethiopia

–Pastoralist & semi-pastoralist zones which arefrequently affected by:

•Malnutrition and food insecurity.

•In times of emergency, women and adolescentgirls are exposed to:

–Anemia, unsafe abortion, GBV/rape, HIV/STIinfection, un-planned pregnancy anddelivery complications.

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2. Introduction

IMC MISP intervention portfolio in Ethiopia (rapid and slowonset emergencies) – integrated with WASH & Nutritionintervens.

Slow onset emergencies

Drought-affected pops of Somali Region, Sep 2006 – Apr 2007

AWD affected comms of E & W Harrarge, May-Oct 2008

Drought-affected pops of Wolayita , Apr-Sept 2009

Drought-affected pops of Wolayita, Apr-Dec 2010

Drought-affected comms of E/H & Wolayita, Sept 2011 – Apr 12

Drought –affected comms of Wolayita, 2013

Rapid onset emergencies

Somali refugees in Dollo Ado refugee corridor, Aug–Oct 2010

GBV program in Dollo Ado refugee corridor, Aug 2010 - Now

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IMC RH intervention areas – bluehighlighted

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3. Program Objective

•Contribute to reduce excess maternal and adolescent girlsmortality and morbidity in drought-affected areas and refugesettings, through emergency RH, HIV and GBV responses.

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4. Program approaches/strategies

Facility based-supply side

- Improve access to qualitySRH services

- Enhance capacity of HealthExtension Workers (HEWs),health professionals andhealth managers

Commu. Based-demand side

- Enhance capacity ofcommunity volunteers/HealthDevelopment Armies(HDAs)/CC facilitators

- Enhance utilization of SRHinformation and services

Reduce effect ofthe crisis on SRH

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5. Program out puts/outcomes

•Major outputs and outcomes achieved during 2012 &2013:

–Needs assessments conducted in 48 health facilities

–100% of health facilities supplied with SRH medicines,supplies and equipment including RH kits as per the gapsassessed

–> 20 HFs got power using solar technology

–13 HFs got permanent water source

–100% of HFs supplied with Iron and Folic Acid (IFA)supplements

–Adolescent friendly services provided in health facilities

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5. Program out puts….

•50% health workers, HEWs and HDAs received training on

–BEmONC

–Gender and HIV/AIDS in emergency context

–Clinical management of rape survivors and referrals

–STI case management and

–ASRH in crisis settings

•Target communities received RH information including HIV/AIDS andGBV through edutainment, CC and IEC materials

•11, 283 pregnant women provided with Clean delivery kits (CDKs)

•4,000 women and girls supplied with menstrual hygienesupplies/dignity kits

•Organized youth got Audio-visual materials

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5. Program out puts….

•20 stretchers provided to community volunteers

•MISP interventions integrated with emergency nutritionand WASH interventions.

•The programs strengthened primary health care services toimplement MISP and improved community health seekingbehavior during emergencies

•MISP institutionalized with existing primary health careservices

•Stakeholders accepted SRH issues as part of humanitarianresponses

•Reduced effects of drought on the SRH condition

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•HEWs providing health education to pregnant mothers

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•SRH FGD/CC conducted with female Adolescents

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CC in rural area

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•ANC provided to pregnant mother by trained HW

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•ANC provided to pregnant mother by trained HW

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•FEFOL supplementation to pregnant mother

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6. Limitations

•RH undermined during emergencies

•Trained staff attrition

•Sustainability – youth SRH programs

8. Next steps

•Ensuring sustainability

•Integrating MISP with primary health care andcommunity based comprehensive SRHprograms

Thank You