Bringing Family Planning toEvery Doorstep
The Ethiopia Experience
![ethiopia_b[1]](data/images/img1.gif)
Meeting the FP Demand to Achieve MDGs: Vision 2015
BACKGROUND
Total Pop. = 76.9 million
Population Growth Rate = 2.6%
Rural Population = 83%
Pop. Under 15 = 44%
TFR = 6.4, 5.9, 5.4 (1990, 2000, 2005)
Unmet Need = 34%
CPR = 13.6% modern methods
CPR 4 regions = 29.3%(L10k Project)
MMR= 673/100,000
* DHS 2005, Census 2007
Ethiopian Population 1900-2020(Past, Present, Future)
Trend in Current Use of Modern Contraceptive Methods byMarried Women of Reproductive Age, L10K Areas byRegion, 2005-2009
Acceleration to reach MDG 4
CONCLUSION: Cannot do business as usual!
Health Extension Program (HEP)
•33,000 health extension workers (98% female) withone year of training, paid by government (2/5000people)
•Supported by voluntary community health workers,the HEP:
Empowers caretakers and produce model families,and communities
Institutionalizes and standardizes “village” healthcare delivery linked to PHCU
Increases access and utilization of promotional,preventive, and essential curative care services
Reduces opportunity cost for families; enhancesparticipation.
Family Health (5)
Disease Prevention
& Control (3)
Hygiene &
Environmental
Health
(7)
Health Education
& Communication
(1)
MCH
FP
Immunization
Nutrition
Adolescent Health
HIV/TB
MalariaFirst AID
Personal Hygiene
Water and sanitation
Food hygiene
Latrine
Solid & liquid waste disposal
Housing construction
Insects & Rodents control
HEP Components of HEP
16 HEP Packages
%
Case Story
Kuhar Michael Health Post inAmhara Region
•Prior to the HEP less than 50Injectable users from thenearby HC
•Took 1-4 hours to reach to HC
•Additional travel costs
•More waiting time at HC
•In 2 years time injectable usersin the HP increased to 398
•within maximum of 30 minutesreach to clients
•Limited opportunity costs andwaiting time
Implanon Insertion by HEWs
• TOT for 350 providers
• Rollout Training for 1189 HEWs
• 67% USAID supported
Lessons Learned
•Access to FP (particularly injectables andImplants) has increased by bringingservices closer to the people
•Task shifting through training anddeployment of HEWs
•Wide scale coverage brings nationalimpact
•HEP promotes women’s empowerment
•Promising practice: use of model families
•Public-private partnerships
Challenges
•Huge unmet need for FP requiring moreresources
•Training of all HEWs in the health post in theprovision of Implanon
•Sustainability of supplies of commodities andconsumables (particularly Implanon)
•New HEP supervisory structure needs moresupport
•Constraints with the monitoring andevaluation system
Way Forward
•Career development for HEWs (morediscussion at HRH section)
•Scale up training and service provision inLAFP
•Multi-sectoral (health, education, youth,women’s affairs ministries) support forAdolescent and Youth ReproductiveHealth
Way Forward (continued..)
•Strengthen YFS within the HEP
•Strengthen HEW supervision through supportof the HEW supervisor (Transport, training,better remuneration)
•Strengthen backup support from the HC to HPusing the principle of the PHCU.
•Strengthen public-private partnerships
