Tenaw Bawoke , IMC: Emergency Sexual and Reproductive

Report
From Relief to Self-Reliance
Emergency SRH interventions in drought
affected and food-insecure areas, Ethiopia
IAWG annual meeting,
Kuala Lumpur, May 31-June 01, 2013
Tenaw Bawoke – IMC Ethiopia
©2012 International Medical Corps
Presentation outline
• Background
• Introduction
• Program Objective
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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 are
frequently affected by:
• Malnutrition and food insecurity.
• In times of emergency, women and adolescent
girls are exposed to:
–Anemia, unsafe abortion, GBV/rape, HIV/STI
infection, un-planned pregnancy and
delivery complications.
.
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2. Introduction
IMC MISP intervention portfolio in Ethiopia (rapid and slow
onset emergencies) – integrated with WASH & Nutrition
intervens.
 Slow onset emergencies
 Drought-affected pops of Somali Region, Sep 2006 – Apr 2007
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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 – blue
highlighted
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3. Program Objective
• Contribute to reduce excess maternal and adolescent girls
mortality and morbidity in drought-affected areas and refuge
settings, through emergency RH, HIV and GBV responses.
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4. Program approaches/strategies
Commu. Baseddemand side
Facility basedsupply side
- Improve access to quality
SRH services
- Enhance capacity of Health
Extension Workers (HEWs),
health professionals and
health managers
- Enhance capacity of
community volunteers/Health
Development Armies
(HDAs)/CC facilitators
- Enhance utilization of SRH
information and services
Reduce effect of
the 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 gaps
assessed
– > 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
©2012 International Medical Corps
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5. Program out puts….
• 50% health workers, HEWs and HDAs received training on
•
•
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– 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 and
GBV through edutainment, CC and IEC materials
11, 283 pregnant women provided with Clean delivery kits (CDKs)
4,000 women and girls supplied with menstrual hygiene
supplies/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 nutrition
and WASH interventions.
• The programs strengthened primary health care services to
implement MISP and improved community health seeking
behavior during emergencies
• MISP institutionalized with existing primary health care
services
• Stakeholders accepted SRH issues as part of humanitarian
responses
• 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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International Medical Corps
• ©2012
FEFOL
supplementation to pregnant mother
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6. Limitations
• RH undermined during emergencies
• Trained staff attrition
• Sustainability – youth SRH programs
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8. Next steps
• Ensuring sustainability
• Integrating MISP with primary health care and
community based comprehensive SRH
programs
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Thank You
©2012 International Medical Corps
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