Emergency SRH interventions in drought affected and food-insecure areas, Ethiopia

1. 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

2. Presentation outline • Background • Introduction • Program Objective • Program approaches • Program findings/outcomes • Limitations • Next steps

3. 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

4. 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. .

5. 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, Sep2006 – Apr 2007 • AWD affected comms of E & W Harrarge, May-Oct 2008 • Drought-affected pops of Wolayita , Apr-Sept2009 • 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

6. IMC RH intervention areas – blue highlighted

7. 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.

8. 4. Program approaches/strategies

9. 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

10. 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 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

11. 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

12. HEWs providing health education to pregnant mothers

13. SRH FGD/CC conducted with female Adolescents

14. CC in rural area

15. ANC provided to pregnant mother by trained HW

16. ANC provided to pregnant mother by trained HW

17. FEFOL supplementation to pregnant mother

18. 6. Limitations • RH undermined during emergencies • Trained staff attrition • Sustainability – youth SRH programs

19. 8. Next steps • Ensuring sustainability • Integrating MISP with primary health care and community based comprehensive SRH programs

20. Thank You