Family planning in Southern Ethiopia
Neil Lensink
April 1, 2011
I had a chance in early March to visit the South Omo region of southern Ethiopia, where AMREF is helping the regional government set up a number of health posts. AMREF also trains the health extension workers - individuals with elementary or secondary education plus 6 to12 months of health training (this is one of the government's ways of dealing with Ethiopia's massive shortage of health professionals). As a keen monitoring and evaluation intern, I was visiting South Omo to help track activities at each post.
My visit to the AMREF health post in the South Ari area of South Omo was fairly typical. As soon as the health extension worker opens the doors, the room fills up with pregnant women, women with infants, and pregnant women with infants. The women are tired but smiling, and the kids are mostly healthy.
Ethiopia's fertility rate of 5.2 (and probably higher in this area) is problematic for a number of reasons. The first is the health of the women. Only 6% of births in Ethiopia are attended by a skilled health personnel (doctor, nurse or midwife). The annual number of deaths of women from pregnancy-related causes is 470 per 100,000 live births (or roughly 1 per 200). Many women will die during self-induced or back-street abortions. Then there is the health of babies, most of which do not receive proper care during birth or in the months following. Finally, the high birthrate is a major obstacle to poverty alleviation and development: most Ethiopian families can not afford 5-6 kids. If families are able to limit their children to 2-3, they might be able to afford better healthcare and education for all of them.
The health extension worker does a great job performing checkups and counseling the women. The really important work starts when she stands up and begins her lesson on family planning. In Ethiopia, only 15 per cent of women aged 15-49 use contraception. She teaches all the basics of sexual reproduction and contraception. This includes anatomy, condoms, pills, and more. The walls are covered with diagrams and pictures, and she also has props. The ladies ask questions and discuss the issues while trying to pacify their kids.
They also discuss the actual planning part. This is a challenge in the traditional societies of southern Ethiopia, where women often do not have a say in how many babies they have or when. So, AMREF helps train community mobilizers who encourage conversations about these difficult issues, and some of these community mobilizers are men. Involving both men and women is an important part of the family planning process.
Statistics are from Unicef (http://www.unicef.org/infobycountry/ethiopia_statistics.html).
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