Ethiopia
Ethiopia is the second most populous country in Sub-Saharan Africa and sixth least developed country in the world. While diversifying Ethiopia’s exports from a reliance on coffee alone has been economically beneficial, the recent global economic crisis as well as recurrent drought and other natural calamities continue to inhibit the country’s economic development. Initiatives to address widespread poverty have led to increased primary school enrollment, expanded access to clean water, and significant reduction in child mortality. Despite these advances, more than one out of every three Ethiopians lives in absolute poverty.
Ethiopia is also one of the least urbanized countries in the world with only 16% of the total population living in the urban centers. This lack of access to urban facilities results in inadequate access to medical centers, which contributes poor health care and a low life expectancy of 49 years.
Traditional women in Ethiopia follow strict societal roles that include raising children, cooking and a lack of decision making. Women are often subjected to female genital mutilization, early marriage, rape and domestic abuse. The 2009 Global Gender Gap report ranked Ethiopia a low 122 of 134 countries, depicting their inability to divide resources equitably between genders. This large gender inequality has a dramatically negative effect on the health of women and children.
Unmet Need for Family Planning
Early marriage is the norm in Ethiopia; 49% of women are married by age 18, and in some regions of the country half are married by age 15. Girls who are married are expected to bear children as soon as possible, contributing to the epidemic of pregnancy complications in Ethiopia, where rates of maternal mortality and morbidity are among the world’s worst.
Until recently, the policy environment for population and reproductive health was favorable, enabling most reproductive health organizations to expand services in Ethiopia. This resulted in increased use of family planning services and the establishment of various institutions and forums, including the Consortium of Reproductive Health Associations (CORHA) and the Reproductive Health Advocacy Forum. These organizations, in collaboration with the Ministry of Health, have designed and adopted the following strategies to expand family planning services to the population:
- Integrating family planning services into other reproductive health services at all levels
- Training and deploying health extension workers in every kebele (local government unit) to expand family planning services
- Social marketing to promote contraceptives, create awareness about HIV/AIDS and encourage family planning
- Community and market-based distribution of contraceptives through health extension workers and Community Based Reproductive Health Agents (CBRHAS)
- Media advocacy to disseminate family planning and reproductive health information
Additionally, there has been a shift to emphasize girls’ education especially in secondary and higher institutions which will also positively impact reproductive health outcomes.
Leading for Change
Over 411 Ethiopian Leadership Fellows have participated in various training programs over the span of the LDM program. To strengthen local leadership development programs, and to address the needs of Leadership Fellows whose limited English proficiency has made it difficult to participate in international workshops, LDM designed and implemented leadership development workshops in the Ethiopian language of Amharic. These local programs enabled LDM to expand the network, reaching more women and young leaders who otherwise would not have had access to leadership development training. These local trainings also paved the way for Ethiopia’s National Task Force on Population/Reproductive Health (POP/RH) to continue to implement leadership programs and replicate them on a wider scale. Both locally and abroad, Leadership Fellows have participated in unique opportunities to gain skills and knowledge to improve reproductive health options in Ethiopia. Some of these opportunities have included:
- Facilitative Leadership training
- Presentation skills training
- Advocacy training
- Refresher training in leadership
- Women’s leadership training
Employing new approaches of leadership development and increasing emphasis on youth leadership were major achievements for the LDM program in Ethiopia. For example, the strategy of bringing in several participants from an organizations’ top and mid-level management provided the trainees with unique opportunities to assess and reflect back on their organizations. Moreover, the training was designed in such a way that the trainees took time to internalize and practice what they learned. It has also paved the way for improved communication within organizations and exposed participants to new methods and approaches that they can utilize together.
Many Leadership Fellows have become facilitators of leadership development trainings. They recognize the need for adopting new methods to analyze and explore practical solutions to the population and reproductive health challenges facing Ethiopia today.
In 2003, the Leadership Fellows in Ethiopia came together to establish a National Network of POP/RH Leaders. This network was eventually decentralized into regional networks. These networks conduct regular meetings, and collaborate on projects. One example of a collaborative project was the creation of a program on leadership and sexual reproductive health for Marie Stopes International.
LDM Ethiopia focused on three key strategies to sustain its impact after LDM’s completion in 2011:
- Ensured that the LDM models of leadership training will be replicated by organizations like Family Guidance Association of Ethiopia (FGAE), the German Population Program (DSW), and PACT International Ethiopia
- Expanded the Youth Organization Leadership Program (YOLP) to youth clubs
- Promoted the National Task Force’s continual development of new leaders working in family planning and reproductive health
Sources:
- The World Bank (2009)
- Population Reference Bureau (2009)
- Wikipedia (2009)
- Ethiopian census (2007)