©2012 International Medical Corps Emergency SRH interventions in drought affected and food-insecure areas, Ethiopia From Relief to Self-Reliance IAWG annual meeting, Kuala Lumpur, May 31-June 01, 2013 Tenaw Bawoke – IMC Ethiopia

©2012 International Medical Corps Presentation outline Background Introduction Program Objective Program approaches Program findings/outcomes Limitations Next steps 2

©2012 International Medical Corps 1. Background Main RMNCH indicators of Ethiopia (2011 DHS) – MMR (per 100,000 live births) – 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 3

©2012 International Medical Corps 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.. 4

©2012 International Medical Corps 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  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 Now 5

©2012 International Medical Corps IMC RH intervention areas – blue highlighted 6

©2012 International Medical Corps 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. 7

©2012 International Medical Corps 4. Program approaches/strategies Facility based- supply side - Improve access to quality SRH services - Enhance capacity of Health Extension Workers (HEWs), health professionals and health managers Commu. Based- demand side - 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 8

©2012 International Medical Corps 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 9

©2012 International Medical Corps 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 10

©2012 International Medical Corps 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 11

©2012 International Medical Corps HEWs providing health education to pregnant mothers 12

©2012 International Medical Corps SRH FGD/CC conducted with female Adolescents 13

©2012 International Medical Corps CC in rural area 14

©2012 International Medical Corps ANC provided to pregnant mother by trained HW 15

©2012 International Medical Corps ANC provided to pregnant mother by trained HW 16

©2012 International Medical Corps FEFOL supplementation to pregnant mother 17

©2012 International Medical Corps 6. Limitations RH undermined during emergencies Trained staff attrition Sustainability – youth SRH programs 18

©2012 International Medical Corps 8. Next steps Ensuring sustainability Integrating MISP with primary health care and community based comprehensive SRH programs 19

©2012 International Medical Corps Thank You 20