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Improving Uptake of Sexual Reproductive Health Services in Afar Regional State of Ethiopia.

Tiruzer Ethiopia for Africa (TEA) aims to implement SMS Strategy to address poor uptake of SRHS in Afar Region of Ethiopia.

Photo of Ethiopia for Africa
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What specific problem(s) are you trying to address?

More than 90% of the population in Afar Region are pastoral and entirely depend on livestock keeping. In the recent years, the region has been hard hit by droughts and floods making them under develop and hard to reach. The literacy level is very low and gender equality is a thing of the future and women are vulnerable and have no voice at all. They still use traditional birth attendants, harmful cultural practices like female genital mutilation/cutting is widely practiced and the rate of maternal and neonatal deaths are high. Although the government has tried to avail health service facilities, the quality of the services provided are very poor and the demand for the uptake of modern SRHS is very low. They lack awareness on modern SRHS.

What are some of your unanswered questions about the problem(s) you are working to address?

Majority of the people in the region don't own memory chips and we lack enough financial support to provide these needed facilities and services especially to the adolescents and members of organized groups.

Explain Your Idea

We have 3 innovative strategies that are believed to encourage behaviors that promote healthy and appropriate SRHS-seeking behavior and eradicate those practices that are harmful among pastoral communities of Ethiopia. The strategies are social mobilization (S), money for women (M) and service quality promotion (S) which we refer to as SMS. Social mobilization strategy uses social groups of youth, women, religious leaders, teachers, opinion leaders, local officials to sensitize the communities on SRHS. These groups are trained and supported to serve as agents of change in their communities through local songs and role plays on issues of SRH, gender right, harmful traditional practices; record them on mobile memory chips and distribute to their peer groups using their mobile phones. The groups also link the communities with local health facilities. Money for women strategy aims to empower women economically and socially to improve their position and help them access needed SRHS of their own choices. through women-goat-saving groups in which the members are given goats on a revolving fund mechanism. Service quality promotion strategy aims to improve the quality of available health services through providing a number of competence building and motivational trainings to local health practitioners and advocating for an increase in the number of female health service providers as there are cultural barriers to the use of modern delivery through male birth attendants in the area.

Name the three most important ways that your idea will address your identified problem(s).

• It will improve individual, household and community behaviors and norms toward the uptake of SRHS and prevent the indirect causes of maternal mortality and poor health outcomes, which may include HIV and AIDS and harmful customary practices such as female genital mutilation/cutting and child marriage. • It will empower women economically and socially which will advance choices and respectful care of women by their respective communities and strengthen the integration of sexual reproductive health services with family planning. • It will improve the capacity and working conditions of SRHS care providers and consequently improve quality of access to and use of SRH services by the most vulnerable women and girls.

How is your idea unique?

One of the uniqueness of our strategy is the use of the local people in creating awareness among themselves. The organized groups also involves men as it is known that women issues are best addressed by involving men and the rest of the community. Our strategy uses bottom-up approach of community participation to avoid rejection risks by the communities. The use of mobile phone memory chips in distributing information is another unique part of our strategy. People especially the adolescents are more attracted by modern technology and by default they receive and share information on SRHS with others. Members of these groups usually get various forms of rewards based on their achievement records. The awards include but not limited to mobile phones, goats, vocational skill trainings, etc. Annually, 100 best achieving members are nominated for such awards based on criteria developed jointly with them.

What are some outstanding concerns or questions that you have regarding your idea?

How to replicate the strategy in other marginalized and pastoral regions of Ethiopia.

Who are your end users?

More than 15,000 people from the pastoral communities of Afar Region of Ethiopia will directly benefit from this strategy. These will include adolescent girls aged between 13-17 years, women aged between 18-40 years and their spouses. They will directly benefit from community conversation trainings which will change their attitudes towards positive uptake of the Sexual and reproductive services, income generating activities and access to quality SRHS delivery by the providers in the region. Other groups of men, teachers, religious leaders, opinion leaders and community leaders will also benefit from the tailored trainings offered to them. Approximately 55,000 people will benefit indirectly.

Where will your idea be implemented?

  • Ethiopia

What is the primary type of emergency setting where your innovation would operate?

  • Extreme drought
  • Community at risk of disaster

Tell us more about the emergency setting that you intend to implement in

Afar Region is frequently hit by extreme droughts and flooding. Residents are usually displaced from their homes. Due to the effects of these disasters, the region is generally under developed and hard to reach. The government has tried by availing the health facilities but the demand for uptake of the services is unsatisfactory. Women who use SRHS are punished by their communities since their culture doesn't allow that, traditional reproductive methods are still rampant and highly encouraged.

What is your organization's name?

Tiruzer Ethiopia for Africa (TEA)

Tell us more about you.

We are a non-governmental organization registered and operating in Ethiopia with qualified and committed staffs to implement this idea. For almost two years now, our team has been successfully implementing this idea and the outcome is great.

Organizational Characteristics

  • Youth-led organization
  • Locally/community-led organization

What is the current scale of your proposed innovation?

  • Community - 1+ communities within 1 country

Experience in Implementation Country(ies)

  • Yes, for more than one year.

Expertise in Sector

  • Yes, for more than a year.

Organization Location

We are registered and based in Addis Ababa, Ethiopia.

What is your organizational status?

  • Registered non-profit, charity, NGO, or community-based organization.

What is the maturity of your innovation?

  • Existing Prototype or Pilot: Tested a part of my solution with users and am iterating.


Attachments (1)

Afar Region Pastoralist women & Children images.jpg

Afar Region Pastoralist Communities way of life.


Join the conversation:


The SMS text via cellphone is good and great. Because, the girls and boys are very attractive by new and modern technology. So, it can be transferred valuable and key messages of SRHS in easy way. However, it need to consider the local language. As per my opinion and as member of this pastoral community it needs to think more and more the context of the Afar pastoral. Since, you are explained have a plan to establish men groups in order to address the gaps of men and women and boys and girls. These is too challenge during your implementation. Because, the girls and women are extremely shying to discuss with men due to cultural barriers, norms and beliefs of Afar. Therefore, it would be better to empower women and girls separately before going to join together with men. in a very simple example, when we conduct meeting both women and men the women's are dominated by men. But, the women seat together with out men they are freely participated and explained their ideas. As mentioned, i want to recommend you friendly to give attention for women and girls rather than men. However, you idea is look great and appreciable.

Photo of Ethiopia for Africa

We highly appreciate your comment. However, our initiative doesn't include SMS text via cellphone. Our initiative is referred to as SMS being acronym for Social mobilization, Money for women, and Service quality promotion. In the social mobilization strategy, we use organized youth groups called Youth Educators for Success (YES) to produce local songs and role plays on issues of Sexual and Reproductive Health, gender rights, Harmful Cultural Practices; record them on mobile memory chips, and distribute to their peer groups so that the youth will listen to the songs and role plays using their mobile phones. They record in their local language of Afar Oromiya. We also have separate groups of women called Be Model Woman (BMW) in the same strategy. The role of a BMW member is to act as a role model to convince another woman in her circle of influence to go to health centers and use SRHS and other health services available.