Mobile Technology Aids Ethiopian National WASH Inventory (NWI)

By Nadine Tatge

piles of paperEthiopia is making great progress in measuring access to water and sanitation as well as inventorying all water schemes in the country through the National WASH Inventory (NWI).

Previous data collection methods using paper-based surveys were extremely time consuming, involved huge costs, and had a high error rate.

That is why the Government of Ethiopia has piloted the new data collection method using smart mobile phones in one of Ethiopia’s nine regions, the Somali Region.

UntitledThe software used was developed by the Dutch foundation AKVO using the AKVO flow system. Despite battery charging and internet challenges in the region, the new technology has been proven successful. Trained enumerators would collect data from households and visit water points, entering the data directly into previously uploaded survey forms on the mobile phone.

Additionally, they save the exact GPS location of water points and take pictures of the water points. Huge amounts of data can be stored safely on mobile phones until the data is uploaded to a central online server (the cloud/dashboard). The transfer of data requires internet access through either a WiFi , 3G on the phone, or through a PC connected to the internet.

process flowEveryone with granted access to the cloud/dashboard can view the data, extract it in Excel sheets, visualise the data in pie charts and graphs and most importantly see the exact location of water points on maps.

The experience from the Somali Region has shown that the use of smart mobile phones for data collection is time saving, accurate and cost efficient. The Government of Ethiopia has therefore decided to upscale the Somali experience to the rest of the country with the goal of having updated access of data for the NWI until June 2015.

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A Day in the Life of a Well-fed Child: Ethiopia

By Frehiwot Yilma

AMHARA REGION, 05 June 2014 – Kossoye Ambaras is a small lush green village within Wogrea woreda in northern Gondar where it is relatively cold. Amarech Ashager, a 28 years old mother of two, is used to the weather as she lived her whole life here. At the top of her daily agenda is making sure that her family, especially her youngest son, Metages Birhanu of 9 months, is well fed.

Like many of the residents, Amerech does not rise out of bed before 7 a.m., as it is too cold to leave the house. She begins her day by breastfeeding Metages and cooking breakfast for the rest of the household. Her husband, Birhanu Tagel, is a businessman and her eldest son, Muluken, 10, is a third grader. After saying ‘good day’ to Birihanu and Muluken, Amarech will cook breakfast for Metages. Since he was introduced to solid food only three months ago, Metages eats exclusively porridge. Preparing highly nutritious porridge for a child is a technique that Amarech has recently learnt. The base of the porridge, the flour, contains various grains and legumes. For breakfast the added ingredient besides the flour is an egg and minced cabbage. As well as cooking the food, feeding the child to achieve best results is also a discipline. Amarech has learnt to feed her child while also playing and talking to him to keep him engaged.

It takes a village to raise a child

Health Extension workers in Amhara region provide preventive and curative health service to the community
Health Extension workers in Amhara region provide preventive and curative health service to the community ©UNICEF Ethiopia/2014

Amarech and other mothers in the village get support from Health Extension Workers (HEWs) on how to properly raise their children. Today, HEWs Habtam Dese and Yeshiwork Tesfahun are weighing the children in the village to monitor their health and development. They too receive assistance from Gebeyaw Alamerew, the woreda Nutrition and Child Health Officer. In a typical session with a HEW, a six-month-old child will receive a vitamin A supplement, while those aged above one year will additionally receive deworming tablets. With the support of UNICEF, this has become a routine service in the woreda.

Out of 18 children weighed by the HEWs , 16 are in the average weight range. Amarech is one of the happy mothers to learn that her son, Metages, weighs 8.6 kilograms, well in the range of a healthy baby’s weight. “I am so happy that he has gained a few more grams since last time,” she says, smiling. After weighing babies in the community, Habtam and Yeshiwork demonstrate how to make a child’s diet balanced and about the importance of using iodised salt. As the child-friendly food preparation simmers over a fire, the two mothers, whose children’s weight was under the average limit, get counselling on how to improve their baby’s weight. Gebeyaw believes the woreda has come a long way. “In previous years, there were up to eight children per month in Kossoye suffering from Severe Acute Malnutrition (SAM), but this year there have been no cases,” he says. “This is because we monitor the children’s growth and give counselling and other packages of support to the mothers at the earliest stage possible, as we did with the two mothers today.” When the food has finished cooking, Habtam and Yeshiwork let the mothers feed the warm nutritious preparation to their children.

Bridging the nutrition gap before sunset

Amarech Ashager breast feeds Metages Birhanu, 9 months old
Amarech Ashager breast feeds Metages Birhanu, 9 months old © UNICEF Ethiopia/2014

The afternoons in Kossye Ambaras are usually foggy this time of the season. Amarech has subsequently decided to do her laundry the following day and so turns to preparing dinner as well as other domestic chores. For Metages, she has a new menu in mind: adding mashed potatoes and carrots to the porridge. She says she will also never forget adding iodised salt to the food. “Habtam has told us that iodised salt is key to a child’s mental growth. She also told us that we have to put in the salt after the food is cooked and out of the oven so that the iodine does not evaporate with the heat,” she says.

Habtam is one of 38,000 government salaried HEWs currently providing nutritional and other support to mothers and children across all regions of Ethiopia. Development partners such as UNICEF are committed to support this initiative. “Nations will face critical bottlenecks to economic growth if a large proportion of their working-age people’s IQ and productivity are limited by under-nutrition,” says Dr Peter Salama, UNICEF representative in Ethiopia.

As the day draws to an end, Amarech’s house becomes lively as the family come together and discuss their experiences. While breastfeeding Metages, Amarech tells her husband about the importance of investing in their children’s diet to ensure their healthy future. “I will feed my children a variety of foods so that they will have a bright mind,” she says with confidence. “And I will be happy if Metages becomes a doctor.”

On the recent Micronutrient Global Conference (June 2-6, 2014), researchers, policy-makers, program implementers, and the private sector has been discussing ways of overcoming micronutrient malnutrition. The forum has been held under the theme of “Building Bridges”, thus emphasising scientific advances and multi-sectoral programming on adequate micronutrient intake. Read more

In Ethiopia, new programme to reach out to 403,000 vulnerable adolescent girls’ and boys’

Royal Norwegian Embassy donates NOK 100 million (USD17, 421,026) to adolescent and youth development in Ethiopia
Left to Right: Peter Salama UNICEF representative to Ethiopia, Ambassador Odd-Inge Kvalheim Royal Norwegian Embassy, Mr. Faustin Yao Representative of UNFPA in Ethiopia and Ato Berhanu Feyissa, Director General, Federal HIV/ AIDS prevention control office at the Grant signing ceremony “Royal Norwegian Embassy donates NOK 100 million (USD17, 421,026) to adolescent and youth development in Ethiopia” ©UNICEF Ethiopia/2014/Sewunet

ADDIS ABABA, 4 June 2014 – Today, the Royal Norwegian Embassy in Ethiopia announced a NOK 100 million (USD 17,421, 026 ) grant to  support the joint UNICEF and UNFPA programme on ‘Rights-based Approach to Adolescent and Youth Development in Ethiopia (Phase II – 2014-2017)’. The fund is divided equally between UNICEF and UNFPA and released independently to each agency on a bi-annual basis.

Under the programme, vulnerable adolescent girls and boys will gain improved access to an integrated youth-friendly services on protection and promotion of rights related reproductive health services, HIV/AIDS prevention services, and livelihoods. The funding will benefit 403,000 adolescents and youth aged between 10 and 24 in 30 selected woredas (districts) of six regions (Amhara, Oromia, SNNPR, Afar, Tigray and Addis Ababa City Administration).

His Excellency Ambassador Odd-Inge Kvalheim Royal Norwegian Embassy, speaks at grant signing ceremony
His Excellency Ambassador Odd-Inge Kvalheim Royal Norwegian Embassy, speaks at grant signing ceremony “Royal Norwegian Embassy donates NOK 100 million (USD17, 421,026) to adolescent and youth development in Ethiopia” ©UNICEF Ethiopia/2014/Sewunet

During the grant signing ceremony, the Royal Norwegian Ambassador to Ethiopia H. E Mr. Odd-Inge Kvalheim said, “Promotion of gender equality, women and children’s rights and human rights is key to fight poverty and promote sustainable development in Ethiopia. Promoting the respect and protection of human rights, is also a cornerstone of Norwegian Policy.” The Ambassador further stated, “The Government of Ethiopia, UNICEF, UNFPA and their partners have achieved good results in the first phase of the program. We will in particular encourage them to continue the good cooperation.”

This joint programme will be implemented in partnership and with active collaboration of various government and non-government partners. The Federal HIV/AIDS Prevention and Control Office (FHAPCO) and key sector ministries: Health, Education, Labour and Social Affairs and Women Children and Youth Affairs will play a pivotal role at all levels of the programme implementation. Furthermore, civil society organizations (CSOs), and community based organizations (CBOs) will be active implementing partners.

The Director General of FHAPCO Ato Berhanu Feyissa said, “The collaborative achievements witnessed with Norwegian Embassy, UNICEF and UNFPA gives us an encouragement that together we can ensure reduction and prevention of new infections among young people. Our common goal is to achieve an AIDS-free generation and ultimately end the AIDS epidemic among our society.”

The joint programme aims to improve the capacity of government and non-government institutions as well as youth-run organizations to fulfil the demand of adolescents and youths in the selected 30 woredas. It will also empower communities and parents to ensure a protective and enabling environment which includes protecting them against gender-based violence, Harmful Traditional Practices (HTPs) and violation of their reproductive rights.

Mr. Faustin Yao Representative of UNFPA in Ethiopia speaks at a grant signing ceremony
Mr. Faustin Yao Representative of UNFPA in Ethiopia speaks at a grant signing ceremony “Royal Norwegian Embassy donates NOK 100 million (USD17, 421,026) to adolescent and youth development in Ethiopia” ©UNICEF Ethiopia/2014/Sewunet

Mr. Faustin Yao, UNFPA Country Representative to Ethiopia, on his part noted, “The programme, through provision of sexual and reproductive health information and services, will empower young girls and boys to be able to make informed decisions for themselves and their families.”

In line with rights-based programming approach, disadvantaged adolescents and youth are recognized as key actors in their own development utilizing Sexual Reproductive Health (SRH) and HIV/AIDS prevention services rather than as passive recipients of information, skills, and services.

Building on the experiences gained from the previous joint programme (2007- 2013), the phase II joint programme will provide services on SRH and HIV/AIDS services through youth centres, health facilities, and educational institutions so that adolescents and youths can ultimately make healthy decisions for themselves.

“We commend the Royal Norwegian Government for supporting the Government of Ethiopia, UNFPA and UNICEF to sustain the gains made so far.  UNICEF is firmly committed to enhance the development and protection, care and support of adolescent and young people,” said Dr. Peter Salama, UNICEF Representative in Ethiopia.

Health Extension Workers: Key to Reducing Malnutrition in Ethiopia

Eneayehu Beyene and Tena Esubalew, helth extention workers Amhara rigion of Ethiopia.
Eneayehu Beyene and Tena Esubalew, Health Extension Workers in Delma kebele of Machakel woreda Amhara region of Ethiopia. Preparing their monthly report on community based nutrition activities to submit to the health. ©UNICEF Ethiopia/2014/Tsegaye

AMHARA REGION, 3 April 2014- Tena (meaning health in Amharic) Esubalew, 25, and Eneayehu Beyene, 27, are the heroines of Delma kebele as they have become the health confidants of the community. Delma Kebele (sub district), which is located in Machakel woreda (district) in the Amhara Region in northwest Ethiopia. Delma is a community 10 kilo meter from an asphalt road with a population of 4,733. As part of the EU funded Africa Nutrition Security Project (ANSP), UNICEF launched a community health programme (2012-2015) in 20 districts across three regions of Ethiopia to help the Government boost the nutritional status of children under two in communities like Delma where child malnutrition has been alarmingly high.

Key to the programme’s success has been the role of community Health Extension Workers (HEWs). From Delma, Tena  and Eneayehu have received intensive training with the support from UNICEF on nutrition so they can effectively carry out health extension duties.

“It is clear to us that three years ago no-one in this community could identify if a child was malnourished or not, this problem has been recently solved through the programme’s awareness strengthening on nutrition,” says Eneayehu

Breast Feeding-Tena Esubalew Health Extension Worker coaches Etenesh Belay positioning of the child for effective breast feeding
Tena Esubalew Health Extension Worker coaches Etenesh Belay positioning of the child for effective breast feeding Amhara rigion of Ethiopia. ©UNICEF Ethiopia/2014/Tsegaye

Eneayehu and Tena spend most of their days walking between households in Delma, visiting young mothers in the community and engaging them about the importance of child nutrition. They are trained to identify mild and moderate malnutrition and also growth faltering – based on which they provide age-tailored counselling. Additionally, they can diagnose if a child has Severe Acute Malnutrition (SAM) with or without complications. If a child is suffering from SAM with complications then the health extension workers will quickly have them referred to a health centre in the nearest town.

The health post where Tena and Eneayehu  work is  situated on top of a hill surrounded by open fields and grazing livestock. It is a busy hub frequented by the community’s young mothers, who are eager to learn about their children’s health status. The walls are plastered with graphs charting the health and development of the community’s under-five children. It is here that growth monitoring of all the community’s children under-two-years is conducted on a monthly basis and compared with World Health Organisation growth standards.

Breast Feeding-Yedeneku Aynalem 38 with her son Barkelegn 10 month
Yedeneku Aynalem 38 with her son Barkelegn 10 month, who is benefiting from community based nutrition Machakel woreda Amhara region. ©UNICEF Ethiopia/2014/Tsegaye

Yideneku Aynalem, 38, reaches up to a mud shelf in her hut and retrieves an illustrated booklet. “This is a very important document”, she says carefully opening the page to reveal a colourful chart. The HEWs have distributed  the materials printed with the support of UNICEF throughout the community to enable lactating mothers to track their child’s weight. Yideneku points to a graph and traces with her finger a green upward curve signifying the trajectory of a healthy child’s development based on optimum height and weight measurements. She explains with a smile how her 10 month old child Barkelegn Walelign’s growth has started to correlate with the green line on the chart. “I have been given the knowledge and it is now my responsibility to keep putting this learning into action so that my child can remain strong and healthy”, she says. Yidenku’s child is one of 270 children under-two years of age that have benefited from the EU-UNICEF supported package of high impact interventions in Delma.

The community results are encouraging: the rate of underweight young children has reduced from six per cent to one per cent in two years. “At the start of the programme, six children in the village were diagnosed with Severe Acute Malnutrition (SAM) – this year only two children suffered this extreme health condition”, says, Tena.