Ministers of Water, Sanitation and Hygiene from around the world will meet in Ethiopia from 15-16 March 2016 to plan and prepare for the implementation of the Sustainable Development Goals (SDGs) related to sanitation, water and hygiene.
The meeting is organized by the Sanitation and Water for All partnership (SWA), and convened by UNICEF. SWA has over 100 partners, mostly governments, and works as a platform for encouraging and coordinating political dialogue and action around water, sanitation and hygiene issues.
“This meeting will be different from all other high level meetings organized by SWA previously, mostly because of the timing: it will be the first global meeting on these topics after the UN Member States agreed on the Sustainable Development Goals last September, “says Motuma Mukassa, Minister of Water, Irrigation and Electricity of Ethiopia. Mr Motuma also underscores that the SDG targets on water and sanitation requires a higher level of coordination, alignment and communication both at global and national levels.
Ethiopia is selected to host this meeting for its commitment to implementing innovative ways towards achieving universal access to sanitation, water and hygiene by coordinating different ministries, increasing sector funding and investing in the training of health workers. The country’s One WASH National Progrmame (OWNP), launched in September 2013, is one of the most ambitious in the sector. It is based on a sector-wide approach and involves the ministries of water, health, education and finance and the government’s main development partners. Ethiopia devises this programme to modernize the way water and sanitation services are delivered to its people. Recently, with UNICEF’s support, Ethiopia also started a South-South collaboration with Brazil in the area of urban sanitation and regulatory framework for WASH service delivery.
The Ministerial Meeting is a unique opportunity for countries to identify the major bottlenecks to achieving the SDG water, sanitation, and hygiene targets and lay groundwork for clear action plans, strategies and milestones.
High-level delegates, including the Prime Minister of Ethiopia, Hailemariam Desalegn, Kevin Rudd, Chair of SWA and the 26th Prime Minister of Australia and Anthony Lake, Executive Director of UNICEF will attend the meeting.
By Efa Workineh, CBNC Project Officer, Save the Children, Ethiopia; Tadesse Bekele, Regional Programme Manager, Save the Children, Ethiopia; Hailemariam Legesse, Health Specialist, UNICEF Ethiopia; Asheber Gaym, Health Specialist, UNICEF Ethiopia
Abuna Gindeberet Woreda is one of the eighteen woredas (districts) found in West Shoa Zone, Oromia Regional State, 182 km west of Addis Ababa, Ethiopia’s capital.
Baby Elias Suyum Belacho was born in Guro Furto health centre in Gartoke Kebele (sub district) of Abuna Gindeberet Woreda on September 20 2015. His mother, Shure Negasa and father, Suyum Belacho took good care of Elias, the fourth born in the family, even prior to his birth. During her pregnancy, Shure attended three Ante Natal Care (ANC) visits at the Guro Furto health centre. Unfortunately, she had not received the required post-natal visit schedule following her delivery.
When Elias was three weeks old, he attended the routine community based new-born care assessment provided as part of the community based new-born care programme of the national Health Extension Programme (HEP) package. (The HEP is a community health programme covering the whole of Ethiopia provided by two female community health workers (health extension workers) working at rural health posts, at present over 38,000 health extension workers are providing services in over 16,000 health posts across Ethiopia. The community based new-born care programme (CBNC) is one of the key public health interventions provided by HEP through extensive partner support. UNICEF is the major supporter of CBNC scale up in Ethiopia). Emushe Abebe, the health extension worker providing CBNC noted that Elias’ respiration rate was found to be 72 breaths per minutes in two counts; much higher than the upper limit of 60 expected at his age. During the assessment, Emushe asked Shure if she has noted any other symptoms that Elias has been showing recently. Shure explained that Elias had been coughing for the last two days. Thanks to her Community Based New-born Care (CBNC) training, the health extension worker correctly diagnosed Elias’ condition as new-born sepsis; a potentially lethal advanced infection in new-borns. In addition, she found out that Elias was underweight, which was caused by not enough breastfeeding. As per her CBNC training, she classified Elias’s condition to be very severe. Shure was not aware that she had to breastfeed at least eight times per day and because she did not realise that Elias was seriously sick, she never reached out for medical assistance.
After counselling by the health extension worker, Shure agreed to start the treatment at home immediately and to continue taking Elias to the health post. 48 hours after initiating the standardised (Chart Booklet) treatment with gentamicin and amoxicillin antibiotics, the HEW assessed the status of the child and found that he was rapidly improving. By now he was physically stable: he showed a lower breathing rate of 48/minute and he was breastfed more than 10 times a day. Following the seven days’ full course treatment, Elias completely recovered from his illness.
Elias’ mother Shure Negasa, who was not aware of her child being in life threatening condition, has promised to seriously take care for her new-born child and other children. From now onwards she will seek health care when ever needed and she will teach her neighbour’s what she experienced.
When Ethiopia along with 196 other countries signed the Millennium Declaration in New York in 2000, maternal and child health situation was bad for the majority of the population. Under five mortality rate – number of children dying before their fifth birthday from 1000 born alive- in 1990 (the beginning of measurements for the MDGs) was 222; one of the highest in the world. Many were sceptical that the country would achieve the targeted reduction of two thirds of the 1990 levels by 2015. Against all odds, the country has achieved child health target of the millennium development goals MDG 4 three years ahead of 2015 by reducing the 1990 child mortality rate to less than 68 child deaths per 1000 live births.
Clear health policy and strong implementation supported by coordinated international partnership; a large scale community health programme targeting rural villages through the health extension programme; sustained investments in health and sustained economic growth are among the reasons for this success story.
Highly appreciable as the improvements in child health are, an under five mortality rate of 68 translates to the unacceptable number of over 200,000 child deaths annually. More than 43 per cent of these child deaths occur during the first 28 days following child birth (the neonatal period) the majority occurring in the few days following birth. Breathing difficulties; premature birth and new-born infections/sepsis are responsible for the majority of neonatal deaths and most are preventable or easily treatable with currently available medical care. Access to health care is nevertheless essential to obtain the benefits of these lifesaving interventions. For the tens of thousands of new-borns born at home and far from health facilities, accessing these lifesaving interventions have been largely impossible.
To overcome this formidable challenge to access key new-born health interventions, Ethiopia in collaboration with its major child health partners including UNICEF has adopted novel public health interventions of ICCM/CBNC (Integrated community case management of childhood illnesses/ community based new-born care). ICCM/CBNC interventions rely on task shifting of key child health interventions responsible for majority of child deaths to community health workers who receive training on detection and treatment of key childhood illnesses at home or at village clinics (health posts). They also timely refer new-borns and older children with severe illnesses to higher level care.
The EU-ESDE (European Union- Enhancing Skilled Delivery in Ethiopia) project, allocated Euro 42 million for a three-year support to maternal and new-born health to Ethiopia from 2014-2016. The EU is one of the major partners for the national scale up of ICCM/CBNC programme in Ethiopia. Since its inception in 2013, the ICCM/CBNC programme has rapidly scaled up to increase availability of CBNC services in 75 per cent of the total health posts in the country. Key interventions of the programme include training and mentoring of health extension workers on key skills of detections of new-borns and infants with illness through clear symptoms and signs and provision of essential interventions including provision of antibiotics to sick new-borns.
Emushe Abebe, the HEW who provided the critical intervention that saved the life of Elias is one of the 2500 health extension workers who received training through EU-ESDE (European Union- Enhancing Skilled Delivery in Ethiopia) project support. She is saving lives of many children like Elias, and teaches mothers like Shure the importance of seeking health care.
UNICEF calls for ambitious action on climate change
PARIS, 10 December 2015 – Children are already paying a heavy price for the world’s inaction on climate change, UNICEF said.
“The future of today’s children, particularly the most disadvantaged, is at stake,” said UNICEF Executive Director Anthony Lake, speaking at an event at the 21st United Nations climate change conference in Paris, known as COP21. “Sadly, we are failing them. Because today’s children are disproportionately bearing the brunt of the effects of our changing climate. They are paying for our failure with their health and safety. With their futures. And too often, with their lives.”
A UNICEF report ‘Unless we act now – The impact of climate change on children’ points out that climate change brings more droughts, floods, heatwaves and other severe weather conditions, which contribute to the increased spread of major killers of children such as malnutrition, malaria and diarrhoea. The report also shows that over half a billion children live in areas where floods are extremely frequent, and thus are highly exposed to climate change. Many of those children are in countries with high levels of poverty.
“We can no longer allow our collective inaction on climate change to perpetuate a vicious cycle that condemns the most disadvantaged children to lives with little hope, at the mercy of disasters beyond their control,” Lake said.
In addition to cutting emissions, steps need to be taken to reduce inequities among children, Lake said, citing the need for investments in health and other essential services and in basic infrastructure that can withstand climate-related disasters.
“The path the world chooses here in Paris will indelibly mark humanity’s future,” Lake said. “History will judge us. And most importantly, our children will — and should — judge us for our stewardship of the planet they will inherit.”
Lake spoke at an event jointly hosted with the Organisation for Economic Co-operation and Development (OECD), which featured discussions amongst civil society and young people about ways to reduce the impact of climate risks on the most vulnerable children.
Wukro Town, situated in Ethiopia’s Tigray Region, received two Brazilian experts in the area of sanitary sewerage from 12 to 23 October 2015. The two officials from the Water and Sewerage Company of the State of Ceará (CAGECE), Fabiano Lira and Marcondes Ribeiro Lima, travelled to Ethiopia as part of the Trilateral South-South Cooperation initiative between Brazil, Ethiopia and UNICEF.
In the early 2015, a 2-year tripartite South-South collaboration has been developed between the Governments of Ethiopia and Brazil with the assistance of UNICEF Brazil and UNICEF Ethiopia. The theme is ‘urban sanitation and urban water’ and aims at strengthening Ethiopia’s water supply and sanitary sewerage services, directly benefitting Ethiopian institutions and, in the long term, the country’s urban population.
In 1960, less than 50 per cent of Brazilians lived in urban areas. By 2012, more than 85 per cent of Brazilians lived in urban areas. Africa is urbanizing at a similar rate, with Ethiopia having one of Africa’s quickest urbanization rates. According to the Ethiopian Central Statistics Agency, the urban population is projected to nearly triple from 15.2 million in 2012 to 42.3 million in 2037.
During their visit, the Brazilian officials provided key technical expertise in the development and finalization of the technical project to provide a pilot sewage network in a condominium of Wukro Town, as well as in the identification of a management system for the sewage network. Most of the condominium blocks in Ethiopia are not provided with treatment systems for the waste water produced by residents, whom are systematically exposed to severe risks related to the contaminated environment. The project will therefore contribute to the promotion of better health and quality of life for the residents of the town, with opportunities for expansion.
During the mission, Scoping and technical work was conducted in the field, where key data was gathered for the preparation of the project. The delegates, delighted by the warm hospitality of the people from Wukro, not too different from the semi-arid state of Ceará, presented the drafted project both to the residents of the condominium, requested to play a key role in the management of the proposed facility, local authorities and to Ethiopia’s Ministry of Water, Irrigation and Energy.
The project proposal was received positively by the Ethiopian Government and local population, signalling a productive first step in the cooperation agreement signed by both countries and facilitated by UNICEF Ethiopia and Brazil Country Offices. The next steps in the cooperation plan will be the building and implementation of the project in Wukro Town, alongside training of institutional partners and eventual expansion into other regions of the country.
Addis Ababa, Gonder, 17 September 2015 – UNICEF Ethiopia, in partnership with the Amhara Bureau of Women Children and Youth Affairs (BoWCYA), the Gonder City Administration Culture, Tourism and Sport Department and the Great Ethiopian Run, are organising a mass participation 5 km race in Gonder on Sunday 20 September 2015, and in Samara on 4 October 2015, to promote Girls’ Empowerment.
A total of 5,000 adults and 1,250 children are expected to participate in the running events, while over 10,000 thousand spectators are expected to attend the event and the messaging. Besides, two community outreach programmes are planned in both locations and expect to reach thousands. In addition, a photo and art exhibition and media roundtable discussion will take place on the eve of the race.
The two races will focus on themes relevant to each region. In Gonder, the focus will be on “Ending Child Marriage” while in Samara, the emphasis will be on “Ending Female Genital Mutilation/ Cutting (FGM/C).”
In Ethiopia, one in every five girls is married before the age of 18 and this practice is prevalent across all the regions. In Amhara nearly half of the girls are married before the age of 18 (44.8 per cent, EGLDAM, 2008). Nearly 60 per cent of cases of Female Genital Mutilation/Cutting is practiced in the Afar Region.
“UNICEF strongly believes that by 2025, Ethiopia will no longer have cases of child marriage, but this will only happen if we all work together – the government, civil society, religious and community leaders, women, men, boys and the girls themselves,” said Gillian Mellsop, UNICEF Representative to Ethiopia.
The event will be attended by high-level government dignitaries, representatives from the UN, NGOs, CSOs and members of the media. In addition, Abelone Melesse, UNICEF National Ambassador to Ethiopia, and renowned artists and sport personalities including Haregwoine Assefa and athlete Gebeyaneshe Ayele respectively (winner of the 15 km Dasani Road Race in Addis Ababa in June and winner of Millennium half marathon in Accra Ghana two weeks ago) will be attending the activities in Gonder to support the messaging around Girls’ Empowerment.
A joint EU-UNICEF programme reaches rural communities in Ethiopia to address undernutrition among mothers and children through monitoring, treatment and guidance.
GEMECHIS, Ethiopia, 24 August 2015 – Early in the morning, one-and-a-half-year-old Mikias Asnake laughs as his mother, Meseret Haile, bathes him at home in the Gemechis woreda (district), in the Oromia region of Ethiopia. Meseret is preparing to join a community conversation at the nearby Wolargi health post, to learn how to ensure the health of children and mothers in the community.
Meseret and her son Mikias are among approximately a million children and 600,000 pregnant and lactating women in four African countries (Burkina Faso, Ethiopia, Mali and Uganda) targeted by Africa’s Nutrition Security Partnership (ANSP). In Ethiopia, the focus is on 20 woredas in the Amhara, Oromia and Southern Nations and Nationalities Peoples (SNNP) regions. Ethiopia is nearing the end of a four-year national nutrition security programme supported jointly by the European Union and UNICEF, which builds on government-led efforts to reduce the rates of undernutrition among children under 5 years old and mothers.
With a population of more than 30 million people, Oromia is Ethiopia’s largest region, and more than 80 per cent of its residents live in rural areas. Health Extension Worker Binti Mohammed is one of those helping to improve infant and young feeding practices, as well as maternal and adolescent nutrition.
Key aspects of the community-based nutrition programme are monthly growth monitoring and promotion, community conversations, iron folate supplementation for pregnant mothers as well as promoting local complementary food production.
“Before the nutrition programmes started, there was a lack of awareness in the community,” Binti says. “Some people didn’t know they could feed their children well using locally available ingredients.”
Today, the Government’s Heath Extension Programme deploys more than 36,000 health extension workers, who provide community-based health promotion and disease-prevention services, mostly to people in rural areas.
Binti explains that women bring their children to the health post on a monthly basis for growth-monitoring sessions and nutrition counselling. If the child is doing well, Binti encourages the mother to continue feeding her child properly. If the child is moderately underweight or has not gained enough weight since the previous growth-monitoring session, she will counsel the mother on possible causes and solutions. Inadequate household food security, poor child feeding practices, inadequate access to sanitation and safe water, recurring drought and harmful social and traditional practices all contribute to malnutrition in Oromia.
Reflecting on the past situation, Binti notes, “There is a big change. Previously, if their children became malnourished, people would take them to traditional healers and wait until they were close to dying. They never took them to a health facility. Now, since we saved children here at the facility, people have started bringing malnourished children from every village to the health post.”
At the Wolargi Health Post, Meseret attends the dialogue with community members exploring best practices for feeding children in their community, followed by a practical demonstration.
“We started in the morning with a community conversation, and then the health worker showed us how to prepare nutritious food for our children,” she says. “We learned that the porridge should also include vegetables, because they’re good for the child’s health.”
The ingredients of the porridge include wheat, barley, sorghum, oats, lentils, beans, groundnuts, cabbage, milk, egg, potato, carrot, beetroot, iodised salt and oil.
“My plan, starting from today, is to feed my baby in a proper way, and to keep his mind bright, and to make him a good student, to help him have a good status in society in the future,” Meseret says.
Through the community-based nutrition programme, the project supports building the resilience of communities to food insecurity. It is also designed to strengthen the community’s ability to recognise the causes of malnutrition and to take action by making better use of family, community and external support networks. Since 2011, the number of underweight children participating in the programme has been halved.
Not so very long ago Ethiopia had one of the worst child mortality rates in Africa but it’s managed to slash the death toll by two-thirds, three years ahead of the Millennium Development Goal’s (MDG’s).
On a recent interview with CCTV, UNICEF Representative to Ethiopia, Ms. Gillian Mellsop, said “The key heroes in reducing child mortality by two third in Ethiopia are the 38,000, mainly women government salaried, health extension workers in addition to the political commitment and the vision of the government and sustainable funding.”
See the full programme which was aired on CCTV below: