WHO, UNICEF and Rotary International urge to sustain the polio-free status of Ethiopia

24 October 2017, Addis Ababa: Today, as the world commemorates World Polio Day, we, the World Health Organization (WHO), UNICEF and Rotary International, reaffirm our commitment to building on the success of our joint polio eradication efforts and sustaining the polio free status of the country.

Today, we are looking back at nearly three decades of concerted global polio eradication efforts. The Global Polio Eradication Initiative was created in 1988 after the World Health Assembly resolved to eradicate poliomyelitis globally and has since made remarkable progress towards reaching the eradication target. As a result, polio cases globally decreased by over 99 per cent from an estimated 350,000 cases in 1988, to only 37 reported cases in 2016. Furthermore, the number of countries with polio endemic decreased from 125 to only three countries – Afghanistan, Nigeria and Pakistan. However, until the polio virus transmission is interrupted in these polio endemic countries, all countries remain at risk of polio importation.

 

Nahom Alemseged gets a mark after receiving a polio vaccination
Nahom Alemseged get his finger marked after receiving a polio vaccination during a national campaign. ©UNICEF Ethiopia/2013/Sewunet

Ethiopia maintained its polio-free status for almost four years (45 months) after the last wild polio case was reported in Somali region in January 2014. We recognize that this achievement is a result of the effective leadership of the Federal Ministry of Health and the great partnership of polio eradication initiative collaborators, donors and partners including: Rotary International; Bill and Melinda Gates Foundation; WHO; UNICEF; USAID; CDC; CORE Group; and many frontline health workers who have played a key role in the successful fight against polio. 

We are committed to building on the recommendations which Ethiopia received from the Africa Regional Certification Commission (ARCC) in June 2017 when Ethiopia’s submission of a national polio free status report was accepted. As such, we will strive to strengthen and maintain routine immunization and surveillance with a particular focus on pastoralist communities, refugees, hard to reach and border areas as well as strengthening outbreak preparedness and coordination, cross-border surveillance with Somalia and others.

The theme for this year’s World Polio Day in Ethiopia is Commending Ethiopia polio free status, sustaining the gain.While we celebrate Ethiopia’s polio eradication success, we remain committed to continuing our joint polio eradication efforts in order to sustain this incredible achievement. In particular, we will build on the lessons learned as we strive to achieve regional certification.

The Polio Eradication and End Game Strategic Plan, developed by the Global Polio Eradication Initiative, envisages a polio free world by 2018. While we have come very close to achieving this goal, much remains to be done. We would like to call on all stakeholders to renew their commitment to a world which is free of polio.

 

Sweden Signs an Agreement with UNICEF to Build an Integrated Safety Net System for the Most Vulnerable Women and Children in Ethiopia

The Government avails US$ 9.2 million contribution to implement the programme in five years

12 October 2017, ADDIS ABABA – The Government of Sweden provided US$9.2 million to UNICEF Ethiopia to support a national integrated safety net system for the most vulnerable women and children in both rural and urban parts of the country. The initial phase will provide direct cash support to 1,000 households in Amhara region and 1,000 households in Addis Ababa with the objective to scale up innovations for the 8 million Rural Productive Safety Net Programme (PSNP) beneficiaries and the envisaged 4.7 million urban poor who are going to benefit from the Urban PSNP. The programme will be implemented from 2017 to 2022.

The objective of this programme is to implement nationally appropriate social protection systems and measures which ensure increased access to a comprehensive package of social protection interventions and services to poor and vulnerable citizens coping with social and economic risks, vulnerabilities and deprivations. It also aims to strengthen the Government’s capacity to develop, implement, coordinate and monitor a national, child-sensitive social protection system in the country.

At the signing ceremony, H.E Mr Torbjörn Petterson, Ambassador of Sweden to Ethiopia said, “In spite of existing challenges, it is impressive to see strong government commitment, financially as well as technically, to support the Productive Safety Net Programme (PSNP). Partnering with UNICEF in this particular endeavour, gives us leverage in terms of significant experience with previously supported pilot programmes which helped inform the design of PSNP 4.”

The first joint pilot project supported by UNICEF in Tigray, which MoLSA implemented between 2012-2015 together with the Tigray Bureau of Labour and Social Affairs (BoLSA), was guided by a rigorous evidence generation plan and demonstrated the role of community care structures and social workers. As a result, community care structures and social workers have since become crucial components of the national social protection system – a major milestone towards establishing a countrywide social welfare workforce.

Ms Gillian Mellsop, UNICEF Representative to Ethiopia and Mr Torbjörn Petterson, Ambassador of Sweden to Ethiopia signing the grant agreement. ©UNICEF Ethiopia/2017/Demissew Bizuwerk

“This timely contribution from SIDA will allow us to build on the rich experience of these successful pilot interventions. We are also expanding existing multi-sectoral linkages and will explore synergies between different public social protection measures, for example between PSNP and Community Based Health Insurance,” said Ms Gillian Mellsop, UNICEF Representative to Ethiopia. “We embrace this partnership with great enthusiasm since the outcome of the programme will extend beyond the pilot regions and further assist the Government of Ethiopia and UNICEF to develop a nationwide social protection system that is child sensitive and which prioritizes the most vulnerable and marginalized.”

Despite Ethiopia’s significant economic growth over the past decades, 32 per cent of Ethiopian children still live in poverty. Building an integrated and child sensitive social protection system, which focuses on those left behind, is a critical element in ensuring more inclusive development to the benefit of all children.

With the provision of access to an integrated social protection system in urban and rural areas, the programme aims to contribute to long-term poverty alleviation. In addition, the programme is expected to have a significant impact on the nutrition, health and education-related status of the target groups with a focus on adolescent girls. Furthermore, the proposed interventions will provide solid evidence to enable relevant government authorities to implement efficient and effective integrated social protection measures which will inform annual reviews of the social protection sector and future phases of national programmes such as the PSNP and the Urban PSNP.

 

Japanese Support to make reliable water sources available in Gashamo

By Ayuko Matsuhashi

Gashamo Woreda, Somali REGION, 6 September 2017 – What if you are told that the water you would have daily for drinking, cooking and bathing is rain-dependent and dries up into a muddy puddle during eight out of the 12 months of the year?

For the lucky ones, life without water is unthinkable. Sadly enough, this still remains a daily life reality in arid and semi-arid areas in Ethiopia.

A shortage of water in Somali region has been devastating due to the ongoing multi-year drought. While climate resilient water source development is a key to mitigate negative impacts of the drought, the majority of the population in Somali region is still dependent on seasonal water harvesting ponds. Farah Abdulahi is a 34 year old single mother of four who has become an Internally Displaced Person (IDP) in Gashamo IDP site from a village which is 15km away. “I came here because I have lost all of my 150 goats and sheep since the onset of the drought,” Farah said. Several hydro-geological complications and costly investments have prevented the WASH sector from actively investing in drilling a deep borehole in the region whereas surface water sources are highly vulnerable to drought and put people at a greater risk. “I used to fetch water from birkas*. But they all dried up because there had been no rain,” Farah describes her life in the previous village before she was displaced. “Thanks to the humanitarian aid providing water at this IDP site, we are barely surviving.”

Deep borehole drilling, Gashamo woreda, Somali region
Farah Abdulahi with her children in her temporary shelter in Gashamo IDP site
© UNICEF Ethiopia/2017/ Michael Tsegaye

Ahmed Hussein Brerale, 57 years old, is one of the community elders in Haji Dereye kebele (sub-district) near Gashamo town. As a long time resident of Haji Dereye, he has witnessed the dreadful decrease of water in the area and says, “There is no borehole in this area. We heard that the nearest borehole is 78km away and is the only potable water source in this large woreda (district). What we have here is only seasonal water sources like birkas. As the last two rain seasons failed, the available volume of water in birkas has significantly decreased. We are worried.”

Deep borehole drilling, Gashamo woreda ,Somali region
Ahmed Hussein Brerale telling us their difficult situation with water © UNICEF Ethiopia/2017/ Michael Tsegaye

In order to provide access to potable water for children and women such as Farah and her children, UNICEF Ethiopia has started drilling a new borehole near Gashamo town in partnership with a private sector partner with financial support from the Government of Japan’s emergency grant aid for the Middle East and Africa region for emergencies since August 2017. The drilling site was carefully located by using hydro-geological data from satellites in close collaboration with the Somali Regional State Water Bureau. According to the satellite data, the estimated depth of finding an aquifer is at around 500-600 metres. So far one-fourth of the planned depth has been achieved. Since there is no alternative safe and reliable water source in the area, this new borehole is going to be an ‘oasis in the desert’. Although this drilling work is one of the UNICEF’s emergency projects, in a longer term the project will also bring a sustainable solution for the area which is high vulnerability to climate change. The borehole is expected to provide clean water directly to 11,000 – 25,000 people in Gashamo town with a potential to indirect beneficiaries who are passing by from surrounding areas in search of water.

“I heard about the new borehole drilling. I am looking forward to seeing clean water. That has been always my dream to have clean water nearby in my life,” says Farah with a smile on her face.

UNICEF will keep working together with the regional water bureau to ensure that people who have been living without reliable water sources get sustainable access to potable water without interruption.

 

Deep borehole drilling, Gashamo woreda, Somali region
The drilling work is ongoing with support from the Japanese government near Gashamo town © UNICEF Ethiopia/2017/ Michael Tsegaye

 

 

*Birka – A traditional water harvesting pond which collects run-off water when it rains.

Ethiopia to Host the fourth Acting on the Call Conference of Ministers and Policy Makers on maternal and child survival

Media Advisory

What: The Ministry of Health will officially announce that Ethiopia will be hosting Acting on the Call conference of Ministers and high-level policy makers on maternal and child survival

When: Friday 18 August 2017, from 2:00 P.M – 3:30 P.M

Where: Ministry of Health, Addis Ababa Ethiopia

Who:
· H.E Prof. Yifru Berhan, Minister of Health, Federal Democratic Republic of Ethiopia
· Dr Ephrem Tekle, Director, Maternal Child Health and Nutrition Directorate, Minister of Health, Federal Democratic Republic of Ethiopia

Why:

Hosted by the governments of Ethiopia and India, 2017 Acting on the Call conference will gather around 500 participants across the world, including Ministers and high-level policy makers from both the public and private sectors from 24 countries. The organization of this conference has been supported by many partner organizations such as USAID, UNICEF, the Bill & Melinda Gates Foundation, NGOs as well as private sector actors. This conference has these objectives:
· Highlight successful approaches to increase the use of high-impact reproductive, maternal, newborn, child and adolescent health interventions (RMNCAH) with equity, quality and sustainability.
· Increase commitment from countries, private sector and NGOs to strengthen the system required to overcome the remaining key obstacles for maternal and child survival both within and outside the health sector.
· Demonstrate global commitment and continued the momentum to move forward towards the goal of ending preventable child and maternal deaths.

Menstrual Hygiene in Ethiopia – the Importance of Including Boys in the Discussion

By Jane Bevan and Kalkidan Gugsa

ADDIS ABABA, 30 May 2017 – Daniel Worku, a 12-year-old from Sheno Primary School in Oromia region, admits he did not know much about menstruation and thought it only an issue for girls and women to discuss. “The [menstrual hygiene management (MHM)] education in the school helped me to know more about it and how to be supportive of girls. I am a member of the MHM club, motivating my peers, particularly boys to be part of it too.”

Daniel and three courageous female students were telling their MHM experiences to a crowded room of health sector and development partners in Ethiopia. The advocacy event was held on global Menstrual Hygiene Day and organised by the Ministry of Health, in partnership with UNICEF and other MHM partners – Splash, WaterAid, SNV, Care and World Vision.

IMG_0781
Left to right: Daniel Worku, Hiwot Werka and Simret Hailu, students from Sheno Primary School in Oromia; and Zinebech Daniel from Bole Primary School in Addis Ababa share their experiences about menstruation during the Menstrual Hygiene Day event. ©UNICEF Ethiopia /2017/Tadesse

While menstruation is biologically a female issue, UNICEF’s recent knowledge, attitudes and practice (KAP) baseline survey of MHM in Ethiopia found that teasing from boys was a major reason that girls often skip school while menstruating, sometimes resulting in dropping out of school altogether. Thus, the involvement of boys in education about menstrual hygiene is key to improve understanding and reduce teasing, and thereby the retention of girls in school.

The KAP study found that over half of schoolgirls in Ethiopia knew nothing about menstruation prior to menarche, leaving them shocked and frightened and less than half of the girls in the county are taught about menstrual hygiene in school. The majority of adolescent girls never discuss menstruation with another person. On average, 11 per cent of girls miss school for reasons related to their periods – this is as high as 46 per cent in some regions. The main reasons for missing school were cited as pain/discomfort and teasing.

The study found there is a common misconception in Ethiopia that girls are no longer virgins because they begin menstruating and have been at times punished by parents who blame them for having sex or being raped if blood is seen on their clothes. These misunderstandings, in addition to teasing and bullying, cause girls to feel shame and isolate themselves.

“The girl who menstruates stays in a corner of the classroom or stays at desk until all classmates are gone because she does not want to be bothered by anyone,” said Hiwot Werka, grade 7.

Breaking the silence around menstruation and educating boys and men about this natural bodily function is seen as key by UNICEF to reduce harmful teasing. In schools, this includes male teachers’ awareness and sensitivity about MHM to ensure girls receive the support they need in school.

UNICEF Ethiopia’s MHM programme, funded by the Netherlands Government, began in 2016 and is piloting girl-friendly water, sanitation and hygiene (WASH) facilities in 96 schools across six regions. The facilities include more privacy, water for washing, safe spaces for girls to rest and change pads or clothes as necessary. The programme also developed and adapted educational material such as the Grow and Know booklet, a social and behavioural change tool which is being translated into local languages. The booklet targets girls, ages 10-14 years old and contains information on their changing bodies, including MHM.

A community-level component of the programme supports local women’s groups to produce reusable sanitary pads, which are sold to women and girls at an affordable price.

At the national level, UNICEF and partner agencies have worked closely with the Ministry of Health and Ministries such as Education and Women and Children’s Affairs to develop a national MHM guideline, which was also launched at the 30 May event. The guideline provides detailed guidance about the role of stakeholders in supporting women and girls with MHM. It also provides standards, for example regarding MHM kits for schools. The WASH Facilities in Schools construction manual is also being revised by the Ministry of Education to incorporate MHM facilities.

IMG_0728
Launching the national MHM policy and implementation guideline on Menstrual hygiene management day: “Let us break the silence about menstruation”, Capital hotel, 30 May, 2017 (Left to right: Dr. Zufan Abera, Ministry of Health, Jane Bevan, UNICEF, Bethlehem Mengistu, Water Aid, )© UNICEF Ethiopia /2017/Tadesse

Through the initiatives described above, the aim of the UNICEF MHM programme is to improve girls’ attendance and retention in schools.  By promoting understanding of MHM and finding solutions to the challenges faced by girls in schools, the unnecessary silence surrounding menstruation may be lifted. Including men and boys in the discussion is a vital aspect of equalizing opportunities and improving the future for girls.

Promotion of Dietary Diversity for the Healthy Growth and Development of Children

By Esete Yeshitla

Sekota, AMHARA, 21 June 2017- Meet Netsanet, a strong and independent 25-year-old mother who is very self-assured; reminiscent of her name, which means ‘freedom’.

When we visit Netsanet in her house, it is a typical morning for her. First, she waters her home garden: cabbage, carrots, tomatoes and other vegetables. The seeds were provided by FAO with funding from the European Union through the woreda (district) agriculture office as a support for her family to have balanced meals. Her next task is feeding her chickens, from which she uses eggs for cooking and as a source of income. She sells eggs on Thursdays at the nearby Hamusit market. She then starts preparing breakfast. She takes fresh vegetables from her garden; a couple of eggs, milk, mixed grains and starts to cook the meal for her daughter.

Netsanet, preparing food as per lessons learned from health extension workers
Netsanet, preparing food as per lessons learned from health extension workers, at the woreda health post. Sekota woreda , Hamusit kebele ©UNICEF Ethiopia/2017/Nahom Tesfaye

Netsanet has two daughters, Mekdes age 5 and in kindergarten; and Tsige age 2. Netsanet explains the difference between her two pregnancies, birth and the girls’ first two years of life. “I had my first child at home, as we did not have awareness. I was lucky that I did not face any complications when I had her. If something bad had happened, I would have regretted it,” says Netsanet.

Back then, even when health extension workers insisted that women give birth at the health centre, it was embarrassing for most women. Netsanet explains, “Nowadays, even the wife of a priest gives birth at the health centre. We lost many of our sisters due to high blood loss during birth. I am grateful for the awareness we are getting now.”

Twice a month, they participate in awareness training at the health post, as part of a UNICEF-supported, European Union-funded programme called EU-SHARE. They also receive education on how to prepare balanced meals for young children under two years old, something Netsanet did not know how with her first child. She says, “I was younger, I only breastfed Mekdes when I had spare time as I was busy with house chores.” For her second daughter, she breastfeeds her 8-10 times per day. Netsanet says, “It makes my child strong and at the same time, it serves as protection against unwanted pregnancy.”

Netsanet has witnessed the results. “My first child was fragile and got sick regularly. I used to spend most of my time at the hospital or pharmacy. She was malnourished and at one point, I thought I would lose her. Thank God she was better after she started taking the [ready-to-use therapeutic foods] that was provided by the health post.”

Netsanet put into practice the education given to her about healthy nutrition with Tsige. She started to feed her food when she was six months old. She says, “We did not know that we can feed different vegetables to our babies.”

Netsanet and her husband have three plots of land allotted by the Government, which they use for harvesting crops. Netsanet says, “We do not sell what we produce. We use it for our consumption.”  In addition to selling eggs, Netsanet buys lambs, raises them and sells the sheep. She also buys grains from retailers and sells it for extra money. Netsanet adds, “So the money I get, I use it to buy other stuff.”

This is not the only work Netsanet has. She is also a member of the health development army (HDA), a strategic network the Government has galvanised to reach rural communities. As part of the Government’s intervention, health extension workers train women from the community to become HDA members and drive health-related behaviour change, including breastfeeding and child feeding practices, within their communities. Netsanet is a leader of five teams that each consist of five women- a ‘network’. Netsanet and five additional network leaders are supervised by a health extension worker.

Netsanet, feeding her tow year daughter porridge made of balance nutritional ingredients based on lessons from the wereda health post.
Netsanet, feeding her two-year-old daughter porridge made of balance nutritional ingredients based on lessons from the woreda health post; Sekota woreda, Hamusit kebele ©UNICEF Ethiopia/2017/Nahom Tesfaye

Mothers meet to discuss twice a month. They meet at the health post to demonstrate how to make food for children. They bring whatever food stuff they can find at home such as eggs, flour and milk, then they cook and feed their children.

The Government of Ethiopia has placed malnutrition high on both the political and the development agenda over the past decade. As a result, bold actions have been taken in health and other nutrition-related sectors, putting in place policies, programmes and large-scale interventions to significantly reduce malnutrition among the most vulnerable groups: young children and pregnant and lactating women.

The EU- SHARE project addresses gaps in implementation of the National Nutrition Programme while strengthening nutrition outcomes of major health, food security and livelihoods Government programmes. The primary focus is on the first 1, 000 days of a child’s life, in order to accelerate the decline in stunting.

Sekota is the woredas targeted by the project and has received support with an aim to enhance quality and uptake of nutrition services being delivered to the community. This is done through building the technical capacity of health workers, improving availability of nutrition supplies and sensitizing community members towards proper infant and young child feeding practices.

These interventions have a significant impact in the overall reduction of child malnutrition, especially through contributing to the improvement of nutrition and dietary diversification practices for adolescent girls, pregnant and lactating women, and children younger than five, just like Netsanet and her girls.

Child Birth Registration Sets Hope for Protecting Children’s Basic Rights

By Esete Yeshitla

MECHA, AMHARA, 09 June 2017 – Mulugeta Yetayew and his wife Yezena Adane, both in their early 40s, warmly welcome us inside their rustic one-room cottage which serves as a bedroom and family room for them and their eight children, as well as a grain storage.

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Mulugeta Yetayew, 43 and his wife Yezena Adane 40, pictured here with two of their eight children and a neighbour’s son, live in Mecha woreda, Amhara region. Only four-month-old Sindu Mulugeta has a birth certificate. ©UNICEF/2017/Michael Tsegaye

Mulugeta barely remembers the birth dates of his children. It is only baby Sindu Mulugeta, four months old, who was registered within 90 days of her birth. However, Mulugeta is able to tell his children’s ages. “My firstborn is 24, then 23, the third is 20, then 18, then 16, then comes 15, the next 13, then 4. The last is Sindu, she was born in February.” When Mulugeta and Yezena were growing up, there was no registration or certification of birth. Mulugeta and Yezena did not know the importance of recording their children’s age and consequently, their children did not receive basic immunizations at the appropriate time. Sending children to school at an early age is also not a common occurrence, in Mecha. Children were expected to help with household work or herd cattle. Receiving a modern education was considered a luxury, as supporting the family was far more important. It was also common for 14 or 15-year-old girls to be married.

With grief on his face, Mulugeta continued, “My firstborn did not get a proper education. He is now a daily labourer in the desert of Benishangul-Gumuz region.” Thankfully, it is different for his other children. Even though most of them started school at a later age, Mulugeta is determined to ensure his children receive an education.

Mulugeta is grateful for the sensitization conducted in Bachema kebele (sub-district). Awareness raising, social mobilization and demand creation for registration and certification services are interventions implemented by the Government to encourage birth registration and registration of other vital events.

UNICEF Ethiopia has supported the Government’s initiative through technical and financial contributions, as well as regular follow up and monitoring of implementation. “Even religious leaders are advising us to get our children get registered,” Mulugeta says before continuing, “Now everyone is neke,” which is slang in Amharic meaning, ‘people are conscious’.  Mulugeta continued, “We are going to make Semegne start school when she is seven. I hope that my children will be educated and have better jobs.”

Birth Registration in Amhara
Memeher Yitbarek Shegaw, an Orthodox priest in Merhawi city, West Gojam zone of Amhara region ©UNICEF/2017/Michael Tsegaye

As part of the community intervention, religious leaders and social structures are utilized to convey messages. Memeher Yitbarek Shegaw is a priest of the Ethiopian Orthodox faith in Merhawi city. Yitbarek explains, “In the orthodox church tradition there is a registration for birth and death. However, the city’s mayor invited us for discussion and convinced us that even if registration in the church is customary, the need to be registered according to the law is important and beneficiary for a child.”

Training was also provided to kebele leaders and religious leaders. Yitbarek says, “When parents come to us for christening, we encourage parents to get their children get registered.”

To improve the coverage of birth registration, UNICEF is supporting the Vital Events Registration Agency (VERA) and the Regional Health Bureau to integrate birth registration into maternal and new born health services. This integration alerts kebele registration centres when births happen in health facilities.

Systematic registration of vital events such as birth, death, marriage and divorce is new; previously registration only occurred upon request. Based on a 2014 Government law, VERA was created and training ensued for different Government bodies.

According to VERA, between August 2016 and May 2017, only 94,008 out of 669,008 births in Amhara, were registered. Furthermore, out of the total registered, 62 per cent are current (registered within 90 days of birth), 18 per cent are late (registered after 90 days but within one year) and 20 per cent are backlog (registered after one year from occurrence of birth).

The vital events registration programme is a key component of the Government’s efforts to support children and their rights. A birth certificate is fundamental to the realization of a number of rights and practical needs, including access to healthcare and immunizations, supporting timely school registration, enforcing laws related to child labour and securing a child’s right to a nationality, among others. With the nationwide VERA in place, Ethiopia will soon see all its children with a birth certificate, providing them one further step towards a better future.