Early Childhood Development- Investing in the seeds of tomorrow’s fruits

Gillian Mellsop, UNICEF Representative to Ethiopia

‘Children are today’s flowers and tomorrow’s fruit’ is a saying in Ethiopia and there is no better investment that cultivates the fruit and speaks to the ‘right in principle and right in practice’ mantra more than early childhood development.

Parents and communities want the best for their children and understand that the early years of a child’s life are crucial. However, they may not have the means or the knowledge on how to ensure their next generation best thrives.

Last week, the latest offering from the world-renowned Lancet, Advancing Early Childhood Development: from Science to Scale, showed that almost one in two – 43 per cent – of children under five in low-and middle-income countries are at risk of not achieving their cognitive potential. No country can risk losing nearly half of the brain potential of its youngest citizens – low- and middle-income countries least of all.

Advances in neuroscience show that experiences in early childhood have a profound impact on brain development and on subsequent learning and health. Children who are poorly nourished and nurtured, or those who do not receive early stimulation, are likely to learn less in school and go on to earn less as adults.

In Ethiopia, over 5 million children are stunted which has a serious impact on human development and economic growth. And currently, the most disadvantaged children in rural and hard to reach communities are either coming to grade 1 without having the necessary preparation or are enrolling late – under 40 per cent of children in Ethiopia have access to pre-school provision. Once in primary education, many are at risk of dropping out of school too early.

The good news is that early childhood development interventions, including parenting and care programmes, cost as little as 50 cents (US$) per child per year, when combined with existing services such as health – according to the Lancet Series. And much of what needs to be done at the community level can be achieved by mothers and fathers, grandparents, siblings and caregivers.

The findings in the Series underscore the importance of increased global dedication to early childhood development. Earlier this year, World Bank Group President Jim Yong Kim and UNICEF Executive Director Anthony Lake signalled a renewed commitment to prioritizing investments in the youngest children when they announced a new alliance urging global and national leaders to step up and accelerate action and funding for nutrition and early childhood development (ECD) programmes. The Lancet estimates that individuals who suffer a loss of about a quarter of average adult income per year, while countries may forfeit up to as much as two times their current GDP expenditures on health or education. Consequences of inaction impact not only present but future generations.

Drought response in Afar - UK AID
Zebiba Meher feeds her son Ready to Use Therapeutic Food (RUTF) for the past four months. Now the nutritional status of eleven-month-old Bedru has improved from severe to moderate acute malnutrition. He is a much healthier and happier child now. Dubti health center, Afar region, Ethiopia. 25-August-2016 ©UNICEF Ethiopia/2016/Ayene

When children have the opportunity to develop their cognitive capacity, they will pass similar or even better opportunities to their children when they grow up.  Increasing investment in Ethiopia’s young children can break the vicious cycle of intergenerational poverty.

Therefore, prioritizing ECD at the national level is a way for governments to stimulate economic growth. Evidence suggests that every dollar invested in quality ECD programmes brings a return of between US$6 and US$17. Moreover, research by

Nobel Laureate James Heckman found that the rate of return for investments in quality early childhood development for disadvantaged children is 7-10 per cent per annum through better outcomes in education, health, sociability, economic productivity and reduced crime.

This year, the importance of interventions in early childhood was also recognized by the inclusion of an ECD target in the Sustainable Development Goals – indeed, this is the first time ECD has been explicitly included in global development goals. SDG Target 4.2 aims to increase the percentage of children under 5 years of age who are developmentally on track in health, learning and psychosocial well-being.

For many children, lack of educational support at home is one of the biggest obstacles to reaching their full potential. In light of differing needs of families, a range of early childhood education services are offered in Ethiopia, including kindergarten, pre-primary class (‘O-class’) and several school readiness programmes. Parenting education programmes are also provided so families can learn about the importance of early nutrition, hygiene, care and stimulation.

The evidence presented this past week, combined with the current momentum globally, speaks for itself. We are well versed in the elements that affect the development of children’s brains – good nourishment, stimulated minds, and protection from violence. It is now vital that we use this growing body of evidence to effect real changes for children, at both the community and policy levels.

Early child development has to be put on the agenda for children’s rights. In Ethiopia, UNICEF, with the support from partners, takes an integrated approach to addressing early childhood development within Ethiopia’s Early Childhood Care Education Policy.

We owe it to our future generations to prioritize and invest in young children. It is our moral, economic, and social imperative to enable all children to reach their full potential.

After a harrowing journey, a bittersweet homecoming for Ethiopian migrant children

By Christine Yohannes

ADDIS ABABA, 29 June 2016–One year ago, 14-year-old Tesfaye* set off from his hometown of Hadiya in the Southern Nations, Nationalities, and Peoples’ Region of Ethiopia towards South Africa. Like many young people, Tesfaye sought what he thought would be a brighter future abroad.

Unfortunately for Tesfaye, his journey came to an abrupt halt after one month when he was arrested in Zambia. Along with 39 other Ethiopian children, he was charged under the Anti-Human Trafficking Act that prescribes a minimum mandatory sentence of 15 years for smuggling or consenting to be smuggled.

UNICEF- IOM partnership assisted voluntary returning children to Ethiopia
Tesfaye 15 and one of the youngest from the returnees is slowly readjusting to the possibility of reuniting with the family he had decided to leave behind. He is now finding relief in the piece of paper as he draws and writes his past struggles to be a living example to his peers who would consider a similar escape. UNICEF in collaboration with IOM returns children from third countries. Which is facilitated through a Cooperation Agreement signed between the two agencies since 2013 and renewed in 2016. This collaboration supports the Government of Ethiopia’s (GoE) Safe Return and Reunification Programme for Unaccompanied and Migrant Children. ©UNICEF Ethiopia/2016/Tsegaye

Although he was not yet 15 at the time, Tesfaye was tried as a 23-year-old because of the eight-year difference between Gregorian calendar used in most of the world, including Zambia, and the Julian calendar used in Ethiopia. Tesfaye was unable to explain the situation due to his limited English and was subsequently convicted and jailed in Mukobeko Maximum Security Prison in Kabwe, which houses adult criminal offenders,along with other children who had been detained.

A long  journey

In response to news of this detainment, UNICEF and the International Organization for Migration (IOM) worked together with the Zambian Human Rights Commission and Zambian officials to get the children released from prison and sent home. Following high level advocacy and personal commitment from IOM and UNICEF staff members, all 39 children were pardoned by the Zambian President.

IOM Zambia provided support to the Zambian authorities to ensure that protection assistance, including safe shelter and medical assistance was provided to all children once they were released from prison. Their first stop for these children once in Ethiopia is the IOM Assisted Voluntary Return and Reintegration (AVRR) Transit Centre, which is operated in close collaboration with UNICEF and the Government of Ethiopia, in Addis Ababa. The centre receives some 100 to 200 unaccompanied minors every month who have returned from other transit or destination countries.

UNICEF supports the Ethiopian Bureau of Women and Children Affairs with trained social workers to conduct documentation, family identification and reunification of the children. The social workers provide psychosocial support services at the transit center and accompany the children to their families, where they also provide a reunification grant to each child’s family.

Although Tesfaye is now safe in the IOM Transit Centre, he will not soon forget the ordeal he went through. He says, “I want to teach and raise awareness for others that might try to do this,” adding, “It should stop with me!”

Dreams cut short

Jacky* 17, also from Hadiya, was a straight-A student with big dreams for his future when he left home in search of better opportunities. “I do not blame my country for my decision to leave and for trying my luck in South Africa,” he says.

He recalls 25 days of travelling on foot, his subsequent arrest and confinement in a prison room shared with over 200 other detainees, going days without food and enduring brutality and theft.

“I sold my cow and my inherited share of my father’s land to pay for my trip, only to be arrested a 120km from my destination,” said Jacky. “I had high hopes for my future in South Africa but being exposed to deadly diseases in prison made me realize that it is worth striving for a better life in my own country.”

Home at last

UNICEF- IOM partnership assisted voluntary returning children to Ethiopia
UNICEF in collaboration with IOM returns children from third countries. Which is facilitated through a Cooperation Agreement signed between the two agencies since 2013 and renewed in 2016. This collaboration supports the Government of Ethiopia’s (GoE) Safe Return and Reunification Programme for Unaccompanied and Migrant Children. ©UNICEF Ethiopia/2016/Tsegaye

Harrowing as their stories are, at least Tesfaye and Jacky are home at last. Some children remain in Kabwe as they had come of age while in prison. The Zambian Human Rights Commission , with support from UNICEFand IOM, continues to work to enable the release of these children and their return to Ethiopia.

Going forward, UNICEF, in partnership with IOM, will support the Child Justice Forum and the Zambian Human Rights Commission to prevent this from happening to other children in the future. UNICEF will also extend its support by monitoring prisons and police cells to identify and help children in similar situations as there are reports of more smuggled and trafficked children; eight more children await trial on a similar accusation.

“I cannot say I have come [home] when half of me [more children] is still in prison” Jacky continued “ I have learned from my mistakes, so I would like to teach everyone about creating jobs in our lands.”

*Names of the children have been changed to protect their privacy

Ethiopia: Vital events registration launched

By Nikodimos Alemayehu and Marie Angeline Aquino

ADDIS ABABA, Ethiopia. August 2016 – Ethiopia launched throughout the country on 4 August 2016 a permanent, compulsory and universal registration and certification of vital events such as birth, death, marriage and divorce.

Vital events registration kicks off in Ethiopia
(L-R) Ms. Gillian Mellsop, UNICEF Representative to Ethiopia , H.E Ms Elsa Tesfaye, Director General of Vital Events Registration Agency (VERA), H.E Dr Mulatu Teshome, President of the Federal Democratic Republic of Ethiopia and H.E Mr Getachew Ambaye, Attorney General holds a symbolic certificate for birth registration. ©UNICEF Ethiopia/2016/Ayene

The inauguration ceremony took place in the presence of the Ethiopian President Dr Mulatu Teshome, UNICEF Representative Gillian Mellsop as well as representatives of other ministries and development partners.

“The Government of Ethiopia has given great emphasis to vital events registration across the country by putting the appropriate policies in place, establishing a system up to the lowest administrative level and deploying massive resources in this endeavor,” said Teshome at the ceremony. “I am confident that, with the collaboration and commitment of all stakeholders, we will succeed in the operationalization of the system, just like we have succeeded in other development sectors in the country.”

Mellsop underscored in her address the importance of the registry in protecting children and combatting child trafficking.

‘’With no proof of age and identity, Ethiopian children become a more attractive ‘commodity’ to a child trafficker, and will not even have the minimal protection that a birth certificate provides against early marriage, child labour, or detention and prosecution of the child as an adult.”

Ethiopia ranks among the lowest in sub-Saharan countries on birth registration with less than 10 per cent of children under the age of 5 with their births registered.

The issue is especially urgent because 48 per cent of the 92 million-strong population is under the age of 18 – 90 per cent of whom are unregistered. The Government has committed itself to reaching at least 50 per cent of children with registration and certification services over the next two years.

UNICEF’s support to Ethiopia’s national civil registration is based on a recognition that birth registration is an important element of ensuring the rights and protection of children.

For children, being registered at birth is key to other rights such as access to basic social services, protection, nationality and later the full rights of citizenship, including the right to vote. Moreover, not only is vital events registration essential for compiling statistics that are required to develop policies and implement social services, it is also, as Mellsop points out, “a pre-requisite in measuring equity; for monitoring trends such as child mortality, maternal health and gender equality.”

Inaugural ceremony of National Vital Events Registration in SNNPR capital Hawassa
One-month child Samrawit at a birth registration centre in Southern Nations, Nationalities and People’s Region (SNNPR) capital Hawassa August 6, 2016. ©UNICEF Ethiopia/2016/Ayene

UNICEF has supported the Government in putting in place a decentralized registration and certification system, which is informed by a legislative framework promulgated in August 2012.

UNICEF is a catalyst in creating this new system with support that includes the reform of the legislative framework, the development of a national strategy and its implementation across the country.

An important element of the Civil Registration and Vital Statistics (CRVS) system is its interoperability with the health sector. On this aspect, UNICEF has worked in collaboration with the Ministry of Justice and Ministry of Health in its efforts to formalize the interoperability, culminating in the signing of Memorandum of Understanding (MoU) between the two ministries.

The important of involving the Health Ministry is because it already has its own well organized and decentralized network stretching across the country. This arrangement allows the health facilities found in nearly every community to manage notifications of births and deaths.

The actual registration and certification of all vital events started on 6 August 2016 at the lowest administrative level of the kebele (sub-district).

With Ethiopia’s new conventional vital events registration system in place, there are better opportunities for accelerating vital events registration in Ethiopia, and realizing one of the fundamental rights of children – the right to be registered upon birth.

EU gives €3 million to improve the nutritional status of children in Ethiopia

Funds to reach over one million beneficiaries in Ethiopia 

Asmera Bere feeds her son, Amanuel Shibabaw, feeds to her child a nutritious porridge made from locally available products, at the health post as a demonstration to cook at home
Asmera Bere feeds her son, Amanuel Shibabaw, a nutritious porridge made from locally available products, at the health post as a demonstration to cook at home ©UNICEF Ethiopia/2014/Sewunet

ADDIS ABABA, 21 March 2016 – The European Commission today announced a €3 million grant to UNICEF to improve the nutrition for severely malnourished children in the drought affected areas in Ethiopia. 

The EU funding aims to strengthen the current emergency response and reach an estimated 40,000 Severe Acute Malnutrition (SAM) children. It will help provide supplies (40,000 boxes of Ready-to-use Therapeutic Food (RUTF) and 19,700 packs of amoxicillin). The funds will also support one round of Extended Outreach Strategy (EOS) screening which provides biannual vitamin A supplementation and de-worming to children under 5 years of age. Screening for acute malnutrition for children and pregnant and lactating women will also be covered.

“The El Niño phenomenon is impacting entire regions in Africa, notably Ethiopia. The EU support will help UNICEF provide life-saving assistance to the most vulnerable. It will help more than a million children suffering from malnutrition get treatment,” said Jean-Louis De Brouwer, Director of Operations in the European Commission’s Humanitarian and Civil Protection department (ECHO).

“We are grateful to the EU for its continued support for life saving interventions addressing malnutrition in Ethiopia,” said UNICEF Representative to Ethiopia, Ms Gillian Mellsop. “Children are always the most vulnerable group in emergencies but when support is made available, we can change their lives for the better.”

The EU funding targets close to half a million children under the age of five along with nearly 140 000 pregnant and lactating women in the Somali region. UNICEF, at the request of the Government, is responsible for the procurement of supplies for Severe Acute Malnutrition (SAM) management as a key input to the emergency nutrition responses throughout the country. It also provides technical and financial support to ensure programme quality and coverage. 

UNICEF is supporting the Government in responding to the emergency by scaling up and strengthening the treatment of children with severe acute malnutrition, increasing the intensity and frequency of screening of children and pregnant and lactating women, and ensuring key preventative nutrition services are provided to prevent excess morbidity and mortality.

According to the revised Humanitarian Requirement Document (HRD), over 10.2 million people in need of food aid and estimated 435,000 in need of treatment for severe acute malnutrition by the end of 2016. This has significantly devastated livelihoods and greatly compromised the health and wellbeing of children and women, through malnutrition and hygiene-related diseases across Ethiopia with six regions hit particularly hard.

Priests in Amhara advocate to End Child Marriage

Yazew Tagela and Degu Eneyew are both Priests of the Ethiopian Orthodox Church and members of the UNICEF supported Community Conversation Group against Child Marriage in the Bandani Kebele (neighbourhood) of the Dangla Woreda (district) in Amhara, Ethiopia.

Both are vehemently against child marriage, but come from different perspectives:

Yazew Tagela, 41, has directly experienced financial loss as a result of marrying his daughters as children.

Preist Yazew Tagel, member of the conversation group, regrets marrying his two young daughters at a very early age, having learned of the negative consequences of child marriage after the community advocates group was formed. Dangla Woreda, Badani Kebel
Priest Yazew Tagela, 41, has directly experienced financial loss as a result of marrying his daughters as children. He is a member of Bandani Kebele’s Community Conversation Group against Child Marriage, Amhara, Ethiopia ©UNICEF Ethiopia/2016/Mersha

Yazew Tagela comments: “If I had known before what I know now, I could have helped save so many girls. I married both my daughters at age 12 and 16, and I really regret it. I spent 20,000 ETB (around $1,000) on the marriages of my two girls. I could have bought urban land with that, which would now be worth up to 200,000 ETB ($10,000). The girls lead a rural life like me, and do not enjoy life like their peers who were educated.

“Three years later, neither are yet pregnant, but I really worry about that. With the poor living conditions they have, if they give birth life will get more complicated. If I had not married them, they could have contributed a lot to their country through their being educated.

“My own wife was 15 when we married – I was 25. She showed such childish behaviour but I supported her and she became pregnant straight away.”

“As a priest I am responsible for these marriages as I have to marry a virgin girl, so there is so much pressure on the girls being of younger ages. But I am no longer prepared to bless a marriage if a girl is below the age of 18.

“The government has committed to stop child marriage by 2025, but I know we can stop it way before then. This Kebele is a role model for what can be achieved, a learning site. Everyone here shares ideas and supports each other against child marriage.”

Degu Eneyew, 50, has seen first-hand how girls thrive when they are educated.

Preist Degu Eniyew, 50 lives at Dangla Woreda, Badani Kebele, Awi Zone, Amhara Region. He says he values the education of girls after seeing how they can economically improve their own lifestyle as well as their family's, after finishing school.
Priest Degu Eneyew, 50, has seen first-hand how girls thrive when they are educated. He is a member of Bandani Kebele’s Community Conversation Group against Child Marriage, Amhara, Ethiopia. ©UNICEF Ethiopia/2016/Mersha

Degu Eneyew comments: “At the age of 38 in 2003 I went back to school. It was then that I saw the impact education has on the girl – how well she can do in life. But the community sees education negatively as they associate it with a girl’s exposure to risk. We are teaching the community that if a girl is educated she will support the family. Every Sunday I include in my regular preaching to say “no to child marriage” and send girls to school instead.

“Look at the difference between two families – one which is fast to marry its girls too young, one which does not. You can see life’s consequences from child marriage – giving birth early, scarce resources, limited land. You marry a girl before 18 and it is like killing the very life of the girl. Where families are strong enough to send their girls to school the girls have jobs. Her life will be completely different.

“In the past, a priest would bless the marriage of a child. But today, if the girl is under 18 the priest will not be told. The family will conduct a customary marriage instead with any elder, but witnesses to such marriages are criminally liable.

“Hereafter if a marriage involves parties who are under 18 I will denounce it and report it to the police. If the couple are 18 or above I will bless the marriage. I want everyone to condemn the practise as an evil act.”

Drilling Deep to Keep Children’s Teeth and Bones Protected in Ethiopia

By Samuel Godfrey

Amanuel Fiseha 13 years old one of the residents of Boset woreda who is affected by Fluoride water.
Amanuel Fiseha 13 years old one of the residents of Boset woreda, Wellenchiti, Ethiopia, has stained teeth, as the result of drinking water that contains high level of fluoride.. ©UNICEF Ethiopia/2014/Tesfaye.

Many people living in the Rift Valley area of Ethiopia have stained teeth, as the result of drinking water that contains high level of fluoride. The yellowing of the teeth is one of the physical symptoms of consuming high levels of fluoride. Other symptoms include skeletal fluorosis, where children’s legs and arms are deformed resulting in physical disabilities. The World Health Organisation (WHO) recommends that drinking water should contain less than 1.5 milligram of fluoride per litre to ensure that teeth and bones are protected.

Fluoride gets into the water supply from the geological rock formations of the Ethiopian Rift Valley. Studies undertaken by the British Geological Survey have recorded levels of fluoride as high as 25 milligrams per litre in the area. These excess levels of fluoride are affecting more than 14 million women and children from Afar, Oromia and the Southern Nations Nationalities and Peoples Region (SNNPR), as well as parts of the Ethiopian Somali Region.

To solve the problem of excess fluoride, numerous water treatment technologies have been piloted by the Government of Ethiopia and International Agencies. These have resulted in varying levels of success. In the past, UNICEF has supported the mitigation of fluoride through de-fluoridation techniques in affected woredas, mainly in Oromia and SNNPR. UNICEF has also supported two studies, entitled ‘Study of fluoride and fluorosis in Ethiopia with recommendations on appropriate de-fluoridation technologies’ in 2005 and ‘Spatial distribution of fluoride in the Ethiopian Rift and its adjacent highlands’ in 2011.

Deep well drilling in Abomsa town Wolenchiti woreda of Oromia region
Deep well drilling in Abomsa town Wolenchiti woreda of Oromia region ©UNICEF Ethiopia/2015

With the financial support of the UK Department for International Development (DFID), UNICEF has developed a new approach that involves the ‘below ground’ treatment of fluoride. This approach is a permanent hydrogeological solution, which requires study of both the geological formations in which the fluoride occurs as well as the use of advanced remote sensing and groundwater drilling techniques.

Most deep wells that have been drilled in the Rift Valley have a maximum depth of 200 metres. This is due to both the occurrence of productive shallow aquifers (underground layers of water-bearing permeable rocks) and the limitations of available deep well drilling machines. UNICEF proposed to drill ‘deeper’ and to access aquifers that are 250, 300 or even 400 metres below ground level.

In April 2015 , UNICEF drilled a deep well in Welenchiti Town, a first for the Oromia region, to a depth of 259 metres and applied a phased casing technique to block off the shallow aquifers that are contaminated with fluoride. The result is a highly productive deep well with a yield of 11 litres per second – almost 40 thousand litres per hour (or 4 large water tankers per hour) – and a fluoride level of 0.9 milligrams per litre.

As a result of the planned intervention in Welenchiti Town and three surrounding villages, there will be approximately 45,870 beneficiaries by the year 2025. The project is expected to provide acceptable fluoride levels, with far greater health benefits than current supplies, which have resulted in chronic disease that affect all sections of the population, including children, with dental and skeletal fluorosis.

Donors appreciative of the joint UNFPA/UNICEF programme to stop FGM/C in Afar Region

By Wossen Mulatu

Trust fund donors visit of the UNFPA/UNICEF joint programme acceleration of change to eliminate FGM/C
Visit by Donors to the Social mobilisation interventions to end FGM/C in Wasero Village, Sabure Kebele, Afar Region. ©UNICEF Ethiopia/2015/Mulatu

26 MARCH, AFAR REGION, ETHIOPIA – Donors to the UNFPA/UNICEF programme to stop female genital mutilation and cutting in Ethiopia’s Afar region carried out a visit in March to see its progress.

Accompanied by staff from UNFPA and UNICEF, the donors from the governments of Italy, Norway, the United Kingdom and Luxembourg visited programmes run by implementing partner agencies, including the Afar Bureau of Women, Children and Youth Affairs (BoWCYA), Afar Pastoralist Development Association (ADPA) and the Rohi Weddu Pastoralist Development Association.

Work under the programme is being delivered in two phases – the first ran from 2008-2013 and saw interventions launched in six woredas (districts) out of a total of 32 in the Afar region. The second phase began last year and will run until 2017, covering three more woredas and including advocacy engagement at a federal level.

The implementing partners have responsibility for different aspects of the programme – the regional BoWCYA is responsible for the programme’s overall co-ordination and legal implementation, APDA focuses on reproductive health issues and Rohi Weddu aims to deliver wider community mobilisation and facilitating community dialogue.

In the last five years, the partners, with technical and financial support from UNFPA and UNICEF, have achieved impressive results.

The first phase of the project is running in 74 kebeles (sub-districts) of the six woredas of Zone Three of the region, with a total population of more than 400,000 people. These are: Awash Fentale, Gelaelo (Burimodaytu), Amibara, Gewane, Argoba, and Dulesa.

According to Zahra Humed Ali, Head of the Bureau of Women, Children and Youth Affairs, Afar is the first Ethiopian region to issue a proclamation on the abandonment of FGM/C.

Trust fund donors visit of the UNFPA/UNICEF joint programme acceleration of change to eliminate FGM/C
Group photo of adolescent girls from Aasero village, Sabure Kebele, Awash District in Afar region representing the new generation of uncut girls in the Region. ©UNICEF Ethiopia/2015/Mulatu

“Community conversations facilitated by influential leaders in the community including kebele administrators, women’s associations and Traditional Birth Attendants is making a significant impact on the road to the abandonment of FGM/C in the region and religious leaders are leading the movement,” she said.

Eleven woredas in Afar have already abandoned FGM/C, with six doing so with support from the UNFPA/UNICEF joint programme.

According to Valerie Browning, Programme Coordinator of Afar Pastoralist Development Association (APDA), the majority of women of reproductive age in Afar have undergone FGM/C and as a result commonly experience urinary retention, kidney disease and problems with menstruation and sexual intercourse.

The APDA is working to identify and support women affected by FGM/C through its work in the region.

The Barbra May Maternity Hospital in Mille is one health institution in the Afar Region to include FGM/C intervention as part of its maternal and health child services. The hospital opened in 2011 and is run by the APDA, treating many conditions related to FGM/C, like opening up infibulations, as well as more routine obstetric procedures.

Asmelash Woldemaraim, Executive Director of Rohi Weddu, says the UNFPA/UNICEF programme has dramatically raised awareness on FGM/C.

This has brought about a rapid decline in the prevalence of the practice, with 39 per cent of women affected in 2013, compared with 90 per cent in 2008.

Trust fund donors visit of the UNFPA/UNICEF joint programme acceleration of change to eliminate FGM/C
Momina Gida, 17 years old in Aasero village, Sabure Kebele, Awash District in Afar region represents the new generation of uncut girls in the Region. ©UNICEF Ethiopia/2015/Mulatu

Recognising the influential nature of the Afar social and clan structures, the UNFPA/UNICEF joint programme focuses on changing the attitudes of community leaders by creating a core group of advocates for change.

The group consists of senior regional government officials, religious and clan leaders, elders and FGM/C practitioners. The aim is to change the attitudes of people within this group, prompting community dialogue to bring about a consensus within the wider community.

Data collected at the sub-district and regional level show that more than 7,000 girls in the six districts of Zone Three of the Afar region have remained uncut since the start of the programme.

Following the visit, the donors acknowledged the commitment of the Afar regional government, as well as the two UN agencies running the joint programme, to bringing about a significant reduction of the rate of FGM/C in the region.

They agreed on the need to increase funding, as resources are stretched, even though the programme is delivering results and highlighted the importance of reaching less accessible areas.

This is a particular challenge, given the pastoralist nature of the community, with 90 per cent of livelihoods being reliant on subsistence livestock production. The region’s harsh climate is another challenge.

Finally, the donors expressed their belief that breaking down taboos and educating the community about the problems posed by FGM/C will bring about positive change – the hope is that once the majority can be convinced that this practice is wrong, the message will spread among more communities and end it for good.