In Ethiopia, I have worked we work with local, regional and national government, and with Norwegian Lutheran Mission and The Ethiopian Evangelical Church Mekane Yesus.
Deaths from maternal causes represent the leading cause of deaths among women of reproductive age in Ethiopia. Thus, in line with the Millennium Development Goal for maternal health (MDG-5), this health project aims to reduce maternal mortality among the target population by two-thirds by 2015.Experience from other countries show that two conditions are needed to reduce maternal deaths: Staff should be able to carry out comprehensive emergency obstetric care (CEOC), and these services should be available to and used by the pregnant women.
The target population are pregnant women in two zones and three special woredas in south-west Ethiopia. About 2.5 million people live here. The regional government owns this project. It shall enable nine public health institutions to provide CEOC. In accordance with WHO recommendations, this will provide the target population with an acceptable coverage of CEOC.
The project aims to strengthen the antenatal services so the health extension workers can help normal deliveries and identify and refer women in need of help during delivery to health institutions. We shall enable these health institutions to practice safe delivery. As most maternal deaths occur with delivery, particular attention is on intrapartum care. Thus, we equip institutions, and train health officers, and midwifes, and operating theatre staff to get the necessary skills to carry out CEOC.
About 12 years ago we started a work to make the hospital sustainable managerially and financially. The results of this work are encouraging. Despite heavy patient loads, the hospitals have managed to become managerially and financially sustainable within a regional context. And, the model developed at Yirga Alem and Arba Minch Hospitals have now become a part of the national health system.
Antiretroviral therapy started in south Ethiopia in 2003. The hospitals in Yirga Alem and Arba Minch were the among first hospitals in Ethiopia to start this important and essential service.
Dr Degu Dare’s PhD work showed that antiretroviral treatment can be carried out in district hospitals. And, recently, Asfaw Bikila showed that such treatment is cost-effective in an Ethiopian context.
Currently, about 2600 patients are followed, and about 1400 HIV patients have started treatment at the hospital. Unfortunately, some patients stop taking their drugs. We are now trying to find ways to reduce the number of patients who stop taking their drugs, and have employed community health workers to find the defaulters. Through this work we hope to learn more about the reasons they stop taking drugs, and find new ways so patients take the drugs regularly.
For more information see the [intlink id=”112″ type=”category”]ART category[/intlink] in this research blog