Transcript Federal Democratic Republic of Ethiopia

Federal Democratic Republic of
Ethiopia
Ministry of Health
Reproductive Maternal and
Newborn Innovative Fund (RIF)
Findings of
the Assessment to identify barriers to RMNH
service uptake among pastoralist communities
Objective of the assessment
To Identify
• Barriers of service uptake at individual
level
• Socio cultural barriers that hinder women
and young girls seek RMNH services
• environmental context that affects RMNH
service uptake
Data collection method
• FGD guide and key informant interview guides
developed, tested and used
• 10 Data collectors recruited and oriented on the
tools
• Seven days of field work to collect data
• FGD
– 2 FGDs in each zone involving young girls,
women and men
– Key informant interview with 10 key informants
from each region identified and contacted
Geographic coverage
Region
Zone
Woreda
Afar
01
Dubti and Asayta
Oromia
Borena
Metagefersa and did
Yabello
Guji
Wadera and Sebaboru
Somali
Degehabur and
Jigjiga
Kebribeyah and fafen
SNNPR
South Omo
Bena Tsemay and Hamer
Major findings of the assessment
• Individual level:
– Limited knowledge and information
– Misconceptions (might not be pregnant for long
periods if she gives birth at health institution)
– past experience
– Fear of stigma among girls
– difficulty to accept male service providers at L&D,
ANC,
– feeling of shame to give birth at health institution
with support of outsiders
– prefer their own positioning during labor than
professional’s advice
• Social level:
– Gender related
•
•
•
•
male dominance,
Control over resource
women and girls long working hour
women don’t have the right to limit the number of
children they possibly could have
• Lack of decision making power among women
• Women expected to obey decisions of their partners
– Lack of male partner support
– Cultural and social ceremonies at birth
• isolating laboring woman to give birth alone
– Children are considered as blessing and keepers of the clan
strength
– Religious values discouraging FP
– Lack of open discussion on RH issues among family
members
– Female genital cutting family honor (respect), cleanliness,
a woman’s ability to walk for long distances and women
giving birth with ease
– Young married couples expected to have their first child
soon
– common unprotected sex for unmarried girls which results
in repeated abortion (girls are not allowed to give birth
before marriage)
• Environmental
– Transportation (ambulance one way)
– professionals mistreatment
•
•
RMNH
information
and knowledge
Open
discussion in
family
•
Attitude and
past experience
•
Cultural and
religious norms
and values
•
Access
•
Transportation
•
Adolescent
Health
Postnatal care
Family planning
Comprehensive
abortion care
Facility delivery
and EmONC
services
•
ANC
•
Fear of Stigma
•
Women/yout
h
friendly
services
•
Traditional
beliefs
•
Partner
family
support
•
Gender roles
•
Community
participation
and
Women
and
girls
empowerment
Addressing barriers to increase uptake
• Increase acceptability of RMNH services
among women, girls and the community
through
– Increased knowledge and awareness
– Behavior change
– Addressing norms and values
– Empowerment of women and girls
– Enhancing Male engagement and support
– strengthening networking and partnership
• Improve community attitude to RMNH
services
– Create Positive attitude to RMNH services and
service providers
– Creating enabling social environment (enhance
role of religious leaders, community leaders etc
– Community mobilization
• Empower women and girls to use RMNH
services
– Enhance self esteem and self confidence among
women and girls
– Strengthen multi-sectoral approach
– Address gender stereotype and enhance male
involvement
– Community mobilization to address GBV and other
forms of violence
– Foster decision making and action through collective
processes
– Working with relevant stakeholders to ensure equal
participation in developmental processes
• Enhance Responsiveness of health service to
communities needs
– Working with relevant stakeholders to ensure
accountability
– Improve IPC of service providers
– Promote women and girls participation in facility
management boards
– Promote women and youth friendly service
– Ensure Gender mainstreaming
Thank you!