Improving maternal and child health in Ethiopia: one health centre at a time

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Ethiopia 2017/01/02

2 January 2017

"We can treat our patients so much better now that we can actually provide appropriate Services." - Abeba Bayelegn, health worker at Gebaba health centre

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In Ethiopia’s rural areas, where around 85 percent of the population lives, it can be extremely difficult to access health care facilities. Access to electricity is critical to health care, yet the availability of electricity is almost entirely concentrated in urban areas. Despite the progress Ethiopia made in recent years, the utilisation of maternal, newborn and child health (MNCH) services are still very limited. In fact, only 10 percent of deliveries are attended by skilled birth attendants and maternal, under-5 and neonatal mortality rates in the Sub-Saharan country are among the highest in the world (WHO, 2010-2011).

In order to enhance access to health services in rural areas, EnDev Ethiopia has electrified over 145 health centres and 6 health posts with PV solar energy. The centres, located in the four main regions of Ethiopia, provide improved health services to off-grid rural farming populations living in a radius of up to 10 km from the installations. Co-financed by Irish Aid, the project improves MNCH by facilitating modern health services through solar electrification and water provision. In order to guarantee the sustainability of the service and maintenance structure, solar technicians from installation companies, operators and end users are trained by EnDev. In addition, the installation and construction work is done by national companies who are trained to take care of maintenance and repair in the future.

Mebaneh Germaye, health worker Azeba health centre - electrified by EnDev in Ganta Afeshum Woreda in Central Tigray Zone, admits the working condition were very difficult before the electrification. Providing service without light and being dependent on paraffin didn’t make his job any easier. “In the past I had to use a flashlight, squeezed between my neck and shoulder when I was delivering during the night. Now I only have to turn on the switch”, He says with an exciting voice. “Prior to the installation of the solar system, four to five patients gave birth in this centre per year. Now it’s around four to five a week. Besides delivering, we treat about thirty patients each month.”

Abeba Bayelegn, another health worker at Gebaba health centre in Lamfro district Silte zone SNNPR region, is also full of praise for the improved service thanks to access to energy and drinking water provision. “We can treat our patients so much better now that we can actually provide appropriate services. We can even warm up clean water for deliveries! Being able to provide good service to my clients has reduced the daily stress of my work greatly.” Another positive evaluation of the project came from one of its main donors, Irish Aid, which co-financed the electrification of 25 rural health centres in the SNNPR. The health centres were officially handed over by the German and Irish Ambassadors to the Regional Bureau of Health in SNNPR during a high-level ceremony last year.

Improving maternal and child health in rural areas of Ethiopia is a major objective of Irish Aid's activities in Ethiopia. Electrified health centres provide improved medical care thanks to a reliable energy supply for lighting and basic medical equipment. The PV systems allow for the operation of microscopes, sterilisers and vaccine fridges, improving the quality of the health centres tremendously. Due to the joint intervention between Irish Aid and EnDev Ethiopia, over a million people in SNNPR and Tigray gained access to improved health services. Furthermore it increased personal hygiene thanks to the availability of warm water. In some of the health centres, the solar power generated also pumps clean water to the clinic and to surrounding villages. In Irish Aid’s final evaluation report, it was concluded that the solar power systems in all of the assessed health centres were functional or easy to bring back to functionality and were well maintained. Furthermore, access to and quality of MNCH services greatly increased and the working conditions of health workers and services received by clients improved. The high staff turn-over is identified as one of the key challenges in rural health centre electrification. This issue will be addressed with the Ethiopian health authorities as part of a plan to improve health centre maintenance in general.