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Strengthening the Link between Households and Primary Health Care Units for Improved RH/FP Services

1. Project Title: Strengthening the Link between Households and Primary Health Care Units for Improved Reproductive Health /Family Planning Services.
2. Project Donor: The David and Lucile Packard Foundation 
3. Project Summary: The Ethiopian Public Health Association has been implementing repositioning RH/FP project since 2006 with the support of the David and Lucille Packard Foundation in North Wollo and South Wollo of Amhara regional state. EPHA initiated and implemented this collaborative project together with Federal Ministry of Health to strengthen family planning program by improving performance of Health Extension Workers.
As a result of the project, Health Extension Workers (HEWs) obtained knowledge and gained new hands on skills on family planning service provision which they did not apprehend in the pre-service training.  This was made possible by training 1516 HEW, 37 supervisors and 71 RH leaders as well as by developing and distributing 84,000 copies of quarterly newsletters on regular bases.    
The project enhanced the capacity of FP/RH leaders to contribute to the achievement of the Millennium Development Goals (MDGs), especially 4 and 5. Through this project, EPHA fostered the inclusion of topics that focus on linkages between the MDGs and FP/RH into the teaching curriculums of health professionals. In line with this, 12 university lecturers from six universities were trained on achieving MDGs: reproductive health, poverty reduction and health sector reform.
The project has also helped EPHA to learn more about the challenges and opportunities available for scaling-up its intervention and maximize the impact of repositioning FP.  The major lessons learned from the project include: 
(a) Although the project has enabled HEWs to reach households with RH/FP information and selected services, the attitude and knowledge of HEWs towards young people SRH is very minimal.  “I will advice a girl or a student not to start such a thing (sexual intercourse) and will not give her if she come seeking a contraception” (EPHA baseline study 2006); 
(b) There is limited knowledge and skill of HEWs in providing long acting FP methods; 
(c) There is no linkage among the primary health care unit, which includes the HEWs and  health posts and centers are not youth friendly; and
(d) There is limited knowledge of service providers at all level on exiting national policies and guidelines and adolescent reproductive health issues.
In line with the above, EPHA envisages changing the current situation by enhancing the capacity of service providers, including HEW and community Health volunteers; fostering the link between households and Primary Health Care Units  and by promoting national policies and guidelines on RH at all levels. In this regard, EPPHA has prepared a continuation project proposal that is built on the achievements of the past project and informed by the lessons learned.
4. Project Justifications: One of the gaps evidenced during the implementation of the repositioning project is the reproductive health needs of youths and adolescents.  EPHA has especially observed that the RH needs of married girls are seemingly overlooked by health extension workers and others.  There is a general lack of awareness among health service providers, teachers, parents, community health volunteers and the community at large about the reproductive health needs of youth. Therefore, much has to be done to make the health services youth friendly.
5. Project Goal: To strengthening the link between Households and Primary Health Care Units for improved reproductive health of women and young people
6. Implementation Location:  North Wollo and South Wollo Zones of Amhara National Regional State (ANRS)