Ethiopia has a very well organized healthcare system. There are health centers and health posts - health centers are in the bigger towns and serve a certain catchment area. The health posts are in smaller villages within that catchment area. For example, at my future site there is a health center because it is the biggest town in its area and it serves 4 other smaller villages that each have health posts. The health center is where everyone in the catchment area comes when they are sick or if they need antenatal, delivery and postnatal care. (Pregnant women are encouraged to travel to their local health center for delivery rather than delivering at home, in an effort to improve maternal and infant mortality.) So the health center is staffed with nurses, midwives, a laboratory, a pharmacist, a cashier, they have a room for health records/registration, and someone doing health information management. Paperwork, record keeping, data collection and reporting is a big deal. (So it turns out there is no escaping it!) People pay for the care/treatment they receive when they receive it with the exception of perinatal care, family planning, vaccinations, etc; those services are free/covered by the govt. The health posts provide some treatment but they are more focused on illness prevention and health promotion. Each health post is ideally staffed with two health extension workers. HEW's complete some health training beyond high school and they are charged with making home visits to provide health teaching and outreach to their communities. So let's say it's a village of just 500 - that's still a lot of ground for 1 or 2 workers to cover! They have very nice educational materials (provided by the govt with international support) that cover a range of topics - nutrition, family planning, sanitation, hygiene, etc. There are families that readily adopt the HEW's health information and begin to practice health promoting behaviors so they become 'model families' - these model families are expected to share their knowledge and have a positive influence on their community as well. Each model family (they are actually part of what's called the 'health development army') is assigned 5 other families. It's a very organized, strategic approach for disseminating health information and encouraging behavior change in the community.
There are private clinics in the bigger towns as well, so people can pay to go there when they are sick if they want. I presume it's more expensive. And of course there are hospitals in the bigger towns. Anything that the health center can't manage they will refer to the next level of care.
Although I am a nurse, my role here is not to provide clinical care. There are plenty of qualified individuals who work at the health center and health posts - who know their community, are respected by their community, and will continue to serve their community long after my two years are up. My role is to support the work they are already doing, to assess the needs of the community and motivate the health center and health post staff to work with me on projects targeting the needs identified. I don't know yet what those projects will be! But it is my intention that they be relevant and of value to the community, that they have a long term vision and are sustainable, and that everyone has a voice and is part of the process. My first several months at site will be spent integrating into the community and completing a 'community needs assessment'. When I have enough information to start making plans I'm sure there will be a blog post about it!
This week we practiced building a pit latrine/squat toilet/mana fincanii/shint bet
It started out as just a hole in the ground, here it is almost finished - still needs a roof and wall covering of course.
Proof that I contributed to the cause!
Our crew! I've spent a lot of time with these guys during training - I'll miss them when I move to site.
Love from Ethiopia!
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