Mid Term EVALUATION PLI II project - CARE International's ...

IBTCI – Mid-Term Performance Evaluation of the Pastoral Livelihoods Initiative Phase II (PLI II) - DRAFT
Clean and safe delivery training
KII with Saad Abdi, Head, Communicable diseases prevention and control desk and MNCH
focal person, Miesso Woreda, Shinile zone, Mullu town, and Abdulaziz Hussein, HEW
supervisor, May 15, 2012:
Mercy Corps is actively working with the health office, operating in six kebeles. The support from PLI II
is in the area of MNCH including family planning and HTPs which has not been addressed by previous
projects. Specific support given by the NGO include: establishment of MNCH committees in six
Kebeles; training of HEW supervisors, Woreda Health office workers and Health Centre staff on
supportive supervision; CHVs training, and development and provision of referral cards and reporting
formats and registration book. Transportation of medical supplies from the regional office and
distributing it further to the kebeles is also facilitated by the NGO.
The MNCH committee has 18 members which include the chairman of the kebele and the kebele’s
manager, religious leaders, clan leaders, women representatives, Traditional Birth Attendants (TBAs),
Community Health Volunteers (CHVs) and Health Extension Workers (HEWs). The committee meets
every two weeks and they have also succeeded to formulate bylaws on FGM and other MNCH issues,
and is waiting for the final signatures from the respective government offices, i.e., women affairs office,
the police, justice and the Woreda administration. Parents who get their female child circumcised face a
fine of 1,000 birr while the circumciser will receive a 500 birr fine. If a woman delivers at home, she will
receive a fine of 500 birr.
They report that the MNCH activities are effective and claim to have already seen results even before
the bylaws are approved. HEWs are trained for one month on safe and clean delivery in Jijiga town and
the TBAs were trained on institutional delivery for seven days. The training has helped to create
demand for services and expecting mothers have begun coming to the health facility for ANC, delivery,
and PNC. The key informants point out the government strategy for reducing maternal and child
mortality also contributes to its success.
FGD with MNCH committee members
The MNCH committees explained that among all the activities, abandoning the practice of FGM is
challenging. Although girls and mothers are convinced about the negative consequences of FGM, the
tradition that uncircumcised girls will not get married is one of the challenges still faced by the women.
They maintain this long standing tradition with perceived roots in religion make positive outcomes in the
short-run a challenge. The Imams and Sheiks are now teaching that this practice has nothing to do with
religion. They also reported that there are 168 uncircumcised girls, 5 years and above, who are being
followed by the committee.
MNCH is another area of intervention for the committee requiring expecting mothers to visit the health
facility at least four times for ANC, and to deliver there. The continuum of care starting from onset of
pregnancy until delivery and even beyond into the postnatal period has increased acceptance of the
MNCH program. There are 73 users of ANC so far.
Misconceptions about family planning prevents women from using the services offered, making the
program unsuccessful. FM is erroneously perceived to cause infertility, and bleeding which will prevent
women from participating in religious rituals. FM is also believed to be against their religion. There are
10 users of the services so far, which is insignificant compared to the total population size of the
woreda.
DRAFT 79