Saving Newborns in Ethiopia

Ethiopia

State of Ethiopia's Newborns

Issues Influencing Newborn Health in Ethiopia

Of the 75 million people in Ethiopia, 85 percent live in rural areas, and the majority lacks access to basic health care — factors that contribute to an annual death toll of 120,000 Ethiopian newborns, according to the Center for Health Development in Ethiopia. Many of these deaths result from treatable causes like birth asphyxia and preterm birth. The largest cause—responsible for almost half of all newborn deaths — is infection, including tetanus, which is an entirely preventable disease. In fact, according to Opportunities for Africa's Newborns, Ethiopia ranks in the top five countries with the highest burdens of neonatal tetanus worldwide.

According to Ethiopia's 2005 Demographic and Health Survey, only six percent of women give birth with a skilled health worker present; in most instances, relatives and traditional birth attendants manage the delivery at home. Ethiopian families place a high value on their children's health, but poor access to basic health education and services means that sometimes harmful birth practices are the norm. After the baby is born, for example, any sharp object—sterilized or not—might be used to cut the umbilical cord, and family members or traditional birth attendants often rub cow dung and butter on the newborn's umbilical stump.

Ethiopia has a long way to go before reaching all mothers and newborns with the high impact interventions that would save newborn lives each year. However, progress is being made. An example is the Ethiopian government's Health Extension Worker (HEW) program. Through the HEW program, 30,000 individuals will be trained to offer basic health care — like vaccinations and health education — to families at home. Save the Children and John Snow, Inc. (JSI) will study the effects of strengthened HEW newborn care skills on newborn mortality. In addition, they will examine the effect on mortality of HEW management of newborn infections. Currently, referral to a higher level facility is the only option for families with sick infants.

Save the Children's Newborn Health Accomplishments in Ethiopia

Since 2002, Save the Children in Ethiopia has helped elevate newborn health from a neglected issue to a national concern.

Battling tetanus

One of Save the Children's key accomplishments for newborn health in Ethiopia was its role in the national maternal and neonatal tetanus elimination campaign from 2004-2005. Building on longstanding relationships with community members, and working with the Ministry of Health, UNICEF, and World Health Organization (WHO), Save the Children created demand for the immunization campaign — that is, it developed strategies to urge women of reproductive age to receive the tetanus toxoid vaccine. The resulting behavior change communication materials — billboards, radio spots and traveling plays — reached more than 324,500 people across 115 districts and contributed to the immunization of 2.86 million women, according to the final report on Ethiopia produced during the first phase of Save the Children's Saving Newborn Lives (SNL) program. For information on creating demand, see Communication for Maternal and Neonatal Tetanus Elimination Immunization Campaigns.

Educating community members

Since most Ethiopian mothers give birth at home in the absence of skilled medical care, in 2002 Save the Children set out to educate families and traditional birth attendants on proven healthy behaviors and home-based maternal and newborn care. With the United States Agency for International Development (USAID), Save the Children ensured that 300 traditional birth attendants learned to recognize symptoms of complications and infections, avoid delays in seeking care at facilities, and provide family planning counseling (SNL1 Ethiopia Final Report).

Creating lasting change

Since 2002, Save the Children has improved access to maternal and newborn care while building a national movement to improve newborn health. Through partnership with other non-governmental agencies, donors and the Ethiopian government, Save the Children has advocated for the enactment of several national newborn health safeguards. Newborn health standards are now incorporated into Ethiopia's National Child Survival Strategy and the National Reproductive Health Strategy.

Save the Children's Current Newborn Health Activities in Ethiopia

Save the Children continues to work with partners for better newborn health in Ethiopia. In partnership with the government of Ethiopia and John Snow, Inc. (JSI), Save the Children is supporting an effectiveness trial to evaluate the impact of the training of government health extension workers (HEWs) to deliver essential newborn care services, as well as to identify and manage newborn sepsis within communities—where most births take place. Documentation of HEW success in reducing sepsis-related deaths in project areas will provide important evidence for policymakers in Ethiopia as well as in other African countries regarding the potential for effective community-based management of a major newborn killer.

Building on its earlier successes during Ethiopia's maternal and neonatal tetanus elimination campaign, Save the Children will produce promotional and educational materials for the country's upcoming tetanus immunization campaign.

Finally, Save the Children continues to support the national advocacy efforts of various professional associations and partners to ensure that newborn health remains on Ethiopia's national health agenda.

Partnering for Newborns

Ethiopian Pediatric Society (EPS)

Ethiopian Public Health Association (EPHA)

Ethiopian Society of Obstetricians & Gynecologists (ESOG)

John Snow, Inc (JSI), Ethiopia Essential Services for Health (ESHE) program

Federal Democratic Republic of Ethiopia Ministry of Health

Partnership for Maternal, Newborn & Child Health (PMNCH)

UNICEF

United States Agency for International Development (USAID)

World Health Organization (WHO)