Ethiopia

C-Change is working with the regional Oromia government in Ethiopia to combat the devastating effects of malaria with funding from the U.S. President’s Malaria Initiative (PMI).

Malaria Prevention

C-Change is assisting the Oromia Regional Health Bureau (ORHB) to carry out malaria prevention activities in Ethiopia’s Oromia region. Under the established ORHB Health Extension Program, zonal and local health workers are the frontline workers carrying out the social and behavior change communication (SBCC) malaria prevention activities with families in villages and communities under the Model Families Program.

Model Families Program

The Model Families Program engages health workers who help families improve their knowledge about malaria prevention actions and assist them to carry out specific actions that will prevent malaria. These specific actions grew out of community workshops conducted by C-Change in 2009. Designated essential malaria actions (EMA), these eight actions were modified into four doable actions. The four actions are visually represented on a scorecard that each family maintains as a record. This scorecard is one of several tools that C-Change has developed as part of this malaria prevention activity.

Training local health workers

C-Change is also carrying out a Training of Trainers for the zonal and woreda (Ethiopian administrative unit similar to a district) professionals on how to implement the Model Families Program as well as information on interpersonal communication (IPC), and on partner CARE’s “community conversation” model. Using a cascading training approach, the zonal and local health officials in turn are training the health extension workers (HEW) and volunteer community health workers (vCHW) as well as community-based and faith-based organization staff and local school personnel.

Qualitative and quantitative studies carried out by C-Change indicated that Ethiopian community members consider “HEWs and vCHWs as the most trusted and common sources of health information.”

These communication activities are receiving support through radio programs and integration into other health programs such as antenatal care (ANC). In addition, school directors are initiating anti-malaria school clubs activities.

Following training, the vCHW and HEW visit households using the C-Change developed flipcharts, posters and scorecards and provide information to families on malaria prevention, treatment and control. They assist families to carry out the four doable actions—sleep under a net and give priority to pregnant women and children under five; seek treatment at first sign of fever; adhere to treatment and do not share medication with others; and follow guidance on not plastering after indoor residual spraying.

Malaria Protection Stickers

Families earn Malaria Protection Stickers and become Model Families when they successfully carry out the four doable actions. HEWs and vCHWs use the Malaria Protection Scorecard when they conduct house-to-house visits and community group meetings. The scorecard guides a family step-by-step towards carrying out the four doable actions and earning the Malaria Protection Sticker and helps families chart their own progress.

As each doable action is carried out, the family member and a HEW or vCHWs check the appropriate box and initial that the action has indeed been carried out. When families have earned a Malaria Protection Sticker, they affix it to their front door, where it serves as a reminder to other families that this is a Model Families household. These families are encouraged to mentor three other families. Mentoring is one of the benchmarks of the Model Families Program—families and neighbors encouraging each other to succeed. The Model Families Program will last 90 days in each woreda. 

The rapid scale-up will expand to an additional 812 kebeles in the next five months with an estimated 15 million people reached by the end of 2010. C-Change continues to operate in Arsi and West Arsi and is expanding to East Wollega, Southwest Shoa, and West Shoa zones.