Structural improvement of basic health services in Tigray (Shire area), Ethiopia

Context and situation

Tigray is a poor, rural area in northern Ethiopia. Shire (also called Endaselasie, city of around 50,000 inhabitants) lies near the border with Eritrea. In terms of basic health problems, the four largest are:

  • The limited access to clean drinking water
  • The limited access to proper sanitation and lack of knowledge about the health implications
  • Cooking on wood cabins provides an unhealthy indoor environment (smoke) and presses the environment (wood consumption)
  • Unhygienic environment around the homes because cattle lives too close/within the fence  

The organizations that are involved in this project are: The Well Foundation, the Huisman Foundation and  Amref Ethiopia. The Well Foundation has been active for many years in Tigray, especially around Shire. The Well Foundation is currently funding a health extension worker.  

Purpose

Improving primary health care in Tigray (particularly around Shire / Endaselasie).  

Approach

Currently, an inventory and analysis is made. It will include looking at the situation in four health centers. The first impression is that in some of these health centers problems exist in the areas of:

  • Absence of good management
  • Lack of clean drinking water
  • Lack of (and / or insufficient use of) certain materials  

The next period the focus of the project lies on the improvement of the situation on the four above-mentioned problems. Addressing these issues provides the most basic health benefits and is the most cost effective approach. Solutions may lie in the areas of: making more deep bore holes, installation of sanitary facilities, purchasing fuel-efficient wood stoves, the placing of biogas installations and providing information on sanitation, smoke effects during cooking and the importance of a clean living environment.

An important component of the approach is to invest in the health extension workers, these workers are  the local people (linked to health centers) who provide health education to the population (even in rural areas). These health extension workers understand the culture and remain living in the area. In addition, a qualified nurse can be recruited, who gives leadership, steering and training/coaching to the health extension workers.    

Planning and resources

Period: 2011 and beyond

Contribution of the Huisman Foundation: € 30.000,-- (for 2011)