With 192 people per square kilometer, Hulet Eju Enessie district in Amhara is among Ethiopia's most densely populated areas. But until 2003, families living there had no access to information on women's health or family planning.
That changed when USAID began supporting an effort to offer an integrated primary and women's health care program to the district's communities. The program aims to improve the health of mothers and children, promote immunization, prevent the transmission of HIV/AIDS and malaria, encourage family planning and discourage early marriage. Since USAID began supporting this program, Ethiopia's contraceptive prevalence rate has increased significantly, from 8 to 21 percent.
Community-based health agents like Ato Terefe Emirie are integral to the program. Ato Terefe counsels families on HIV/AIDS and refers clients to the health center for voluntary HIV tests. He helps families get their children vaccinated, encourages pregnant women to be inoculated against tetanus toxoid and advises on the draining of mosquito breeding sites to prevent malaria outbreaks. To improve sanitary conditions in his community of 1,325 households, 866 pit latrines were constructed in one year, 87 of which he personally supervised.
Ato Terefe also helps his clients meet their family planning needs in a timely manner and has recruited religious leaders and other community members to help educate the community on eliminating harmful traditional practices, promoting family planning and preventing HIV/AIDS. "I mobilized the wives of the local development committee to serve as role models to demonstrate the acceptance of family planning to the rest of the community," he says.