EXPANDING HORIZONS

PSI ETHIOPIA’S JOURNEY BEYOND SMART START FOR MATERNAL AND CHILD HEALTH.

Author: Fana Abay, Marketing and Communications Director, PSI Ethiopia

Population Services International (PSI) Ethiopia embarked on a transformative journey in 2016, pioneering innovative approaches like Smart Start to provide comprehensive sexual and reproductive health services tailored explicitly to married adolescent girls aged 15–19 in Ethiopia. With the generous support of the Bill and Melinda Gates Foundation, PSI Ethiopia is expanding its horizons and developing comprehensive strategies targeting the reproductive, maternal, newborn, and child health (RMNCH) continuum. This expansion aims to equip married adolescent girls and young women (AGYW) with the knowledge and support they need to make healthy choices throughout their reproductive lives.

Smart Start Expansion: SMART PATHWAY

Developed under the Adolescents 360 (A360) initiative, Smart Start has made remarkable progress in reducing teenage pregnancy and increasing contraceptive use among married girls ages 15–19 in Ethiopia. To date, more than 356,688 married adolescents ages 15–19 have voluntarily taken contraception of their choice. Building on these successes, PSI Ethiopia is expanding its reach to the entire reproductive journey of adolescent girls and young women with Smart Pathways. This initiative builds on the achievements of Smart Start and offers support before, during, and after pregnancy that goes beyond contraception alone.

Smart Pathways focuses on the aspirations of girls and young women and aims to empower them to prioritize their health and realize their future aspirations. This comprehensive approach includes:

1. Expanding the target audience to include 20–24-year-olds. The initiative aims to equip adolescent girls and young women with the knowledge and resources they need to make informed decisions about delaying and spacing pregnancies.
2. Introducing the Smart Pathways tool for pregnancy to increase understanding and promote positive prenatal care behaviors, such as good nutrition and healthy child spacing, among adolescent girls and young women during the pre-conception period.
3. This initiative strengthens the ability of providers to deliver client-centered antenatal care to pregnant AGYW. It improves linkages between health posts and health centers to ensure seamless access to essential prenatal care services.
4. To close the continuum of care for AGYW postpartum, Smart Start messages promoting the use of postpartum family planning (PPFP) will be integrated into both prenatal care and postpartum counseling. This initiative also includes training midwives and health workers in PPFP counseling and service delivery and strengthening health center structures for prenatal care (PNC). These measures are intended to increase the acceptance of PPFP and improve access to PNC services for AGYW.

Expected outcomes of this expanded RMNCH component include empowerment of AGYW and overall improvement of their health and well-being. This includes better knowledge about nutrition, signs of pregnancy, and dangers during pregnancy. In addition, the initiative aims to improve the uptake of services, such as increased use of antenatal care (ANC), prenatal care (PNC), and postpartum family planning (PPFP). The initiative also aims to encourage AGYW to utilize PPFP and ANC services, ensuring a comprehensive approach to maternal and child health.

“At the heart of this initiative is a partnership in which Population Services International Ethiopia is a key ally of the Ministry of Health in strengthening the health system and consumer-driven health care. We are proud of our ongoing collaboration, mainly through the RISE project, and are pleased to announce today the expansion of our Smart Start partnership — an example of innovation and progress.” Dr. Dorothy Balaba, PSI Ethiopia Country Representative.

Conclusion

Expanding the PSI Ethiopia initiative beyond Smart Start is a critical step toward achieving comprehensive sexual and reproductive health services for adolescents. By prioritizing quality and person-centered services, we aim to equip AGYW with the tools to make healthy reproductive choices. Through strategic partnerships with the Ministry of Health, the Ethiopian Midwives’ Association and the Bill and Melinda Gates Foundation, PSI Ethiopia is committed to a future where all married adolescent girls and young women in rural Ethiopia have access to safe and quality maternal health services.