FOSTERING SELF-CARE MOVEMENT IN ETHIOPIA
EMPOWERING CONSUMERS TO MANAGE THEIR HEALTH
Imagine a world where every woman and girl is allowed to live their dreams; a world where they can make informed decisions about their health and future. PSI Ethiopia is an organization that is committed to making this a reality through self-care.
The idea of self-care has recently become a focus area in the global health platforms and organizations. Considering self-care’s numerous benefits both to the health system and consumers, it has become one of the priority areas for PSI.
The self-care movement is one of the critical steppingstones towards achieving universal health coverage mainly because it relieves the strain of the health care system by empowering consumers to take care of their health.
What is self-care?
The World Health Organization defines self-care as the ability of individuals, families, and communities to promote health, prevent disease, maintain health and cope with illness and disability with or without the support of a health worker.
Self-administration of injectable contraceptives such as DMPA-SC is one of the self-care interventions that is recommended by the World Health Organization as it promotes access to contraceptives, diversifies options, decreases unmet need, ensures continuity of family planning method use, saves time for women and girls while keeping them autonomous and relieving strain from the health system allowing health providers to focus on other health care services. Likewise, the provision of DMPA-SC for self-inject is also ideal to use in times of pandemics like COVID-19 where people are reluctant to go to health facilities for their regular family planning visits.
Self-care is the ability of individuals, families, and communities to promote health, prevent disease, maintain health and cope with illness and disability with or without the support of a health worker and Self-care interventions as tools supporting self-care.
PSI Ethiopia through the RISE (Roadmap for Integrating Smart Start in Ethiopia) project is now conducting a pilot study on DMPA-SC for self-inject in collaboration with the Ministry of Health, Ethiopian Public Health Institute, Addis Ababa City Administration Health Bureau, Marie Stopes International Ethiopia, and FHI 360 in six selected public health care facilities in six sub-cities of Addis Ababa. This pilot aims to enroll 400 women and enrolled 14 family planning providers to determine clients’ competence to self-inject DMPA-SC, assess their experiences, and document the experiences of family planning providers who train clients to self-inject through enrollment and follow-up phases. This study is the first of its kind in Ethiopia where the outcome will serve as a vital input for the development of an evidence-based DMPA-SC introduction and scale-up plan at a national level.
Before launching the enrollment process, Training of Trainers (ToT) on DMPA-SC for self-inject was given to staff from the Addis Ababa city administration Health Bureau, selected sub-cities, and health facilities to cascade training to health providers and clients to self-inject DMPA-SC. After the training, one health provider who was a trainee stated that “The DMPA-SC option is not just for the urban but for rural girls and women; they could benefit a lot from it.”
The other exciting thing about this pilot is the engagement of young women as research officers that had the opportunity to interact with clients who had come for their family planning visits to understand their experiences and assess their views about self-injection. This group of young women has backgrounds in health-related fields and experience in data collection which makes them ideal to work in this project. They have been trained on study protocol and tools, research ethics, and more, which has allowed them to be confident in the data collection process. The energy and level of motivation that these young research officers have been promising. One young researcher stated “We appreciate that we are trained before starting implementation of the study as it helps us know what to do”
Moving forward, an introduction plan and learning agenda will be developed in collaboration with MOH and FP stakeholders to enable a national scale-up promoting self-care and DMPA-SC for self-inject.
This pilot study on DMPA-SC for self-inject is one of many steps taken to solve the challenges faced by Ethiopian women and girls who are not able to meet their contraceptive needs. This is also a pivotal initiative by PSI Ethiopia. It will play a crucial role in the success of our mission of creating a consumer-centered health care system. The self-care initiative is one of many innovative approaches that will allow us to be more focused on the consumer's needs and empower consumers to take charge of their health.
