SMART START
TRANSFORMING LIVES OF MARRIED GIRLS IN KUNI SAGARIYA HEALTH POST
By Fana Abay, Marketing and Communications Director, and Feyissa Dechasa, Coordinator III, Quality Assurance & Training, PSI Ethiopia
“Smart Start is a key driver for the success of married girls, enabling them to realize their dreams and achieve their goals.” — Elifinesh Yeyis, Health Extension Worker
Elifinesh Yeyis, Zenebech Solomon, and Addis Shimelis are dedicated Health Extension Workers (HEWs) at Kuni Sagariya Health Post in the West Hararghe Zone, under the Gemechis Woreda Health Office. For years, they provided family planning and other health services to married girls aged 15–19 but often overlooked the unique vulnerabilities these girls faced, including health and financial challenges. Cultural barriers, such as expectations for immediate childbirth and misconceptions about contraceptives, hindered effective enrollment in family planning programs for young adolescent girls.
The launch of the Smart Start program in February 2023 marked a transformative shift. Initially, HEWs received comprehensive orientation from the RISE Primary Health Care Unit focal person, which cascaded to community health structures, Women Development Army (WDA) members, and community stakeholders. This training empowered WDAs to become crucial mobilizers and referral channels, significantly improving the identification and registration of married girls into the Smart Start program.
As Elifinesh Yeyis reflects, “Through community engagement, including integration with other health programs such as vaccination, insurance, and catch-up plans via home visits, we identified 42 married girls. Previously, our family planning utilization for married girls was minimal — no more than 5 to 10 girls annually. Now, 30 married girls have received family planning services of their choice following financial and family planning counseling based on the Smart Start discussion guide.”
The Smart Start program introduced significant changes, addressing gaps in previous counseling approaches. Before Smart Start, counseling focused solely on family planning methods, neglecting essential aspects like financial planning, goal-setting, and personal aspirations. Smart Start has bridged this gap, overcoming community misunderstandings and addressing persistent misconceptions about birth spacing and family planning methods.
This year, Kuni Sagariya Health Post has fully integrated Smart Start approaches into routine activities, establishing it as a key performance indicator. Beyond family planning, the program has fostered the creation of savings groups for 40 married girls. These groups aim to enhance financial stability and create business opportunities. Each member contributes 50 birrs (0.84$) monthly, totaling over 4,000 birrs (67.35$) deposited in Sinqe Bank.
A Model for Success: Smart Start’s Broader Impact
The impact of Smart Start in Kuni Sagariya Health Post has been profound. The program has equipped adolescent girls with the knowledge and tools necessary for effective family planning, contributing to improved health outcomes and greater financial stability. The girls are now better informed about financial planning and the benefits of birth spacing, which has led to healthier pregnancies and better maternal and child health.
