TAPPING EXISTING COMMUNITY STRUCTURES FOR GREATER SCALE:
THE ROLE OF WOMEN DEVELOPMENT ARMY VOLUNTEERS IN HEALTH PROMOTION.
Author: Fana Abay, Marketing and Communications Director, PSI Ethiopia; Mekdim Hailu, Project Communication Manager, PSI Ethiopia and Limi Bedrihun, Program Coordinator, AYSRH, PSI Ethiopia
In today’s rapidly changing world, access to healthcare and health promotion is a basic right everyone should have. At Population Services International Ethiopia, we understand the importance of leveraging existing community structures to ensure sustainable and scalable healthcare. This article sheds light on the Women Development Army’s valuable contribution in health promotion.
WHO ARE THE WOMEN DEVELOPMENT ARMY VOLUNTEERS?
The Women Development Army (WDA) is a grassroots government initiative of women volunteers in rural Ethiopian communities. Its primary objectives are to enable women and drive developmental projects, including public health initiatives.
Over the years, WDA volunteers have significantly promoted public health through health education, immunization campaigns, sanitation programs, and essential health services at the community level. One of the critical strengths of WDA volunteers is that they are members of the local communities they serve, which builds trust and helps them understand the unique challenges of community members. These volunteers work closely with local Health Extension Workers (HEWs) and community leaders to educate women and families about disease prevention, reproductive health, family planning, maternal and newborn health, and immunizations.
Despite the importance of their work, it is essential to note that WDA volunteers receive no financial compensation for their efforts. They devote their time, energy, and knowledge out of goodwill and a desire to serve their communities.
At PSI Ethiopia, we highly value the contribution of WDA volunteers. Their roles and responsibilities are defined and integrated into our community outreach efforts. Their involvement in our Water, Sanitation, and Hygiene (WASH) and adolescent sexual and reproductive health programs has been instrumental in promoting sustainable health, social progress, and community empowerment at scale.
USAID TRANSFORM WASH
USAID Transform WASH takes a comprehensive approach to ensure accessible WASH products and services through strong partnerships with government agencies, the private sector, and community members.
A key aspect of this initiative is the market-based sanitation approach, which promotes access to affordable WASH products and services and behavior change within the community. To achieve this, Transform WASH recognizes the indispensable role of community-based structures like Women Development Army (WDA) volunteers in raising awareness and fostering an enabling environment for improved sanitation. WDA volunteers collaborate with Health Extension Workers (HEWs) to provide their communities with better sanitation and hygiene information.
In areas where Transform WASH is implemented, passionate WDA volunteers have taken on additional roles as sales agents, promoting and selling WASH products and services. Assefash Tadesse, a transformed WDA volunteer in Sidama, achieved remarkable success by selling 239 slabs with Sato Pans within two months of starting her business. Her achievements demonstrate how these income-generating activities uplift living standards and community status. Now, confidently managing her thriving sanitation business, Assefash employs two individuals to support her enterprise. (Read Assefash’s story here).
By harnessing the strength of community structures like WDA volunteers and providing technical training to over 480 local business partners across the country, the Transform WASH activity has contributed to selling more than 155 thousand sanitation products and improving 101,148 household toilets. This success underscores the efficacy of market-based sanitation and the robust partnership with various community stakeholders, including WDA volunteers, in promoting better sanitation practices and significantly enhancing community health and well-being.
ELEVATING ADOLESCENT SEXUAL AND REPRODUCTIVE HEALTH
PSI Ethiopia is committed to advancing the health and well-being of adolescents through targeted initiatives that address their unique needs. Two projects exemplify this commitment: the Roadmap to Integrating Smart Start in Ethiopia and Owning Their Future. These projects, with their comprehensive approaches, have successfully integrated the invaluable efforts of WDA volunteers.
ROADMAP TO INTEGRATING SMART START IN ETHIOPIA
The Roadmap to Integrating Smart Start in Ethiopia (RISE), a program led by the Ministry of Health with technical support from PSI Ethiopia, focuses on providing comprehensive sexual and reproductive health services to married adolescent girls (15- to 19-year-olds) in rural communities. The origins of the RISE program can be traced back to PSI’s Adolescents 360 program. Its innovative and impactful Smart Start program used to counsel rural married girls and their husbands on how to attain their family’s financial and life objectives through family planning.
During integrating Smart Start program into the healthcare system, it was realized that Health Extension Workers (HEWs) could not conduct door-to-door outreach to generate demand for the Smart Start program due to their prioritization of delivering eighteen health packages. Thus, the RISE program entrusted the responsibility of Smart Start demand generation to existing community structures like WDA volunteers. Consequently, WDA volunteers are pivotal in identifying and mobilizing married girls, supporting the development of strategic plans, and referring eligible clients to the local HEWs.
Women Development Army volunteers from Duguna Fango Woreda in the Oromia region share their experiences: “We are enthusiastic about this endeavor as we strive to be positive role models in our community. People refer to us as lifesavers because we provide comprehensive information about the Smart Start program and cover topics like nutrition, breastfeeding, and hygiene.”
Advocating for adolescent sexual and reproductive health as WDA volunteers comes with challenges. Convincing family members of married couples to support family planning decisions is difficult due to a tradition that associate of children with wealth and blessings. However, discussing the complications of teen pregnancy and sharing personal stories makes the process more acceptable.
Though the level of engagement of the WDA volunteer network varies across different areas, their involvement in the RISE program is a significant success story. WDA volunteers have extended the program’s reach, fostered trust, and broken-down cultural barriers in 310 woredas. Their participation in RISE program has ensured the lasting integration of Smart Start into the government health system. As of 2023, the RISE program has benefited 466,194 married adolescent girls through the Smart Start program, with 223,718 eligible client taking contraceptive methods of their choice.
OWNING THEIR FUTURE
The Women Development Army also plays a significant role in the Owning Their Future (OTF) project within PSI’s Sexual and Reproductive Health (SRH) platform. This collaboration with Mariestopes International Ethiopia aims to enhance access to SRH information and services in 39 administrative districts in four regions.
Within the OTF project, WDA volunteers are working alongside local champions and male gatekeepers. They identify, map, mobilize, and connect girls and young women to Smart Start counseling and services. Additionally, WDA volunteers contribute to shaping societal norms through informal communication, increasing awareness about the value of sexual and reproductive health among adolescents and youth. Their involvement also extends to promoting gender equality by influencing husbands and encouraging their participation in SRH sessions.
The contributions of WDA volunteers have been integral to implementing the OTF project across 39 woredas and 707 Kebeles. Thanks to their support, the project has reached an impressive 223,586 married adolescent girls and young women, providing them with essential Smart Start counseling. The collaboration between WDA volunteers, local champions, and male gatekeepers has driven the project’s success, leading to positive outcomes in advancing sexual and reproductive health.
CONCLUSION
In summary, the Ethiopian Women Development Army has demonstrated dedication and played an instrumental role in advancing public health at the grassroots level. Through their efforts, WDA volunteers are advancing individual health and playing a pivotal role in the broader developmental landscape of Ethiopia.
These efforts align seamlessly with PSI Ethiopia’s commitment to shaping a healthier future for all. Through strategic collaboration, PSI/E is actively shaping a landscape where comprehensive health services are accessible to everyone. This collaborative approach exemplifies our dedication to fostering a healthier nation and underscores the potential of community-driven initiatives. With PSI Ethiopia’s visionary outlook and the Women Development Army’s spirit, the journey toward a healthier future is set in motion.
