The Success of Smart Start in Oromia

The Owning Their Future (OTF) project, funded by Global Affairs Canada (GAC), creates ASRH (Adolescent Sexual and Reproductive Health) awareness and demand for SRH products and services. In partnership with MSIE (Marie Stops International Ethiopia) and MOH (Ministry of Health), this project is currently active in 21 woredas of the Oromia Region.

The Need for the Smart Start Approach

The lack of awareness of ASRH information and services is especially critical in remote areas and areas where there are existing barriers related to culture, religious beliefs, and women’s decision-making freedom in the community. On top of these challenges, there is low interpersonal communication between health service providers and clients.

SMART START IMPLEMENTATION AND APPROACH

• Initially, we conducted Owning Their Future project launches for concerned stakeholders and community influencers at the woreda level.
• We provided training and ongoing capacity building sessions on Smart Start counseling for health extension workers and family planning service providers
• We supported community-level engagement for women development army groups, male gatekeepers, peer champions, religious leaders, and community influencers. These stakeholders helped inform the community about the Smart Start approach, identified existing local bottlenecks, proposed solutions, and recruited married adolescent girls and young women for Smart Start counseling sessions and family planning services.
• We recruited one Adolescent Health Officer (AHO) to coordinate Smart Start activities at the woreda level and 2 SSNs who will facilitate Smart Start counseling
• We conducted transition meetings to hand over Smart Start activities to existing government structures and communities.
• Using smart start counseling, we were able to reach previously hard-to-reach community members. The counseling session included mentorship and guidance on financial planning and sharing information about family planning options for young girls and married couples.
• After implementing our smart start approach, we have observed enhanced community awareness of ASRH; gained the support of community influencers, elders, religious leaders; and observed an increase in the uptake of family planning services.

TESTIMONIES

• Jamila Shelema from Gombore Aliy Kebele, a 22-year-old young woman and a mother of one said “I never used any family planning method before because I didn’t get permission from my husband and fear of religious leaders in our vicinity. One day a Smart Start Navigator came to my house and counseled me on Smart Start. I had never heard this information before. When my husband came home, I informed him of what I learned, and he told me he heard about the issue from one of the kebele male gatekeepers. He told me he will support my idea. I was surprised as I didn’t expect that from him. On the next day, I went to the nearby health post and took implants, which will help me over the next three years to achieve our goal. I am happy that we are going to have our own house. I am a known champion for the kebele, recruiting adolescent girls and young women to get Smart Start session counseling so they can have a plan for their family like us.”
• Mulu Sirna, of the Gombore Ali HEW, said “Previously it was challenging to speak about family planning in this kebele as there are existing religious and cultural barriers. After getting Smart Start training and conducting kebele kick-off, we became more confident in speaking about family planning. In the past years, the family planning service coverage was very low in our kebele, especially long-acting Contraception’s (LARC). But currently, 85 people of the 15 -24 age group took up a family planning method within six weeks of Smart Start counselling.