TRANSFORMING LIVES OF MENJA TRIBE, A MARGINALIZED COMMUNITY IN KEFFA ZONE.
Author: Fana Abay, Marketing and Communications Director, PSI Ethiopia
In the heart of Ethiopia’s lush Keffa Zone in the Southwest region, the Menja tribe’s vibrant culture thrives. However, cultural norms and stereotypes cast a shadow beneath their colorful traditions. This close-knit community has endured marginalization due to a variety of reasons. Their unique cultural practices, religious beliefs, and specific dietary habits (such as consuming dead wild animals that are not typically eaten), and remote geographic location have led to economic disparities and hindered access to education and healthcare services. As a result, the Menja tribe’s potential for progress is restricted; however, the Owning Their Future project ignited a spark of hope.
EMPLOYING A HOLISTIC APPROACH FOR GREATER IMPACT
Over the past three years, the Owning Their Future (OTF)1 project has worked diligently to improve access to comprehensive sexual and reproductive health information and services in remote communities like the Menja tribe. The project is a collaborative effort that combines expertise from MSI Reproductive Choice Ethiopia (MSI Ethiopia) and Population Services International. It aims to reduce social and structural barriers that married adolescent girls and young women in marginalized and hard-to-reach communities face in accessing sexual and reproductive health information and services. The OTF project recognizes the complexity of behavior change; thus employs a holistic approach to achieve its goals and create a lasting change.
Almaz Demisse is a dedicated Health Extension Worker in Decha Woreda, Beha Kebele. She said the situation in the area before the OTF project was challenging. Almaz acknowledged the multi-generational struggle: “Discrimination against the Menja tribe has persisted for generations.” Educational and outreach initiatives by the government and non-government entities have contributed to increased acceptance of the Menja community. However, social isolation and discrimination persist, particularly to access essential services, including sexual and reproductive health care.” Almaz underscored the urgent concern of infant mortality among the Menja tribe, further exacerbated by their difficulties in accessing healthcare due to negative stereotypes and social isolation. She explained, “Sometimes other community members do not want to be treated at the same health facilities as the Menja tribe, which discourages them from going. But through the OTF project, we have made significant progress in making sexual and reproductive health services available for the Menja tribe.”
COMMUNITY ENGAGEMENT: FOSTERING AN ENVIRONMENT FOR CHANGE.
To create a supportive environment and gain community support for improved awareness and access for Sexual Reproductive Health (SRH) services, the OTF project contacted the Menja tribe to organize an impactful community event with local influencers and leaders. Attended by fifty participants, this event facilitated open dialogue, raised awareness, dispelled myths, and spread knowledge about the advantages of comprehensive SRH services in the community. Communication campaigns were conducted through public events like market days, community festivals, and community gatherings. From March 2022 to July 2023, communication campaigns carried out through the OTF project, reached more than 1,439 (801 female, 638 male) community members. These communication campaigns challenged harmful norms, educating, and transforming attitudes surrounding sexual and reproductive health and family planning in the community.
Recognizing the pivotal role of men and husbands in driving change, the OTF project conducted husband engagement activities through Weekend Men’s Group, reaching more than one hundred husbands to discuss topics related to sexual reproductive health and family planning. This initiative aimed to enhance their understanding, acceptance, and support for family planning in their homes and be an advocate in the community.
SMART START: THE CORNERSTONE FOR CHANGE
Smart Start, which grew out of PSI’s Adolescents 360 program2, uses an innovative and high-impact approach to counsel rural married girls and their husbands on achieving their family’s financial and life goals through family planning. Smart Start counseling is a cornerstone of the OTF project. Over two years, five Smart Start Navigators (SSNs) made in-person home visits to deliver Smart Start counseling to ensure that 1,500 married adolescent girls and couples in the Menja tribe received personalized SRH information. Birtukan, a Smart Start Navigator in Decha Woreda, explains, “By offering door-to-door counseling to members of the Menja tribe, who often face social, economic, and health marginalization, we were able to encourage their receptiveness to Smart Start counseling and family planning services.”
Additionally, the project worked with frontline health workers, including Health Extension Workers who received specialized training in Smart Start counseling. This training improved the quality of care and created a safe space where married youth and their husband could receive information about SRH without judgment, fear of discrimination or pressure. As a result of these comprehensive community engagement efforts, barriers that once seemed impossible were gradually broken down as awareness of the benefits of SRH and family planning services spread rapidly. From November 2021 to July 2023, SSNs referred 500 eligible clients to Health Extension Workers and mobile clinics after receiving Smart Start counseling sessions. These referrals led to 450 adolescent girls and young women adopting a contraceptive method of their choice.
VOICES OF TRANSFORMATION: MENJA TRIBE COUPLES
The stories of couples from the Menja tribe reflect the change the OTF project has on communities in rural areas. Ketoch Gebremariam and Tigist Hailemariam, farmers and parents of three children, found a new path through Smart Start counseling. Supported and guided by the Smart Start Navigator, they made informed decisions to shape their family’s future. Previously, the couple faced challenges as even the short-term options were not readily accessible, leading to unintended pregnancies. Tigist said, “I wanted to delay having another child because I wanted to raise my three children without economic burden. That’s why I took a five-year shot.” The mobile clinics offer a range of contraceptives, including long-acting methods. This made it easier for this couple to use a method that would provide longer-term protection from unintended pregnancy.
Samuel Woldegiorgis and Etenesh Tako, another recently married couple from the Menja tribe, discovered the profound connection between family planning and economic stability through Smart Start counseling. The couple opted for a long-acting contraceptive method with a clear purpose — to construct a home, diversify their income source, and attain financial security. Samuel elaborated, “We wanted to be economically stable before bearing children, and the education from the Smart Start Navigator about the link between financial security and family planning helped us make this decision. Following the counseling session, my wife and I prioritized raising livestock and building a house before starting a family.”
BREAKING BARRIERS AND FORGING FUTURES
Through community engagement, communication campaigns, tailored Smart Start counseling and husband engagement activities, the OTF project is successfully expanding access to comprehensive sexual and reproductive health information and services in hard-to-reach and marginalized communities. Couples like Samuel and Etenesh embody the impact of the project and demonstrate its potential to help marginalized communities like the Menja tribe shape their destiny. From March 2021 to September 2023, the OTF project has reached a total of 647,141 people were with SRH information. Out of this 248,969 were adolescent girls and young women, of whom 217,293 chose a contraceptive method of their choice and 4,089 gained access to Comprehensive Abortion Care (CAC). In addition, the project has engaged over 239,601 community members in communication campaigns and 134,037 spouses in husband engagement activities.
