PSI Ethiopia
3 min readJan 2, 2024

Author: Fana Abay, Marketing and Communications Director, PSI Ethiopia; Yonatan Tamiru, Communication and PR Specialist, PSI Ethiopia

The Roadmap to Integrating Smart Start in Ethiopia (RISE) program has a clear mission which is to tackle the pressing issue of teenage pregnancy in Ethiopia. Led by the Ministry of Health, with technical support from PSI Ethiopia and funding from the Children’s Investment Fund Foundation and Bill and Melinda Gates Foundation, this program provides family planning counseling and services to married adolescent girls (15 to 19 years old) and couples throughout Ethiopia.

Through the adaptation of the RISE program for the Afar region, a crucial discovery came to light, the immense respect and vital role the Ullatinas (traditional birth attendants) have within their communities, particularly concerning childbirth. This finding is underpinned by the alarming figures from the 2019 Ethiopian Demographic and Health Survey (EDHS), according to which the prevalence of home births is 52% nationwide and is particularly high in the Afar region at 85%. These numbers underscore the urgency for collaborative efforts with traditional birth attendants to elevate maternal and child healthcare. Thus, the RISE Program tailored its approach to working hand in hand with Ullatinas to advance sexual and reproductive health in the Afar community.

Among these revered Ullatinas, Hawa Habib from Afambo Woreda in Afar is a prominent figure renowned not just for her role in childbirth but also as a source of wisdom within a traditional society. Her journey recently intersected with the RISE program. Initially, with 15 years of experience, Hawa was skeptical and concerned that the RISE program might clash with her cultural beliefs and her role as a traditional birth attendant. However, her perspective underwent a significant transformation when Rawda, a PSI Ethiopia Youth Innovation Champion (YIC) from Afar, passionately explained how the RISE program could benefit the youth in the Afar region. Hawa’s trust in Rawda and her growing awareness of the challenges young girls face due to teenage pregnancy and the lack of birth spacing led to a remarkable change of heart.

Hawa Habib and Rawda Ahmed

Despite cultural challenges, Rawda was impressed by Hawa’s receptivity to new ideas. Rawda states, “Hawa’s willingness to listen and learn about family planning and modern contraceptive methods was a major turning point. Her initial fear and hesitation transformed into curiosity.” Today, Hawa is an advocate for family planning and has successfully convinced her three married daughters to use long-acting contraceptives. In addition to her role as a Ullatinas, she actively supports the RISE program, even going door-to-door to invite couples for comprehensive sexual and reproductive counseling and services.

Hawa’s openness and her subsequent passionate advocacy for Sexual Reproductive Health, and family planning highlight the critical role that Ullatinas play in advancing healthcare well beyond childbirth. The RISE Program is intentionally designed to collaborate with community influencers, including Ullatinas, to lead a profound transformation in healthcare practices, ultimately paving the way for a brighter future for married adolescent girls and couples.

Home visit with ullatina in Afar region



PSI Ethiopia

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