25 June 2020

Partner Spotlight: Five Questions With Last Ten Kilometers

The COVID-19 pandemic has jeopardized hard-won gains in women’s, children’s and adolescent health. Though women and children are at less risk from the virus itself, the knock-off effects—such as limited access to vaccines and sexual and reproductive health resources—are projected to do immense harm. Every Woman Every Child believes that women and children must be placed at the center of COVID-19 recovery plans. In that spirit, we have launched a new “Five Questions” feature to feature partners who are working to make sure that no one from these vulnerable groups is left behind.

1. What is your organization’s primary concern with the global pandemic as it relates to women, children and adolescents?

The Last Ten Kilometers (L10K) project, implemented by JSI Research & Training Institute, Inc. with funding from the Bill & Melinda Gates Foundation, focuses on strengthening the health system in Ethiopia to provide equitable access to and use of quality reproductive, maternal, newborn, and child health (RMNCH) services. Ethiopia has made significant gains in RMNCH outcomes over the last two decades but the COVID-19 pandemic, which requires a shift in resources (budget, health workforce, facilities, logistics and supplies, etc), threatens to overburden the health system and reverse these gains. In addition to impacting the availability of health services, COVID-19 has also affected health-seeking behaviors, from childbirth to immunization. Families and communities who fear becoming infected at health care facilities and may have limited transport options are less likely to use essential health services. L10K is working with the Ethiopian Ministry of Health (MOH) and other partners to minimize the impact COVID-19 will have on the delivery of essential services, with particular attention given to protecting mothers and children.

2. What concrete actions are you taking to advance/safeguard the goals of the EWEC Global Strategy during this time, specifically for ending all preventable deaths among women, children and adolescents by 2030?

The MOH developed a mitigation strategy and operational guidelines for the RMNCH workforce to minimize the disruption to essential RMNCH care. L10K, a member of the national MOH-led taskforce and various technical working groups (including the Safe Motherhood and Child Survival technical working groups), worked closely with the MOH, International Institute for Primary Health Care Ethiopia, and other partners to develop the mitigation strategies and operational guidelines and is now supporting their implementation across the health system. 

3. How are you supporting national COVID-19 response and recovery efforts, particularly in ensuring that women, children and adolescents remain at the center of such efforts?

To assess the immediate effects of COVID-19 on the continuity of essential maternal and child health care services, L10K conducted a rapid assessment in selected health facilities in Addis Ababa. The assessment showed the uptake of antenatal and postnatal care services, as well as treatment for child acute respiratory infections, has decreased. Possible reasons for the decrease include diversion of supplies and staff to the pandemic response, facility closures, and restrictions of movement. Both clients and health care providers also expressed their fear of contracting the virus from each other. L10K is working with the MOH, Addis Ababa City Administration Health Bureau, and John Hopkins University Center for Communications Programs to design and implement social behavior change communication interventions to increase the confidence that people, especially mothers, have in the health services provided during the COVID-19 response. 

4. What impact will your organization have on the lives of women, children and adolescents, and how are you measuring this?

To measure the impacts of the project, L10K applies data triangulation procedures to substantiate a link between interventions and observed outcomes or results. L10K has developed measurement and reporting tools to help monitor changes within the project’s scope. In addition, to measure changes at client or beneficiary level, L10K uses routine service statistics and/or secondary data on selected MNH indicators by combining information gathered using semi-structured in-depth interviews focusing on the project’s contribution towards maintaining essential maternal and newborn health service use. To measure its contribution towards mitigating against the COVID-19 pandemic, L10K uses routine COVID-19 testing, contact tracing, and isolation related data that are achieved through the project intervention by building the capacity and confidence of frontline health workers at community and primary health care unit level.

By collaborating closely with the MOH and other partners to support the uninterrupted provision of essential health services, with a specific focus on maintaining RMNCH services, L10K is working to keep women, children, and adolescents safer and healthier during the COVID-19 pandemic. 

5. Who (partner organizations) are you working with to achieve this?

  • Ethiopian Ministry of Health and Addis Ababa City Administration Health Bureau
  • International Institute for Primary Health Care Ethiopia (IIfPHC-E) on the development of training and orientation material and development of modality for the delivery of the training/orientation material and assessment on the impact of COVID-19 on RMNCH; 
  • AMFREF on training for health workers using digital health; 
  • Johns Hopkins University/Centre for Communication Programs (JHU/CCP) – on social and behaviour change communication (SBCC) interventions.