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Reducing harmful traditional practices in Adjibar, Ethiopia: Lessons learned from the Adjibar Safe Motherhood Project
Lisa Natoli
Women and Children's Health Advisor, Centre for International Health, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne VIC
Andre MN Renzaho
Senior Research Fellow, School of Health and Social Development, Deakin University, Burwood VIC
Tony Rinaudo
Senior Country Program Coordinator, Africa, Middle East and Eastern Europe Team, World Vision Australia, East Burwood VIC
Abstract
This paper assesses the impact of the Adjibar Safe Motherhood Project and derives lessons of value to future interventions.
Amongst the participatory qualitative methods used were 15 group discussions, eight semi-structured interviews, a number of opportunistic informal discussions and observation. The information gathering was complemented by a detailed review of project documents. Field visits for data collection took place over a six day period in March 2005.
The project was effective in raising awareness about maternal health, and the social, economic and health consequences of various harmful traditional practices (HTPs). It has also mobilised the community to monitor and report HTPs and has strengthened referral systems for counselling, support and treatment. A number of effective strategies were identified as having contributed to project success. These are presented using the framework offered by the Ottawa Charter for Health Promotion which presents five areas of public health action: developing personal skills; strengthening community action; building healthy public policy; re-orienting health services; and, creating supportive environments.
This evaluation contributes to and strengthens the expanding body of literature about effective development practices to reduce HTPs. It demonstrates that addressing HTPs takes time and long term investment; both are necessary to enable better understanding of the social and cultural reasons for HTPs before attempting to address them, and to build the community trust necessary to overcome the natural resistance to challenging such deeply entrenched practices. The project also highlighted the importance of developing a multi pronged strategy based on engagement with a broad range of stakeholders and supportive legislation.
Keywords
evaluation, female genital mutilation, harmful traditional practices, safe motherhood, Ethiopia
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