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PREVENTING FISTULA : TRANSPORT’S ROLE IN EMPOWERING COMMUNITIES - page 3 / 4

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2. focus areas for the project activities

3. possible interventions and opportunities for collaboration with local stakeholders

4. necessary institutional framework to support such collaboration

5. monitoring issues and possible mechanisms.

6. possible partnerships with relevant donors and the private sector

Addis Ababa workshop

The Addis Ababa workshop was moderated by the head of the ERA Environmental and Social Monitoring Unit and was opened by a representative of the Federal Ministry of Health's Department of Reproductive Health. On the part of the World Bank, Herbert Acquay who represented the Country Director gave an opening speech, and the Task Team Leader for the Ethiopia Health Sector Development Program also participated in the workshop. The workshop received wide coverage on national media, in both television and print media.

Community level consultations in Southern and Ahmara Regions

The team carried out consultations with a wide range of local level stakeholders (Kebele Chief, traditional birth attendants, community health post service providers, leaders of the Regional outreach Fistula centers, leaders of the Regional Bureaus of health, transport service providers, etc.) in communities surrounding Yirgalem and Awassa in the Southern Region and Bahr Dar in the Ahmara Region.

Findings

Project Focus Areas : The project focus areas selected were Yirgalem in Southern Region and Bahr Dar in Ahmara region. The rationale for focus areas was decided upon after consultation with the Fistula Hospital and other relevant stakeholders. The main criteria were: Prevalence rates of fistula (Amhara region has the highest contribution of fistula patients to the Addis Ababa Fistula hospital, with the Southern Region ranking third after Oromia), the creation of Fistula Hospital outreach centers at regional hospitals (Bahr Dar opens this year and Yirgalem expected early next year), the interest of stakeholders, and the potential for aligning efforts with ongoing RRA programs. The Yirgalem center also serves parts of Oromia region, which is the second contributor of patients to the Addis Ababa fistula hospital.

Suggested Interventions

Transport

- Introduction of Emergency Access Cards with the transport service providers, Regional Transport Authorities and local communities;

- Working with NGOs such as the Red Cross ambulance services, the vocational training school in Awassa and the Engineering Faculty at the University in Bahr Dar, introduction of IMT's such as Uhuru vehicles and modified carts in several pilot communities. In addition, further work on the design and introduction of other kinds of IMTs appropriate for each region;

- Procurement of tools for communities to be involved in labor-based construction activities for small improvements such as footbridge and culvert construction and maintenance to help ensure year round access;

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