Project Title: Advocacy and institutionalizing activities to protect the quality of family planning and comprehensive abortion care services in Ethiopia

Objective of the project

General Objective

The general objective of the project is to advocate for and institutionalizing activities to protect the quality of family planning and comprehensive abortion care services (SRHR), strengthening and improving the quality of reproductive health, i.e. family planning & abortion, through implementing evidence-based quality improvement, anti-stigma and advocacy interventions and to enhance existing and new advocacy work targeting emerging and re-emerging hurdles on primary health care unit.

Specific Objectives:

Build a supportive environment for abortion and SRHR through engagement and network-building with Policy influencers and ESOG members, with support from communication professionals and communications and social media platforms.
Reduce abortion stigma and discrimination against safe abortion care providers and clear misconceptions about FP services by consolidating anti-stigma interventions in safe abortion services and VCAT for FP providers and health managers to institutionalize SRH, especially CAC, and FP services.

Project Site –Two Regions: – Oromia and Amhara regions

Oromia Region: – Three Zone/

Facility: -6 hospitals and 60 health centers

Amhara Region: -Two Zone /North Shawe and North Wollo

Facility: – 6 Hospital and 40 health centers

Totally the project implements 12 hospital and 100 health centers.

Project period

The period of the project is going to be between August 1, 2023 to July 31, 2025

Funded by

The David and Lucile Packard Foundation

Project budget

450,000.00 dollar

Partners:

Ministry of Health /MoH /
Amhara Regional Health Bureau
Oromia Regional Health Bureau
Zonal Health Departments and Woreda Health Office
Health facilities /Hospitals and Health Centers
The David and Lucile Packard Foundation

Activities accomplished:

Conducted a consultative workshop to revise the national family planning training module.
Conducted a high-level infertility workshop.
Conducted training for service providers on comprehensive contraceptive family planning (CC-FP) for health providers from west Harerge, West Shewa and Arsi zones.
Conducted Enhances Obstetric Care Mid- Level Providers’ Skills with Basic Obstetrics Ultrasound Training.
Conducted TOT ultrasound Training for obstetricians and gynecologists.
Conducted IUCD refreshment training.
Conducted training for Postpartum Family Planning (PPFP) for West Shew and Arsi zone health providers.
SRH/ Safe Abortion Service and ISM Advocacy Workshop Kicks Off in Ambo.
ESOG Participated in World Contraception Day 2024 Commemoration in Jigjiga.
Workshop to Revise Comprehensive Abortion Care Training Manuals.
World Contraceptive Day Marked in Bahir Dar with focus on Quality Family Planning Services.
SRH advocacy workshop for Media professionals in Oromia region.
Participated two times at family planning bottle neck analysis workshop.

Participated and supported the family planning training manual revision finalization workshop.
Participated and supported the preparation of the national PPH/EMOTIVE training material.
Participated and supported the 3^rd Oromia Regional Health Bureau quality summit.
Participated in an ISM workshop of the Oromia regional health bureau.
Participated in the MPDSR 2024 report writing workshop.
Participated in the safe motherhood technical working group meeting.
Participated and supported in the low utilization of maternal commodity advocacy workshop.
Participated and supported the revision of CAC training manual workshop.
Participated in MoH maternal desk review meeting.
Participated and supported in SRH in humanitarian setting Implementation guideline preparation.
Participated in the Maternal and FP Technical Working Group meetings.
Participated in Safe motherhood technical working group meetings.
Participated in CAC technical working group meetings.

Lessons learned/solutions

The World Health Organization (WHO) has considered Infertility a Public Health problem. This needs attention like other RH services.
SRH issue is not only a health service but main contributor of country economic development.

Challenge

Security problem in project sites Amhara and Oromia region this resulted in restriction of movements, it also affected active implementation of the project.
Overlap of schedule with MoH to conduct workshops.

Project title: Integrated RMNCH + PPFP scale up in high caseload facilities

Objectives:

The objective of the project is to contribute to reduce maternal and newborn morbidity and mortality through increased uptake of voluntary FP and selected RMNCH services in high impact areas in Ethiopia.

Project Outcomes:

Scaled-up IPPFP and PAFP at high caseload health facilities.
Strengthened FP ecosystem to create an enabling platform for scale up of PPFP and enhanced method mix options with introduction and scale up of HIUD.
Strengthened FP/RMNCH-N continuum of care and integrated service delivery at high caseload facilities

Funder: Gates Foundation through Engender Health

Total Budget: $ 800,000

Project lifetime: December 1, 2024 to November 30, 2028

Target beneficiaries: Women and girls in five regions and one city administration in Ethiopia

Activities accomplished:

Participated in preparing facility-based integrated RMNCH+PPFP improvement action plans workshop.
Attended in Clinical Standard training.
Project Regional Inception Meeting Conducted.
Facility baseline assessment.
Project Induction for New Staff.
Mapping Health Facilities and Staff Profiles.
CPD Center Assessment.
Support to Engender Health for Onsite FP Training & VCAT Exercises.
Conducted Onsite Training on FP Integration & VCAT.
Participated in HIUD Advocacy Workshop.
Advocacy for Hormonal IUD delivered via National Radio Broadcasts.
Distribution of Protective Gowns to Enhance Family Planning Service Delivery.
Participation in the Costed Implementation Plan (CIP) Workshop for the National Family Planning Program 2025–2030.
Participated in RMNCH Data Quality Sensitization Workshops.
Participated in the Regional Measles Supplementary Immunization Activity, Nutrition, and Integrated Health Services Campaign.
Supported Woreda-Based Planning.
Engaged in National Workshop on Maternal and Perinatal Health.
MEL Collaboration Activities.

Challenge and Leason Learned

Mismatched Mapping Data as the team began compiling facility data, they quickly discovered discrepancies between what the regional health office provided and the updates from hospital CEOs. Many records haven’t caught up with recent hospital upgrades or reassignments. Adjusting to on-the-ground realities became essential to keep the project aligned and effective.
Training delays across regions onsite training hit a roadblock in four key regions: Central Ethiopia, South Ethiopia, Amhara and Sidama. Some facilities missed out because staff were tied up with other commitments like workshops, while logistical hurdles like transportation gaps made others unreachable.
Scheduling conflicts and staff workload even where training took place, getting timely data proved tricky. Staff at several facilities were juggling multiple responsibilities, causing delays in submissions and reducing training coverage.

Lesson Learned:

Integrating by Inclusion: The diverse mix of participants from different hospital wards turned out to be a game-changer. It helped blend family planning services more naturally into maternal and child health efforts.
Real-Time Support Made the Difference: Keeping momentum wasn’t just about training—it was about staying connected. Assigning focal persons and setting up a shared platform like Telegram helped track progress and solve issues quickly, keeping everyone engaged and informed.
Backing from the Top Matters Hospital leadership stepped up. Their support created a welcoming environment for postpartum and post-abortion family planning services. Even simple moves—like color-coding gowns to match hospital protocols—boosted consistency and provider confidence.
Onsite Training Proved Its Worth, Bringing the training to each facility wasn’t just convenient. It helped make the learning stick. It allowed teams to see their own realities, use resources wisely, and involve more staff. Collaboration with regional partners like Engender Health brought it all together smoothly.

Project Title: Protect the Quality of Family Planning and Comprehensive Abortion Care service in Ethiopia

Objective of the project

General Objective

The general objective of this project is to strengthen the system within ESOG and among selected stakeholders to protect and sustain the quality of Family Planning and Comprehensive Abortion Care in Ethiopia by implementing institution-based interventions.

Specific Objectives:

To build a supportive environment for ESOG members and their respective institutes to actively engage in advocacy and safeguarding Family Planning and Quality Comprehensive Abortion Care services.
To work towards improving laws and policies regarding Comprehensive Abortion Care services.
To tailor members’ leadership roles for the sustainability of Sexual and Reproductive Health and Rights.
To enhance CoCAC with diversified membership, take a leadership role, and proactively engage in supporting national efforts to enable quality abortion care that is effective, efficient, accessible, acceptable, women-centered, equitable, and safe.

Project Site – ESOG

Project period

March 01 , 2024 to July 31, 2025

Funded by

Financial support from the David and Lucile Packard Foundation

Project budget

Total project budget 280,000.00 dollar

Activities accomplished:

SRH sensitization and formation training to social media and mainstreaming Media Journalists.
Supported and coordinated national comprehensive abortion training manual.
Participated and coordinated CoCAC meeting.
ESOG participated in Safe Motherhood Day Celebration in Gambella.

Challenge:

Not able to conduct the TOT Provider Share Workshop due to a shortage of trained providers. The trained providers out of abroad by working for a long time. However, currently they are returning and will be organized in the coming weeks.
Overlap activity with another similar partner for SRH advocacy. We had discussed working together on a plan on SRHR advocacy for high officials.
Security problems in some regions resulted in restrictions on movements; it also affected the active implementation of the project.

Project Title: Protect the access and quality of Comprehensive Abortion Care service in Ethiopia

Objective of the project

The objective of the project is creating proactive health professional and other stkeholders support group for CAC service.

Project Site – National mainly related to ESOG other project sites (Oromia and Amhara regions)

Project period: The period of the project is going to be between May 1, 2024 to September 30, 2025

Funded: Financial support from Marie Stopes International

Project budget: 25,000.00 dollar

Partner: – Project Partners: Ministry of Health /MoH / and RHBs, MSI

Activity performed:

Provided training for health facility managers and administrative staffs on de-stigmatization of safe abortion services /VCAT/.
Conducted SRH/ Safe Abortion Service Advocacy Workshop.
Media Professionals attended workshop on Reproductive, Maternal, Child and Adolescent Health.
Conducted training for service providers on safe abortion service provision as far as permitted by Law/Comprehensive abortion care service

lessons learned:

Not only quality, but it also has gaps for access for SRH/Abortion /, particularly in rural areas, due to turnover trained provider. It affects the service due service interpretation where currently most health facilities 3 Or 4 health providers trained on one facility then it needs our effort to address the gap.
The abortion technical working group at the national level did not regularly meet due to the shift of the task from the maternal desk to the RH desk and it created gaps, and ESOG discussed with the RMNCH lead, and now it forms and conducts the 2024 1st meeting and starts the revision of the abortion training material to align with the 3rd revision of abortion technical and procedural guidelines.

Challenges:

Most advocacy activities work with the government bodies (MOH) at regional and national levels; however, the MOH/RHB overschedules other priority agendas, so some activities are not performed and postponed.
Not able to conduct the TOT Provider Share Workshop due to a shortage of trained providers. The trained providers are out of the country. However, currently they are returning and the trainings will be organized.
Some health facility managers abortion service has not been considered a service, and they have a negative attitude. The service has been interrupted or stopped and currently a number of facilities have reported on MoH. So, we will plan an agenda for discussing on TWG.
Overlap activity with another similar partners for SRH advocacy. We had discussed working together on a plan on SRHR advocacy with high officials.
Security problems in some regions resulted in restrictions on movements; it also affected the active implementation of the project.

Project Title: Ethiopia SCTG National Self-Care Network Project

Objectives:

General objective; – support NSNs, which are established to coordinate self-care advocacy at the national level to transform healthcare systems and place autonomy, power, and control in the hands of individuals.

Specific Objectives

To support the finalization, launch, and dissemination of consolidated national self-care guidelines.
To engage target policymakers and influencers in supporting self-care and instituting self-care policies and financing at national and subnational levels; and
To Increase demand and accountability for self-care among target communities and constituencies.

Partners: – Project Partners:

Ministry of Health /MoH /
NSN members organization

Major activities accomplished:

Finalized and summitted two round Country Monitoring dashboard and endorsed by NSN and MOH.
Conducted quarterly NSN members’ meetings with MoH and other stakeholders on self-care.
Got approval of the National RMNCAYH-N self-care intervention guideline.
Conducted Self-care Implementation Plan workshop.
Conducted Self-care Guideline orientation workshop.
Conducted National Self-care and other maternal health policy guideline launching workshop.
National RMNCAHS-N Orientation and Review Meeting on Self-Care
Conducted national DMPA-SC SI Introduction Plan Validation workshop.
Regional Summit on Self-Care for Sexual and Reproductive Health in Africa.
Participated in changing the narrative around safe abortion training in Nairobi.

Challenges and Lessons learned

Challenges

Advocacy workshops, self-care and values clarification and transformation (VCAT) training for professional associations and health extension works at regional level have been postponed due to overlap country emergency activities.
Delaying decision for self-care implementation strategy document on MoH still under discussion.
Mislead information posted on the social media for Ethiopia abortion law after self-management abortion on technical and procedural guideline is included.
Overlap other activity at MoH so it postponed self-care community practices activity.

Lessons learned

The introduction of RMNCAHS-N self-care guidelines, discussions on creating enabling environments for self-care, and strategies for enhancing maternal and child health through community-based interventions.
Government priority for SRH services and commitment to SDG/UHC.
Growing interest of stakeholders to introduce and scale-up SRH self-care

Project title:

FIGO LDI: REACH-Leadership Development Initiative: Removing Barrier to Effective Access and Coverage of Maternal Healthcare

Postpartum Hemorrhage and Pre-term births are considered to be one of the leading causes of morbidity and mortality of women and children in low- and middle-income countries such as Ethiopia disproportionately affecting women and families. The effects of a maternal death are felt across the family. In addition to the increasing risk that the fetus/newborn will suffer morbidities and death, there are economic and psychological impacts to the family and communities.
The initiative supported and overseen by FIGO will support leadership development to change health care systems so that maternal morbidity and mortality decrease, and birth outcomes improve. It relies on promoting and developing leaders and leadership within ESOG and the health care system in order to achieve improved maternal health and birth outcomes.
The initiative funded by FIGO works in improving the leadership skills in enhancing and elevating evidence based clinical practices within the maternal and newborn health service.

Project Period: November 2022-December 2025

Budget: USD 380 000

ESOG primarily works with FIGO and five others selected FIGO focus members in this initiative through a collaborative and experience sharing platform. FIGO with its rich and boundless experience in women and newborn health assists ESOG in implementing the initiative successfully. Additionally, ESOG partners with multiple other entities such as the MOH, UN agencies, professional associations, CSOs, NGOs etc working in women health. Gender is also at the mainstay of the initiative of leadership transformation for a better clinical practice.

The utilization of Tranexamic Acid for PPH/EMOTIVE implementation and Antenatal Corticosteroid for Pre-term Birth is the initiative’s major thematic area for improvement and up scaling. Capitalizing on leadership skills among ESOG and the health system at all level to bring about changes and improvement from policy adoption to facility utilization of the clinical practices is the initiative’s major goal. By identifying the major systemic and technical barriers and addressing them accordingly, the initiative aims at bringing significant changes in the utilization of these clinical practices which in turn will result in reduced maternal and new born morbidity and mortality

Project nature/approach:
The initiative supported and overseen by FIGO will support leadership development to change health care systems so that maternal morbidity and mortality decrease, and birth outcomes improve. It relies on promoting and developing leaders and leadership within ESOG and the health care system in order to achieve improved maternal health and birth outcomes. It is an implementational research/quality improvement project aimed at assessing the existing practice of TXA/EMOTIVE implementation for PPH and antenatal corticosteroid utilization for preterm birth/RDS and address the gaps and challenges from

Project area/project sites (implementational research sites):
Addis Ababa City Administration: St Paul Hospital, Marie Stopes International-Gotera MCH Center
Central Region: Welkite University Comprehensive Hospital
Sidama Region: Adare General Hospital

Objectives and results framework of the project:
Overall Project Goal: Improving maternal and newborn health outcomes

Primary Outcome 1: Enhanced leadership of Member Societies/ESOG and FIGO

Intermediate Outcome 1.1: Enhanced leadership skills including, but not limited to, the areas of organizational management (financial, grants), advocacy, gender, youth, accountability, women-centered care
Intermediate Outcome 1.2: Increased numbers of publications and speaking engagements by the Member Society (ESOG)
Intermediate Outcome 1.3: Contribute to policy change through increased evidence-based advocacy
Intermediate Outcome 1.4: Enhanced communication and connectedness across FIGO six Indicator/Initiative Societies and other Member societies using a Customer Relationship Management (CRM) Platform

Primary Outcome 2: Increased knowledge and adoption of key maternal and newborn interventions in country

Intermediate Outcome 2.1: Barriers identified at country/state level in each of the 6 Indicator Countries for each of the selected clinical priority areas-Ethiopia: Tranexamic Acid utilization for PPH and Neonatal Corticosteroid utilization
Intermediate Outcome 2.5: Increased investment in MNH services
Intermediate Outcome 2.3: Increased adoption of clinical best practice
Intermediate Outcome 2.4: Increased knowledge sharing and learning development network
Intermediate Outcomes 2.2: Pathway to adopt clinical practice updates identified
Beneficiaries of the project: Women and newborn babies, health workforce in the maternal and newborn care area, maternal and newborn health care system

Activities accomplished:

Project inception/sensitization meeting at the national and subnational level at the respective project sites involving high level authorities and down the line, partners and stakeholders in the area of maternal and child health
Tailored Leadership training to ESOG project and Management Staff, Executive Board Members, MOH MCH LEO and QI LEO representatives. LDI:REACH sites responsible and Quality Officers and OBGYN Residency Program Directors
PPH/EMOTIVE care bundle and PTB/ACS administration Clinical Skill Improvement Training to health care providers at the four project sites and catchment facilities
PPH/EMOTIVE and PTB/ACS clinical data collection compilation and analysis for evidence based quality improvement implementational research purpose
PPH/EMOTIVE and PTB/ACS job aids and policy brief development and printing
Gender LDI Voices and Leadership Empowerment Series activities led by FIGO
LDI:REACH global inter country connectivity forum among the six project countries to exchange learnings and good practices

Project title:

Business and Revenue Planning Project

Objective: To establish and institutionalize a capacity building structure that will be tasked to oversee ESOG’s business (financial) sustainability plan.

Project budget: 62,500 USD

Funder: The David and Lucile Packard Foundation

Project Period: August 1, 2023 to September 30, 2025

Project Site: –ESOG

Major activities accomplished:

Fund raising and strategic plan development training was taken by ESOG staff.
Communication with Non-Profit Builder on consultancy service for business and revenue planning.
Decision made to engage local consultants for cost and context reason.
Request for proposals is prepared to be posted on newspaper.
Consultant is selected.
Business plan development is underway.

Project title:

The use of affordable, non-invasive technology to determine the risk of CPD across duration of pregnancy in Ethiopia: Nationwide study

Objectives:

General objective , To perform a nationwide study to validate whether these two CPD risk assessment tools (i) a 3D Structure camera-, and (ii) tape measurement- based anthropometry can accurately predict CPD based on measurements made from 12- weeks to 42-weeks of gestation, in different regions in Ethiopia.

Specific objectives

Perform a blinded, prospective observational study to develop and validate the predictive capability of 3D camera- and tape measure-based anthropometry CPD risk scores across 6 geographic regions in Ethiopia.

Perform inter- and intra-user variability, usability, and participant acceptability studies to quantify and improve the accuracy, precision, usability, and participant acceptability of the 3D camera and tape measurement-based tools.

Project period: April 2021- March 2026

Project sites: Addis Abeba at Tikur Anbessa Specialized hoapital and Girar Health center

Harari region at Hiwot Fana referral hospital and Arategna health center

Funded by: support for this project is from Georgia institute of Technology and the US National Institute of Health (NIH)

Activities accomplished so far

– Data quality checking

– Currently 2,197 (70%) of study subjects are recruited.

– personnel Recruitment and timely financial management

– Facility preparation and availing material and supplies

– Coordinating facility visits and mgt of activities/ regular financial and technical reports to funding agency/

Project title:

The use of low cost, non-invasive technology to determine the risk of preeclampsia at 12-24 weeks of pregnancy in Ethiopia.

Objectives:

General Objective: To perform a prospective observational study to assess risk of pre-eclampsia based on hemodynamics measures and circulation biomarkers at 12-24 weeks and validate two low-cost tools diagnostic tools to assess pre-eclampsia risk. The specific objectives are to:

Specific objectives

Quantify changes in maternal blood flow and blood pressure waveforms (hemodynamics) across the major vessels of the maternal vasculature from 12-40 weeks of gestation, using ultrasound, echocardiography, applanation tonometry and fluid mechanics computational modeling and to assess risk of preeclampsia based on blood pressure waveform measurements at 12-24 weeks.
Quantify changes in circulating blood plasma biomarkers of preeclampsia from 12-40 weeks of gestation and develop to assess risk of preeclampsia at 12-24 weeks based on blood plasma markers alone, or in parallel with hemodynamic measures.
Validate a novel low-cost blood pressure pulse wave tonometry device, based on photoplethysmogram (PPG), which is currently used in pulse oxygimeter devices.

Project period: July 2022- March 2026

Project sites: Addis Abeba at Teklehaymanot and Girar Health center

Funded by: support for this project is from Georgia institute of Technology and the US National Institute of Health (NIH)

Activities accomplished so far

– Data quality checking

– Sample size: 400 subjects /Currently 290 study subjects enrolled/

we are collecting maternal characteristics, echocardiography, Doppler ultrasound, flow-mediated dilation, applanation tonometry, blood samples for seven potential biomarkers

– personnel Recruitment and timely financial management

– Facility preparation and availing material and supplies

– Coordinating facility visits and mgt of activities/ regular financial and technical reports to funding agency

Project Title: Incorporation of simulation assisted training curriculum on the management of rarely encountered complications during cesarean deliveries into obgyn residency training programs: hybrid implementation effectiveness study

Project Period: January 2023-December 2025

Funded by: Laerdal Foundation, Norway

project objective

Objective: to improve the confidence and skills of obstetrics and gynecology residents regarding the surgical management of two complications that could be encountered during cesarean section: (1) impacted fetal head and, (2) post-partum hemorrhage

Secondary Objectives

To identify implementation determinants

To evaluate implementation & intervention effectiveness in the adoption of an intervention named: ‘‘MamaBirthie simulation assisted training

Budget: 1,874,982.15 Birr

Project Sites:

Paul’s Hospital Millennium Medical College
Hawassa University
Bahir Dar University
Wolaita Sodo University

Activities accomplished:

Trained residents from Welita Sodo University followed by post training evaluation of skills.
Trained residents from Hawassa University followed by post training evaluation of skills.
Data entry on training results completed
Analysis started
Prepared and submitted scientific abstract on B-Lynch component of the project for up-coming scientific conference as part of dissemination plan – awaiting application result expected to be announced in March , 2025

Challenges:

Was not able to train residents from Bahirdar University because of communication interruption (telephone and email), and interruption of educational activities at the target university.
Delay in completing activities RE: Analysis and manuscript preparation for publication

Project Title: Supporting the incorporation of PPH bundle in Ethiopia ESOG ACSIS Project

Project Overview

This project is being implemented in collaboration with ACSIS Starting from April,2025 with the funding from the Gates foundation.

In this partnership ACSIS will facilitate activities to integrate new evidence into the existing national PPH guideline and revise the national haemorrhage response plan and ESOG will provide its technical expertise in developing these strategic documents

Project period: April 22/2025-April 30/2026

Project budget: 8,000,000 ETB

The ESOG-ACSIS project for the second quarter of 2025 focused on three strategic areas:

1. Support the revision of a national hemorrhage response plan
2. Support alignment of PPH care norms and standards with current evidence
3. Advocate for evidence-based PPH care

These focus areas aim to enhance the national postpartum hemorrhage (PPH) response plan by integrating global best practices and aligning national policies with the latest scientific evidence.

Key Activities and Progress

A qualified technical expert was recruited in April and has started contributing to the integration of global evidence into the national guideline.
A second expert was also hired with responsibilities focusing on reviewing and revising the national hemorrhage response plan.
Findings and technical insights were presented in preliminary meetings with key stakeholders.
Experts participated in two sessions, sharing technical evidence on PPH interventions.
Experts participated in preliminary meetings on conducting situational analysis to analyze the current status of PPH and contributing factors.

Challenge:

– Coordination with multiple partners occasionally led to rescheduling of planned meetings to continue the hemorrhage response plan revision activities.