In 2015, Healing Hands of Joy conducted an impact assessment to determine the impact of our "Safe Motherhood Ambassador" program on fistula survivors and maternal health service utilization in the Tigray region of Ethiopia. The main objectives were to determine the trend of maternal health service utilization and compare between three operational and 3 non-operational districts. Successful reintegration of fistula survivors in their communities as self-sustainable members and the awareness of the community towards fistula in the six total districts were also assessed.

Major Finding #1: Community Awareness of Fistula Communities' awareness about harmful tradition practices such as early marriage which predisposes women for obstetric fistula, the benefit of antenatal care and institutional delivery has sharply improved. In addition, previous beliefs about fistula being a "curse from God" have changed in the communities which help to reduce barriers to use services.

Major Finding #2: SMA Program Empowers Fistula Survivors The impact assessment revealed that simple interventions can address the tragedy of obstetric fistula for women who are suffering from physical, mental, social, and physiological issues. Healing Hands of Joy has indeed made a remarkable impact on the lives of these women.

Safe Motherhood Ambassadors served as activists of fistula prevention and as the "voices" of the women. They help to challenge gender issues. Communities found the SMAs' testimonies and fistula information to be credible, valid, and trustworthy since the fistula survivors speak from their own experiences.

The SMAs help to identify new fistula cases and pregnant mothers, bridging the community with local health system and local authorities. The data shows that births attended by skilled health professionals have sharply increased in the last four years.

HHOJ's intervention and the SMAs' work have drastically led to fistula being seen as a very rare event for health workers to see in their districts. SMAs all reported that the rehabilitation and reintegration support from HHOJ made them feel as if they were reborn.

They felt healthier, able to work and participate in social activities, and are economically empowered through the loans received and the support from HHOJ.

Impact of Safe Motherhood Ambassadors

  • 29,347 Pregnant women educated by SMAs
  • 26,498 Pregnant women attended ANC because of SMA intervention
  • 18,798 Women delivered at a health facility after SMA education and intervention