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.

From 506 women who had undergone OF surgery in one of the four treatment centers in Ethiopia between March 2015 and February 2016:

  • 238 - women had participated in HHOJ’s training program (intervention) and 268 had not (comparison).
  • A sample size of 57 for intervention and 59 for comparison was estimated for a power of 80%, based on the following assumptions:
    • 25% - of women in control group will be fully integrated
    • 62.5% of women from intervention group will be fully integrated
    • Women who received intervention were more likely to report feeling financially secure ‘a lot of the time’ than women in the comparison group (26% vs 0.86% respectively) and less likely to report that they felt ‘not at all’ financially secure (28% vs. 44%).
    • Women in the intervention group also had more cash on hand than the comparison group (10,812 vs. 7,148 Ethiopian Birr).

Success Story: Safe Motherhood Ambassador Birtawit

Safe Motherhood Ambassador, Birtawit lives in Enderta, Tigray Region with her 5 children. As a young girl she was forced to quit school when her parents arranged a marriage for her at age 15. She had 8 pregnancies of which 2 of them were still born. About 10 years ago Birtawit developed fistula from her last pregnancy. She says, ``Life with fistula was very difficult. I was mad at God. I was going crazy. I even washed with Holy water but it did not help. Then I received treatment at Hamlin Hospital and trained by Healing Hands of Joy to become Safe Motherhood Ambassador (SMA).

After Birtawit completed her SMA training, she received a $250 micro-loan with which she bought chickens to start a poultry business. She turned it into a profitable business by selling eggs and live chickens. Birtawit says, "I am working hard to change my life. I used my IGA loan to start a profitable business. I was able to buy an ox, a cow and a donkey. I also paid $230 towards my daughter’s college tuition, who graduated recently and will be a teacher soon. I am sending all my children to school. Moreover, I paid back my loan in full and I have $230 in my savings account."

As a Safe Motherhood Ambassador, Birtawit has educated 56 pregnant women and out of them 44 gave birth at health institutions. While conducting her house to house teaching of pregnant women, Birtawit had identified a new woman with fistula and sent her to Mekelle Hamlin Fistula Center for treatment.