Safe Motherhood Ambassador Programs

Literacy & Numeracy Training provides basic maternal health education to each Safe Motherhood Ambassador through a 10 hour curriculum designed and presented by our nurses and/or midwives. The modules include maternal, neonatal, child health, nutrition, and family planning teaching sessions. The lessons include discussions on harmful traditional practices and how to effectively communicate with pregnant women and expectant families.

Psychological, Social, and Spiritual Counseling - The psychological and social, counseling are one-on-one sessions designed to build confidence , restore self-esteem, and to equip each woman with the tools to restore a meaningful life following fistula and divorce. Psychological counseling is provided by a trained psychologist and an in-house counselor who provides on-call support to the women as needed. Spiritual counseling sessions are provided through group sessions and are aimed to dispel the myth that fistula is a punishment from God. These sessions are facilitated by reputable, culturally appropriate individuals (mainly religious academic leaders).

Income Generating Skills equip the women with business skills to enable them to engage in a suitable income generating activity that will improve their financial situation. The training addresses the principle of savings and loans as well as the issue of loan repayment. We train the women in income generating activities that are appropriate to their rural setting (including poultry keeping, animal fattening and buying and selling cereals or other staple agricultural goods). At the conclusion of the program, the women are given a small loan to get their business started.

Micro-loans strive to provide our Safe Motherhood Ambassadors with a basic education in reading and writing. Approximately 78% of our Safe Motherhood Ambassadors are illiterate and most have never learned how to write their own name. We provide literacy and numeracy training to empower our Safe Motherhood Ambassadors with essential life skills.

Community Engagement

Stakeholder Workshops allow us to connect our Safe Motherhood Ambassadors with influential members of their communities that can form a support network for their work and reintegration. Key social influencers include: health extension workers, midwives, women’s association members, religious leaders, and community members.

Film Screenings mobilize a Safe Motherhood Ambassador’s community to end fistula by educating them on the true causes of fistula and steps they can take to end its prevalence in their community. These events introduce the Safe Motherhood Ambassador to the community, raise awareness of safe delivery, and de-stigmatize obstetric fistula. We gather entire rural villages together to screen the film ‘Fistula is Not a Curse’ and hold a post film candle ceremony. A typical event reaches 200-300 people.

Religions Leader training - Religious leaders have the ability to raise awareness about fistula prevention and identification because of their influential role at the community level. With the insight of our Spiritual Counselor, we created a Religious Leader Training program for Christian and Muslim leaders.

Male Family Member Trainings - Male family members are often the decision makers in a family and can help provide support for a Safe Motherhood Ambassador’s work. We now provide male family members with information about Healing Hands and fistula prevention.

Refresher Trainings ensure that no Safe Motherhood Ambassador is ever left behind. We follow up with our SMAs and provide them with refresher trainings in areas where additional support or education is needed. We also use the trainings to collect feedback from our Safe Motherhood Ambassadors on how we can strengthen our support of their work.

Monitoring and Evaluation

Baseline assessments - In order to quantify the impact of our program in a new community, we perform baseline assessments of Maternal Child Health awareness prior to the entry of our Safe Motherhood Ambassadors.

Expert review meetings - We organize and facilitate regional fistula prevention expert review meetings. The objectives of these meetings is to ensure that the learnings from our program are shared broadly across local, institutional programs that are working to eliminate fistula and improve maternal health in rural Ethiopia.

Bi-annual checkins allow us to check in with our Safe Motherhood Ambassadors in order to evaluate their fistula prevention and identification performance as well as ensure that have been successfully reintegrated back into their communities.

Strategic Initiatives

Skilled Hands of Joy - There are just 4,000 midwives in Ethiopia, for a population of 42 million women. Our program, Skilled Hands of Joy, will help equip diploma-level midwives with clinical skills needed to intervene in emergencies and provide comprehensive antenatal care in remote regions of northern Ethiopia.

Mobile phones and shoes - Many of our Safe Motherhood Ambassadors lack basic supplies such as shoes and do not have access to critical communication tools. If our SMAs had access to mobile phones and shoes, they would be able to walk to more homes and more quickly connect expecting mothers to a network of health workers. We include these items in their graduation toolkits.

Sanitation support - While fistula repair surgery is effective in 90% of cases, there are women who remain incontinent and require discreet, adult sanitation support. For these women, we provide them with the supplies that they need so that they can lead an active, shame-free life.