This week, Jennifer James, the founder of Global Team of 200, who I’m honored to write for, is on the ground in Ethiopia learning all about the issues Frontline Health Care Workers face in one of the poorest countries of the world. Jennifer is in Ethiopia along with three distinguished US nurses on behalf of Save the Children. Back in September, I had written a post about Save the Children’s campaign “Every Beat Matters” (to read post, click here). I was extremely touched by this campaign and what Save the Children is doing to help save lives. Jennifer published her first account of day one in Ethiopia today on the Bill & Melinda Gates Foundation’s blog “Impatient Optimists“. I asked Jennifer if I could share her story here as well and she was thrilled. 


A woman has her child vaccinated by a Health Extension Work at the Germana Health Post in Ethiopia. Photo credit: Impatient Optimists


My First Day in Ethiopia: An Army of Women Fight to Save Lives


Written by Jennifer James

December 11, 2012

This week Jennifer James is in Ethiopia to observe Save the Children’s work with frontline health workers who strive to improve newborn and child health. Today she, along with three US-based pediatric and obstetric nurses, was briefed about the state of newborn, child, and maternal health in Ethiopia by the Maternal Newborn Child Health Advisor at Save the Children, Dr. Birkety Mengistu.

Ethiopia, a country of 84 million and one of the world’s poorest according to the World Bank, is working diligently to save the lives of women and children; and it’s doing it with the help of an army of thousands of women.  The country is specifically aiming to reduce child mortality by two thirds and reduce by three quarters the maternal mortality ratio, all by 2015. Unfortunately some of these numbers are stubborn in their refusal to decline rapidly enough – or decline at all. Between 2005 and 2011, Ethiopia’s newborn mortality rate only dropped two percentage points. And for every 100,000 women who give birth in the country, 676 women die from delivery and childbirth complications (What is important to note is that an astounding 90 percent of all Ethiopian women, who on average deliver 4.8 babies who survive, give birth at home. This is due to cultural norms and the lack of access to nearby health centers). It’s why thousands of women are being trained as “frontline health workers” to spot diseases and get women and children treated as quickly as possible.

The Ethiopian government has trained over 38,000 health extension workers (HEWs) since 2003 – all women. Each health extension worker provides direct care for children and women at their community’s health post. At each health post throughout Ethiopia two HEWs are responsible for the health and care of 1000 households or 5000 individuals according to Dr. Mengistu. Health extension workers are paid for their work.

Save the Children and other partners have supported this work by helping to train 6000 health extension workers to treat malaria, pneumonia, malnutrition, and diarrhea through an “integrated community case management” approach. Two or more of these diseases commonly occur together in the same child, noted Save the Children. Children can be treated as soon as possible for these diseases. Before? Health extension workers were forced to refer sick children to professional health workers, but by that time there was a great chance it could be too late.

Now health extension workers are charged with finding “model families” that can be lauded as examples of families who are making the right choices to ensure a healthy family like getting antenatal maternal health, building latrines, and making sure their children get the proper series of immunizations. The women of these “model families” are forging the Health Development Army (HDA), volunteers who share what they have learned about proper health and development with other women.

You can learn more about frontline health workers around the world and how vital they are to communities at Save the Children’s web site Every Beat Matters.

Later this week Jennifer James will share stories from visits to health posts in Hawassa, Ethiopia.


  1. How fascinating! It’s amazing to think of 90% of babies being born at home. When we were living in Haiti, a horrible cholera epidemic broke out. I wonder if there are similar issues in Ethiopia.

    1. Yes can you imagine that?!!! I remember hearing about the cholera epidemic. Not sure on what kinds of other issues Ethiopia has but hoping Jennifer will enlighten me.

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