Reaching the hard to reach in Ethiopia

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Ethiopia is one of 10 pilots where GAVI funds civil society organisations to help with immunisation

Ethiopia CSO 2010

Dr. Gideon Tefera, the emergency health and nutrition programme manager for World Vision Ethiopia, examines a map of Ethiopia in Addis Ababa on October 14th, 2010. The map shows operational regions for GAVI-supported civil society organisations working to reach populations currently outside the catchment of government services. Source: Aydogan/GAVI/2010.

Broken refrigerators, fuel shortages and remote, hard-to-reach communities are issues that are hardly unique to Ethiopia. But the East African country is one of ten pilots where GAVI funds civil society organisations (CSOs) to help with immunisation.

"There are so many gaps that interrupt routine immunisation," explains Filimona Bisrat, who represents a consortium of CSOs called the Christian Relief and Development Association (CC RDA) receiving US$ 3.3 million in GAVI support over two years.

Poor, remote, semi-nomadic

In Ethiopia's western Gambella region, for example, communities are poor, remote, or semi-nomadic. They often know little about immunisation, its importance or how to get it.

Some 85% of Ethiopians live in rural areas, more than 60% cannot read or write, and one third live on less than US$ 1 per day, according to United Nations data.

"We are reaching the hard to reach. It's amazing"

Filimona Bisrat, the Christian Relief and Development Association, a consortium of CSOs

"Ethiopia is a very poor country. People live in remote areas, the infrastructure is not there," says Dr Bisrat.

Works with Ethiopia's churches

In addition to explaining the importance of immunisation directly to mothers and communities, the consortium that Bisrat represents works with Ethiopia's influential churches.

The CC RDA also repairs broken fridges, transports vaccines, informs remote communities when vaccinations are taking place, and encourages those who have not taken the required number of doses to complete their course of immunisation.

"We are reaching the hard to reach," Dr Bisrat says of his project, which saw immunisation rates rise to 71% from 40% in Gambella after just one year. "It's amazing."

Flexible funds

For GAVI, supporting CSOs on the ground provides flexible funds to the places where it is needed most.

Experts say Ethiopia is on track to achieve MDG 4 by 2015, with mortality rates for children under 5 falling to 109 deaths per 1,000 children in 2008 from 210 in 1999.

US$ 80-100 billion

Investing in Gavi’s 2016-2020 strategy has the potential to deliver US$ 80-100 billion in costs averted related to illness, such as productivity loss due to death/disability, treatment costs, caretaker productivity loss and transport costs.

Stack M et al. Estimated economic benefits during Decade of Vaccines, Health Affairs 2011

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