In the districts of Sidama, Central, and South Ethiopia, access to healthcare is often challenging, exacerbated by various health emergencies such as communicable diseases outbreaks, including malaria, measles, and cholera. These regions, particularly in identified hotspot districts, face multifaceted health emergencies like drought, malnutrition, conflicts, displacement, and floods, coupled with poor access to health services and infrastructure.

Despite the efforts of regional health bureaus, public health institutes, WHO, and other partners, outbreaks of malaria, measles, and cholera continue to pose significant threats across the three regions. Protracted outbreaks of malaria and measles have strained the already fragile health systems, further compounded by additional health emergencies or risks like cholera, meningitis, drought, conflicts, and floods.

To address these challenges, a community-led initiative has been making remarkable progress in combating measles, malaria, and malnutrition through collaborative efforts between local health facilities, community health workers, and government agencies. Key successes of the initiative include:

• Mobilization of resources and healthcare workers to support case management efforts, such as the designation of treatment areas for measles cases equipped with essential resources at Shone Primary Hospital.
• Involvement of community health centers like Eddo and Hanicha in extending healthcare services beyond facility walls through facility-based case management and community outreach activities.
• Capacity building and training for healthcare workers through on-site mentorship and orientation sessions, enhancing their skills in case management and strengthening the overall healthcare system.
• Successful community-based interventions, including house-to-house visits and targeted outreach programs, leading to the identification and referral of cases, vaccination of children against measles, and linkage of malnutrition and malaria cases to appropriate services.

As part of a community-based intervention program in the Hadiya Zone, 123 health care workers were trained for a 10-day program. Over 22,000 households were visited during this period. The program focused on childhood immunization, identifying over 2,000 children who had not received any measles vaccinations and another 2,700 who dropped out of the program before receiving the second dose. Through the program, nearly 3,000 children under 2 years old were successfully vaccinated.

Active case search efforts also identified nearly 900 cases of measles and over 140 cases of malaria. Outreach care was provided for these cases, and referrals were made to health facilities when needed.

The program also screened over 17,000 children between the ages of 6 and 59 months for malnutrition. Of these, over 350 were identified with severe acute malnutrition and nearly 1,200 with moderate acute malnutrition. Thankfully, all these children were linked to services to receive proper treatment.

Additionally, the initiative received significant financial support from the European Civil Protection and Humanitarian Aid Operations bolstering the community-based intervention efforts. Furthermore, during the household visits as part of the community-based intervention, a total of 109,693 individuals were sensitized, highlighting the extensive reach and impact of the program in raising awareness about healthcare practices and disease prevention within local communities.

WHO is grateful for the financial support received from the European Civil Protection and Humanitarian Aid Operations. Looking ahead, the initiative aims to build on its success by continuing community-based interventions, strengthening referral systems, and further capacitating healthcare workers. By leveraging collaboration between healthcare facilities, community health workers, and local communities, this initiative represents a beacon of hope in improving healthcare access and outcomes in regions of Ethiopia. It underscores the importance of focused interventions and community engagement in addressing complex health challenges in resource-constrained settings.

Technical Contact
Dr Hassen Ali
Case Management Officer