Shaping Healthier Futures Through Storybooks

To tackle the high rates of NCDs in Ethiopia, THET has collaborated with the Ministry of Health, Health Poverty Action (HPA)/Health limited (HL), and Novartis Global Health to launch the Healthy Family (Tenama Beteseb) programme. The initiative seeks to decentralise healthcare in order to cater to those who may find health facilities too expensive, or too inaccessible. The programme wishes to increase access to services for beneficiaries through capacity building, developing human resources and decentralizing the screening, diagnosis, treatment and care of NCDs. The programme began with the aim to reach and screen 200,000 people, and enrol 15,000 of these in the care and treatment program.  

The Healthy Family project comprises of a total of 14 hospitals and 45 health centres;the 14 hospitals include 3 General Hospitals and 11 Primary Hospitals in 6 regions. Namely, Oromia, Amhara, Southern Nations, Nationalities and Peoples (SNNP), South-Western Ethiopian Peoples (SWEP), Benishangul-Gumuz & Afar Regional States) and Addis Ababa city administration. The programme specifically tackles hypertension, diabetes, epilepsy and chronic respiratory diseases. By decentralising care in this way, we can take a community-centric approach towards healthcare, with a greater focus on engaging directly with those who may have difficulty accessing healthcare and thus may be neglecting it. We are excited to report that as of October 2022, a total of 289,910 individuals were screened at target health facility level for the four NCDs, out of which 16,948 were put on treatment, exceeding our target!  

As our operational areas in North Gondar and North Wollowere war fronts, health facilities have been damaged, looted and unable to deliver required basic services (including NCD care). We are happy to report that the situation in North Gondar has relatively improved and facilities have re-started their operations; however, North Wollo still needs support in terms of equipment, reconstruction, stocking the facilities with medicines and necessary infrastructure.   

Your generous contributions will assist us in tackling the reconstruction of health facilities and continuing our operations towards bettering NCD management in remote regions of Ethiopia. We are grateful for your unending support through such a turbulent year and look forward to reporting our ongoing efforts. 

In Ethiopia as in much of sub-Saharan Africa, high blood pressure is a common health problem. Which, if untreated, leads to severe illnesses including heart disease, stroke and kidney failure. Although the THET Ethiopia NCD Alliance (THENA) is involved in the effort to screen individuals for high blood pressure, a big problem is persuading patients to attend the clinic and take their treatment. Many patients abandon the clinic for a variety of reasons; there is a strong preference for traditional healers and the use of herbalists, holy water and the like.   

Story telling is a traditional and well-established way of communicating ideas in Ethiopia. WIth your generous and unwavering support, we commissioned the production of a short story written by the well-known Ethiopian author Daniel Worku (one of the country’s foremost children’s authors), and illustrated by an Ethiopian artist Gabreiyesus Asmare. 

Our objective was to produce a short, illustrated book (see picture 1) aimed at 10–14-year-olds - the next generation who are now in school, are about to join the workforce, and assume some of the caring responsibilities for older family members. This generation will also be that from which the next group of health workers will be recruited.

In producing this story our aims were for it to stand on its own by having a multiplicity of layers/strands that deal with aspects of life that are relevant to this age group; things such as the tension between tradition and modernity, gender differences and tensions, generation gaps and more. Needless to say, the message regarding the perils of ignoring the modern medical clinic is clearly articulated in the story and runs throughout it. We worked to produce a story that is indigenous in topic, and composition. With the hope that it might be adopted as such and be propagated, in time, from within the community itself. The aim is that the message embedded by us is not one that competes or contradicts indigenous cultural ways and beliefs. 

Having produced the book the next step is to gauge responses of both children and parents. This is underway, by Tsion Afework of Addis Ababa University and Daniel Worku, the book’s author. So far, we have done a public reading at a book fair at the Addis Ababa Exhibition Centre (see picture 2) and plan readings at I Care Ethiopia (a charitable organisation that provides homeless mothers with children with childcare day provision and assistance in starting up new small business enterprises), and within several private homes where there are children of the target group. After readings there will be discussions led by Tsion Afework (see picture 3). These discussions will be directed at getting a sense of the audience’s understanding of the story, the variety of topics involved and whether the story - text and illustrations - is one that engaged them to want to read it again and pass it on.  

We are keen to see how the embedded message regarding the dangers of ignoring what the modern clinic has to offer is received.