Posted by: blog4globalhealth | 04/14/2011


John Donnelly finds the definition of a model family in Ethiopia

SHERA DIBANDIBAN, Ethiopia – Seventy-one kilometers southeast of Addis Ababa, the country capital, two of the country’s 45,000 health extension workers said it wouldn’t be hard to find a model family among this village’s 639 families.

That’s because all 639 were model families, they said.

It was kind of hard to believe. I had traveled out of Addis, on a trip sponsored by theMinisterial Leadership Initiative for Global Health, to learn more about the country’s so-called model families, and was expecting to see an exemplary model family. I was curious as to what one a model.

Just a day before, Health Minister Tedros Adhanom Ghebreyesus had told me that the model families were the leading edge of his ministry’s five-year efforts toward health reform.

In Shera Dibandiban’s tiny three-room health post, Almaz Alemu, 22, and Lomita Bekene, 26, said that all the village’s families had met three-quarters of the 16 requirements under the country’s model family plan, and thus qualified for the designation “model family” as well as becoming eligible for such prizes as large blue water jugs. The requirements included HIV prevention, knowing first aid and emergency measures, immunizing all children, and seeing a health worker during pregnancies.

But not all families met 90 percent of the criteria, they said. In fact, 338 had – a little more than half.

“There is a kind of healthy competition among families to become a model family that meets all the requirements,” said Alemu.

They called them Tier 1 and Tier 2 families. I decided they needed a better name: Super Model Families (SMFs).

Photo by Dominic Chavez

They took me to a SMF, the home of Lomi Desse (pictured, left), 38, the mother of seven children aged 20 to six. Desse’s green-painted cinder-block home was set among orange and raspberry flowering bushes. Two cats sunned in her doorway. Someone washed dishes in a sink (with running water) along the side of the house. The sky was blue. The weather was warm enough for short sleeves.

“This is one of the most beautiful homes I’ve seen in rural Africa,” said Dominic Chavez, a photographer and my traveling partner.

It was true. The model family had a model home.

And that, it turns out, is part of the idea.

“Being a model family means we practice good health, that we have good agriculture, and we keep the house very clean,” said Desse. “By doing this, we are also keeping the community clean.”

Before the model family campaign, Desse said her family didn’t have running water or a pit latrine. When the health extension workers educated them about the benefits for better sanitation, Desse’s family put in running water as well as an enclosed pit toilet. Now she is not only reaping the benefits of proper sanitation, but she is spreading the word as a health ambassador herself, traveling to other communities to preach the importance of good health and sanitation.

“It means you keep yourself clean, you cover water, you boil water, and you prepare good foods,” Desse said.

Listening to Desse was Alemu Sori, the team leader of health prevention for 307 communities, including Shera Dibandiban, population 3,067, which is home to two churches, two mosques, two schools, three shops, 11 water points, and unknown number of livestock, and three cars (all belonging to the same person). Sori said this village was the norm in terms of model families.

“You will find the same in most places,” he said, before adding that this village’s two health extension workers were among the best.

It seemed like the program worked well. Desse said her family was healthier, and eating better. The program had accomplished a truly difficult result: It changed some behaviors.

“People can easily see the different between a model family and one who is not,” Desse said. “When they see the difference, that usually convinces them.”

And Ethiopia counts one more model family.

John Donnelly is a free-lance writer specializing in global health. He traveled to Ethiopia on a trip funded by the Ministerial Leadership Initiative for Global Health(MLI), a program of Aspen Global Health and Development at the Aspen Institute. This is the third and final post inside and outside the Ethiopian Federal Ministry of Health, one of MLI’s five countries. Photo by Dominic Chavez.

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