Building Community Health Worker Capacity to Identify and Reach Vulnerable Populations with HIV and Other Health Services in Ethiopia

Under Ethiopia's Federal Ministry of Health (FMoH)'s Urban Health Extension Program (UHEP), nurses are trained and deployed as ‘UHE professionals' to provide household-centered preventive and curative heath services, including referrals to health facilities. The USAID-funded, John Snow, Inc. (JSI) USAID/UHEP is working to support the FMoH to build the capacity of UHE professionals in 19 cities/towns to identify and reach vulnerable populations with these health services. USAID/UHEP provides a skill-based training, ‘Health Needs and Risk Assessment: A Three-day Skill-based Training' to UHE professionals (and supervisors) to help them assess structural factors that may contribute to, create, and increase vulnerability and risk for health problems, including HIV/AIDS, and to better respond to the concerns and needs of vulnerable populations. Activities help them explore the social ecology of vulnerability and risk for health problems, in order to expand participants' understanding of how risk behavior is influenced by structural drivers of vulnerability such as gender inequality and stigma. The training places emphasis on increasing UHE professionals' awareness about their own attitudes, expanding their knowledge about key barriers to accessing and utilizing services, and building skills to help clients overcome these. The training also focuses on strengthening the UHE professionals' communication and facilitation skills, and facilitates risk assessment and risk reduction for HIV. Follow-up refresher training ensures the UHE professionals deepen and maintain the new skills. To date, UHE professionals have reached more than 11,900 vulnerable individuals, of which 72% were women, and have provided home-based counseling and testing (HCT) for over 3,650 individuals.