Unplugging the Gender and Cultural Norm Bottleneck to MNCH

Pastoralist Dasenech and BenaTsemay women (67,210 women) living in remote southwest Ethiopia are constrained by adverse gender norms, cultural beliefs and traditions and as a result, they cannot make decisions about their own health and well-being. The goal of this holistic integrated approach was to blend traditional wisdom with modern thinking in order to transform the cultural belief that large families mean wealth into healthy families mean wealth, by leveraging their traditional desire to have enough children to work. The initiative tested the impact of integrating adult literacy classes (women gain confidence to self-advocate) with livelihood activities (women contribute to household assets) with a series of structured discussions where the community discovers that in order to have enough healthy children, they need to practice healthy timing and spacing of births. The ability to access health services was improved by the establishment of community-owned and -operated “donkey ambulances.”