Community Engagement in WASH & Health Education for Behavior Change

NALA stands for NTD Advocacy, Learning, Action and is an Israeli non-governmental organization that has been operating in Ethiopia since 2008. It takes a unique and, most importantly, community based-integrated approach, mainly focusing on health education, WASH (Water, Sanitation and Hygiene) and treatments to achieve sustainable behavior change and ultimately control and eliminate neglected tropical diseases (NTDs). Their program is aimed at working together with community leaders, health workers and national health authorities to identify local challenges and develop tailored solutions to fit the social, cultural and environmental context. The organization has developed into a thriving institution that works on the ground in numerous communities and provides technical guidance to local authorities

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An estimated 37.3 million people in Ethiopia are at risk of contracting schistosomiasis, including approximately 12.3 million children.

Back in 2017, the Merck KGaA, Darmstadt, Germany/NALA Foundation Partnership was formed in collaboration with the Ministry of Health of Ethiopia to control and eliminate schistosomiasis and other NTDs in the Bench Sheko & West Omo zones (previously Bench Maji zone) in South-West Ethiopia. This region is known for being one of the toughest NTD hotspots. Special attention and implementation support has been given to areas in which the disease burden remains high despite regular mass drug administrations (MDA). Tailored, community-owned health education and WASH programs have been designed and implemented to reduce prevalence levels and move from control to elimination.

Over 50% of school children were reported to suffer from one or more NTDs. The zones covered through our initiative touches an estimated population of over 900,000 in an area of nearly 20,000 km². The infrastructure in this area is poorly developed and road access to rural communities is difficult during the rainy season, which lasts nine months of the year. During the short dry season, the mud is replaced by dust which chokes Mizan Aman's main trading routes. Farming and agriculture are the main sources of income and several languages are spoken in the zone, including Benchinya, Me’en, Amharic, and local tribal languages. The project zone was selected by the Ministry of Health as the intervention site for a pilot program to reduce the prevalence of schistosomiasis and other NTDs.

In partnership with the NALA Foundation, the “Community Engagement, WASH/Health education Project for the control and elimination of Schistosomiasis and other NTDs as a Public Health Problem” also aims to reduce disease prevalence in all districts where schistosomiasis is endemic to create a proven success model.

Over the course of years of interventions, impact surveys have shown up to 89% prevalence reduction in schistosomiasis. Based on the findings, the regional team note success in the strong partnership established with the Mizan Tepi University for research and report changes in the behavior of school children and their respective families as well as high levels of community involvement and effective collaboration with local government structures.

People impacted by this project : 617,589 people impacted by this project
Students reached: 372,934 students reached with Health Education Programs
Households reached: 49,570 household visits
Schools receiving interventions: 378
Community members received health education: 232,498 Community members reached with Community Health Programs
Health Extension Workers and Health Development Army Volunteers trained: 12,157
Sanitation Campaigns: 573

The next phase of the project (2024 2027) is to validate the sustainability of established platforms and activities for reducing disease prevalence, a government led integrated monitoring framework will be developed and implemented, encouraging the local government to evaluate programs and make informed policy decisions.

Read more through publications in:
Tropical Medicine and Infectious Disease
International Health