A Healthier Future for Adwa

2015-2020, 2023-present Adwa, Tigray Region, Ethiopia

“The NALA training woke me up.. Before the training, I understood that my own personal hygiene was important, but the training paved the way for me to think about the importance of hygiene and sanitation for all the people in my church. I understand now that I can lead the way in making them healthier.”- Priest Hawas Gebremichael, Adwa

In 2015, NALA won a 1–year grant from the Bill & Melinda Gates Foundation to implement our unique behavior change program in Adwa in northern Ethiopia. The program aims to eliminate intestinal parasites in Adwa through intensive outreach to schools and community groups. The district was chosen in consultation with the regional government and based on mapping data that shows a high burden of disease there. In addition, Adwa lacks sufficient access to clean water and sanitation.

For this project, NALA partnered with a local NGO (OSSHD) and hired a local staff to ensure that the project has a deep reach within the community. Since the project began, NALA has worked closely with the local community to identify obstacles, map existing infrastructure and community networks, and design locally-based solutions. NALA has trained thousands of community members and provided small grants for locally-led projects that improved access to water and sanitation.

Each year the project has shown greater reach and ownership by the community. Volunteers from Adwa Teacher’s College were trained to support the schools and promote healthy habits to students through interactive and playful health education activities. Local womens’ groups were engaged to spread health messages to the household level. Religious leaders were mobilized to deliver health messages and lead campaigns to improve health in their communities. A coordination committee of local government representatives was formed to oversee and monitor the project. This increasing level of local ownership has been key to the project’s success. 

In 2019, biological surveys showed that the rate of intestinal parasites in intervention schools had decreased from 26% to 1.5% (a 94% decrease!) Of note, infection by bilharzia dropped from 47 cases in 2015 to zero cases in 2019. As further testament to NALA’s successful model, trained community members were taking the lead on many public health initiatives in Adwa.

However, in 2020 during the project’s final year, the pandemic forced a pause on many project activities. Project staff instead aided the local health authorities in pandemic preparedness and response. Following that, in November 2021, a conflict erupted in the region that led to an ongoing humanitarian crisis. (Link to humanitarian project0

Since November 2022, the region has begun the process of rebuilding and restarting services. NALA plans to also restart our project in Adwa, with a new goal of supporting a return to a healthier normal. 

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