Ethiopia The Last Ten Kilometers: What it Takes to Improve Health Outcomes in Rural Ethiopia (Gates Foundation)

In 2013, Ethiopia achieved Millennium Development Goal 4 by drastically reducing under-five child mortality. However, with 673 deaths per every 100,000 live births, it has the sixth-highest maternal mortality ratio in the world and the second-highest in Africa. Ethiopia is the second most-populous country in sub-Saharan Africa, and around 79% of its estimated 109 million citizens live in rural areas. Since many women still choose to deliver their children outside of a health facility, a community-based approach is essential.

The Last Ten Kilometers: What it Takes to Improve Health Outcomes in Rural Ethiopia Project (L10K) mobilized families and communities to take charge of their own health. L10K strengthened the delivery of health services through engagement with families and kebeles (villages) to improve health norms in communities. L10K complements the Government of Ethiopia’s Health Extension Program (HEP) to jointly achieve sustainable reproductive, maternal, neonatal and child health improvements at scale.

L10K was implemented in 215 woredas in the four most populated regions of Ethiopia: Amhara; Oromia; Tigray; and the Southern Nations, Nationalities and People’s regions. It covered a population of about 25 million people, nearly 23% of the total Ethiopian population.

L10K was implemented by JSI Research & Training Institute, Inc., with support from the Bill & Melinda Gates Foundation and additional funding from UNICEF and USAID. L10K worked closely with the Ethiopian Government and other development partners, and provided technical and financial support to twelve civil society organizations.