BREAKING BARRIERS: HOW THE PREGNANT WOMEN’S CONFERENCE IS REVOLUTIONIZING MATERNAL HEALTH IN KALU WOREDA.
Population Services International/Ethiopia (PSI/E)
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ADDRESSING LOW ANTENATAL CARE (ANC) UPTAKE IN ETHIOPIA
ANC is a critical intervention for ensuring healthy pregnancies, preventing complications, and reducing stillbirths. However, in Ethiopia, ANC uptake remains alarmingly low. According to the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS), only 32% of pregnant women receive the recommended four or more ANC visits, and skilled delivery rates remain similarly low.
To address these challenges, Smart Pathways — an expansion of the Smart Start initiative into Reproductive, Maternal, Newborn, and Child Health (RMNCH) — was launched in Kalu Woreda in March 2024. The initiative focuses on empowering adolescent girls and young women (AGYW) with knowledge, building self-confidence, and improving access to quality maternal health services.
TRANSFORMING MATERNAL HEALTH THROUGH COMMUNITY ENGAGEMENT
Smart Pathways builds community-led support systems to ensure AGYW receive timely ANC and maternal health services through the following interventions:
INCREASED ANC UPTAKE AND BEHAVIORAL SHIFTS
By integrating ANC into broader reproductive health discussions, Smart Pathways has helped shift long-standing cultural norms, creating a new reality where seeking maternal care is the expectation, not the exception.
“Previously, pregnant women lacked awareness. But now, early ANC visits at our health center have increased from 35% to 84% in just six months among women of reproductive health age. Women now consider home births a taboo.” shares Samira.
OVERCOMING BARRIERS TO EARLY ANC UPTAKE
Despite these gains, several challenges traditionally hindered early ANC service uptake in Kalu Woreda:
Recognizing these barriers, Smart Pathways implemented targeted awareness campaigns, stronger community engagement, and service delivery improvements. The active involvement of HEWs, WDAs, and community champions has created a supportive environment where women feel empowered to seek ANC services early and consistently.
BEYOND MATERNAL CARE: A SPACE FOR LEARNING AND EMPOWERMENT
The Pregnant Women’s Conference (PWC) has evolved into more than a health session — it’s a catalyst for shared learning, social cohesion, and generational change. Women gain vital health knowledge, form strong peer networks, and reinforce maternal health practices within their communities. Involving husbands and traditional birth attendants has also strengthened household decision-making and support for institutional deliveries.
The dedication of HEWs like Samira and the efforts of community champions are driving this transformation. With greater awareness and community support, more women are accessing skilled care and making informed reproductive health choices.
LOOKING AHEAD
The Smart Pathways initiative has proven that when women are equipped with the right information, services, and support, maternal health outcomes can improve dramatically.
The progress in Kalu Woreda is a powerful example of how community-driven solutions can reshape maternal and newborn health services.
To sustain and scale these results, continued investment, policy support, and local ownership are essential. Expanding Smart Pathways across more communities could:
By working hand-in-hand with local health systems, government partners, and implementing organizations, we can scale this success and make safe motherhood a reality for every woman.
The transformation in Kalu Woreda is more than a rise in ANC visits — it reflects a cultural shift where maternal health is prioritized, normalized, and celebrated. By scaling Smart Pathways and deepening collaboration, Ethiopia can continue moving toward a future where all women — regardless of age or location — have access to life-saving maternal care.
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Great job. Community led norm identification, prioritization and transformation is crucial to break the barriers and enhance equitable health system👏
HPV Vaccination and Gender Project Officer, Awbare Woreda, Fafan Zone, Somali Region, Ethiopia
3moThoughtful post, thanks Congratulations Kulu Woreda for your Smart pathway that you create ANC Uptakes is a great Example that is required to implemented the rest Woreda other regions, I pairwittness that low utalization of Antenatal Care is low in all regions and there are multifactorial that's affecting and again there are abundance solutions including 1. Cultural Norms Challenge: Influential family members discourage early ANC, viewing it as unnecessary Solutions: Engage Influential Community Members: Involve religious leaders, elders, and traditional birth attendants (TBAs) in promoting early ANC as a norm. Mother-in-Law & Family Dialogues: Facilitate community 2. . Service-Related Challenges Challenge: Distance, workload, and inconsistent care reduce service use. Solutions: Mobile ANC Clinics: Deploy mobile health units to reach remote areas Improve Health Worker Capacity: Hire and train more midwives and health extension workers to reduce staff burden. Strengthen Community-Based Services: Equip health posts and community-level workers to provide basic ANC services and referrals. Incentivize ANC Attendance: Offer small incentives (e.g., soap, iron supplements, or transport vouchers) to encourage timely visits