Category: Uncategorised Published: Monday, 04 July 2016 Written by Super User


1. Leishmaniasis:


Leishmaniasis is endemic in the arid southwest and the Humera & Metema lowlands in the northwest and Libo Kemkem & Fogera districts of Amhara regional state since the 2005 outbreak in Ethiopia. CL is confined mainly to the highlands, although occasional cases have occurred in the Omo Valley, and transmission is currently thought to be zoonotic. However, recently both VL and CL cases are found around Degadamot districts of the Amhara Region.


Some of the challenges identified in the prevention and control of Leishmaniasis so far are:

• Awareness of the disease transmission and prevention among the general public is low and migrants arriving to those endemic due to economic motivation are mostly uninformed about the disease transmission and therefore don’t take informed decision making ;

• Communication and advocacy efforts to increase Knowledge of the diseases and prevention among owners of large scale farming business in areas where the disease is endemic need to be strengthened on top of the encouraging efforts being made by WHO and Regional partners;

• Political commitment to allocate budget for the prevention of the disease and mobilize owners of large scale farming business in support of migrants with prevention packages (IEC materials, Bed nets, etc.) need sustained advocacy and innovative approach to rally decision makers in support of the program.

To give response to these gaps different activities were planned to be undertaken in collaboration with WHO in Amhara region. Among these activities advocacy workshop on Leishmaniasis at regional level with selected endemic woreda representatives, investors & other partners and providing material support for regional mass media and communication office were the prominent ones. The workshop undertaken with investors and pertinent stakeholders to promote their involvement in the prevention of Leishmaniasis and the materials support made is described as follows.



2. Objectives of the Workshop and Material Supports


• To create awareness of the disease burden and means of preventions among business people who own large scale farming business in endemic areas and solicit their support in the development of prevention packages;

• To create awareness of the disease burden among members of the Amhara Regional Council, Zonal and Woreda cabinet members to gain their commitment in support of the prevention efforts;

• To motivate business people and investors so that they can allot sufficient budget for the prevention of Leishmaniasis and gain their commitment • To see the progress made after the previous year’s workshop on Leishmaniasis treatment accessibility and awareness creation

• To build the capacity of communication office and mass media agency by providing materials that are crucial in information recording and storage for media advocacy;


3. Workshop Place: Bahir Dar, ADA Hall


4. Duration of the Workshop: From 23/11/2012-24/11/2012 5.


5. Participants of the Workshop

The advocacy workshop on Leishmaniasis was conducted with participants from different relevant selected offices in 6 selected woredas, zones and sectors from the region. The participants of the workshop are 1 Amhara Regional council, Amhara communication Office, Amhara Mass Media Agency, Regional labor and social affairs office, Trade & transport ,Investment and Land & Natural Resource Bureau, Gamby Pvt. Ltd. Hohete tebeb, North Gondar Investment, Trade & Transport and Labor & Social Affairs Department, BOFED, IFHP,  L10K, Woreda administrations & HDAMA a Total of 64.

The workshop participants from woreda level were those from endemic woredas for Leishmaniasis and pertinent government staffs. The woredas were Dega Damot, Metema, Tach Armachew , Quara, Tsegedie and Libokemekem. Dr. Dadi Jima from EHNRI and Ato Gashu Fentie from federal ministry of health, Malaria advisor were also among the participants of the workshop.


6. Workshop Proceedings

6.1 Program Introduction and Welcome Speech:At the beginning of the workshop, Ato Estifanos Bayabil, regional coordinator of HDAMA introduced the two days workshop schedule and welcomed the workshop participants. Next he made short briefings regarding the establishment of the association, its program areas and the major activities done with WHO so far. He mentioned the major activities accomplished in collaboration with WHO including but not limited to training for media actors, workshops & visits, material supports, school education and establishment of a task force on Leishmaniasis and a series of radio and television programs with the Amhara mass media agency and communication office. Welcome Speech and Program Introduction

6.2 Key Not address and Opening Remarks:Ato Belay Alemu, RHB, PHEM process owner made opening remarks starting with words of thanks for coming to attend the workshop for all the participants. With this juncture he gave an overview of the prevention works being done by the regional health bureau with the support of different partners , WHO taking the lion share in its contribution including: capacity building, awareness raising, research and treatment. He also emphasized the need to pay greater attention to provide every support to intensify promotion and prevention of the disease through collaborative and systematic hard work. With greater emphasis, he highlighted the most important points to be discussed during the workshop mainly the role of investors, media and the need to establish regional health promotion and communication task force as they are essential to work in collaboration. Finally, Ato Belay acknowledged the official opening of the workshop wishing for the best of success in the two days stay.


6.3 Presentation:Assessment Findings and Facts on Leishmaniasis

Presentations were made on Leishmaniasis epidemiology, risk factors, progresses and challenges by an expert from RHB, Basazenew. The situations of Leishmaniasis in Amhara region as well as interventions being made were also incorporated in his presentation. Besides, the supervision report and findings on Leishmaniasis treatment in Felege Hiwot, Debre Tabor and Finote Selam Hospitals were presented. Points forwarded for discussion by the presenter were:

• The number and composition of task force members shall be minimized and its responsibility shall be well thought (Regional Health communication/promotion task force)

• Investors and other partners participation in Leishmaniasis prevention and control programs

• What should be done to revitalize the treatment centers?

• The role of media in prevention and control Leishmaniasis

• How we can maintain enough drugs and test kits for treatment centers?


6.4 Brief Description of Discussions during the Workshop:

The workshop moderators were Dr Amare , Ato Belay Alemu, Dr. Mekonnen Ayichiluhim and Ato Abere Mihretie from WHO, RHB, GAMBY PLC and HDAMA in that order. In the beginning of the discussion, Ato Abere pronounced that there is a trend of insufficient budget allocation for the prevention of Leishmaniasis by the health sector. Besides, the role of media in awareness creation, the contribution of business people in the prevention of Leishmaniasis, and the commitment of the regional government in support of the program is limited. As a result, the need for motivating investors to consider the issue of Leishmaniasis prevention in their sector is unquestionable. During the previous year workshops, participating investors and business people to take part in the prevention of Leishmaniasis was raised by the workshop participants as an issue as investors have information gap on Leishmaniasis. And it was concluded that designing and implementing health insurance systems for the workers should be given proper attention by the investors. “Accordingly’’; said Ato Abere Mihretie, HDAMA director, “this workshop is organized to create/raise awareness of business people and investors on the issue and to help them identify and play their role in an effort made by different actors to prevent the disease”.


To this effect the main agenda for discussion in the first day of the workshop was on the role that investors are expected to play in the prevention of the disease. Following, Dr Dadi from FMOH said that the issue of Leishmaniasis is incorporated in PHEM luckily in Amhara regional state. Yet, he emphasized Leishmaniasis is not a disease to be prevented by the government alone i.e., without the participation of all partners and stakeholders. Adding on his speech, he said as it is a killer disease and the side effect of its drug is severe the major work should be prevention even if the importance of strong treatment center is essential as well. Finally, he acknowledged that the disease is under the national control program of Ethiopia and has got a guideline.


In the second day of the workshop, discussion was made on role of media in raising awareness on Leishmaniasis to the public, accessibility of Leishmaniasis treatment services , maintenance of the stock, and the need for “Regional Health Promotion and Communication Task Force”. Workshop participants Even if the participants have raised different questions, the following were attention seeking that needs serious consideration.


• Why all health facilities have not been in a position to provide treatment for Leishmaniasis patients in the region?

• Why treatment is not given in Debre Tabor and Finote Selam hospital for Leishmaniasis patients while there are endemic sites around?

• Why Leishmaniasis is considered as neglected disease while affecting many people in Ethiopia?


In reacting to the first question, representatives from the regional health bureau responded that as the treatment for Leishmaniasis takes long period of time, it is unrealistic to provide all the services for a patient with the existing condition in all the health facilities of the region. Furthermore, shortages of trained health personnel, the need to use resources wisely, drug shortage to maintain quality of treatment, as elaborated by the expert, are some of the reasons in making services accessible in limited sites which are endemic for the disease.


Concerning the second question raised, Debre Tabor hospital manager reacted that as long as preconditions are not fulfilled, it is impossible to give treatment for patients with the existing number of beds in the hospital for Leishmaniasis patients need treatment for a long number of days being admitted in the hospital. Whereas the manager from Finote Selam hospital said that as long as the regional health bureau couldn’t revise treatment protocols regarding payment, the hospital can’t provide treatment free of cost as the patents are not willing to share cost for treatment, bed and food. Thus, we are only providing treatment for those patients who can share cost for bed and food. The third question was addressed by Dr. Dadi from FMOH in such a way that Leishmaniasis is not a neglected disease in the case of Ethiopia as it is incorporated in the national control program and got guideline.


6.5 Advocacy Issues on Prevention of Leishmaniasis:

The advocacy workshop was guided in such a way to identify issues of concerns critical to reinforce strategic directions for the planning of prevention and treatment of Leishmaniasis for all districts with more focus on the districts which are endemic with Leishmaniasis. Accordingly, the following issues were addressed in the workshop as they were issues that provoked the attention of the participants.

• The involvement of media in awareness creation is by far less than expected while it should have been addressing the large community at all levels with information on Leishmaniasis prevention

• Prevention efforts including health education and promotion by the investors and other stakeholders is less especially in major investment areas for daily laborers and hence the role of investors in prevention efforts should be enhanced

• Budget allotted for prevention and treatment of Leishmaniasis is not as expected which requires due attention of all concerned

• Treatment service accessibility is poor in Debre Tabor and Finote Selam hospitals for Leishmaniasis patients. Finote Selam hospital is providing treatment services only for those Leishmaniasis patients who can afford treatment cost.

• There is less commitment of the sectors at all levels regarding the prevention and treatment of Leishmaniasis which needs to be in place.

• There is no coordinating body, which could provide technical support and follow up on Leishmaniasis prevention and treatment in the region


6.6 Suggested Solutions from the Participants


• Investors are required to be committed to be involved in interventions that are important in prevention of Leishmaniasis such as creating awareness, distributing bed nets, availing shelter for their workers and informing them to seek early treatment as infrastructure is the most important thing to be fulfilled prior to engagement in investment.

• Investors who are investing within 50 km radius may construct health facilities in collaboration and the government shall employee health personnel and make drugs accessible in major investment areas

• Working on health issues of daily laborers and regarding workers handling mechanism through joint planning with investors needs to be given attention by the health bureau • While giving work permits and land for investment bureau of environmental protection needs to critically look the prerequisites that must be fulfilled by the investor

• Capacity building needs to be given for media personnel by WHO

• As investors have information gap, printed and electronic educative materials on Leishmaniasis needs to be produced and disseminated so that they can teach their workers using the materials

• Awareness creation education on Leishmaniasis shall be given in schools, shelters of daily laborers in large investment areas and other places where large number of people can be accessed using and participating volunteers

•Participant investors need to create awareness for the large number of investors found in major investment areas and make discussion with them when they go back to investment areas

• Bureau of health shall set mechanisms so that Finote Selam and Debre tabor hospitals can give treatment services for Leishmaniasis patients

• Investors could form an association and establish health centers in the nearby areas to make easy of treatment accessibility for their workers

• Communication office has made commitment to educate the daily laborers using different channels including TV park, film, leaflets, etc as it has offices down to the grass root levels

• Investment bureau needs to give license for investors in discussion with bureau of health and other sectors so that health issue could be considered by the investors

• All health facilities need to give treatment for Leishmaniasis as the patients have the right to get treatment

• It is late in providing supportive supervision and monitoring to treatment centers. Thus, regional health bureau needs to give due emphasis and make supportive supervision as frequent as possible for service providers.

• Enough budget for treatment of Leishmaniasis needs to be allotted at all levels so as to avail drugs as much as possible, as there is shortage of drugs

• The task force previously established has showed no progress at all and it is recommended to be reestablished at different levels from Region to Woreda level


6.7 The Way Forward

During the workshop deliberations on the way forward were made. The way forwards made were:

• The Health Bureau needs to be committed in making standardized and strong follow up and support in the efforts to be made in the prevention of Leishmaniasis

• Health service accessibility needs to be based on information and the report provided from lower level health facilities

• Regional labor and social affairs bureau should make follow up on the construction of shelter for daily laborers as well as health services accessibility for them

• All the sectors needs to be coordinated to work on the prevention of Leishmaniasis

• The task force established needs to be the one having commitment ,life and be functional in making follow up of priority health issues and the prevention efforts to made

• WHO shall continue supporting the prevention efforts on Leishmaniasis

• Environmental management and control office shall give due attention for health issues while providing work permits and land for investors ;

• The media agents need to be committed to educate the public on Leishmaniasis

• The findings and recommendations of the study made by a team led by the deputy president of the region on the situation of daily laborers in major investment areas shall be implemented to solve the problems identified;

• Debre Tabor and Finote Selam hospital need to begin giving treatment for Leishmaniasis patients as they are not currently providing treatment services for patients around. The health bureau shall also put into effect the provision of treatment services by the two hospitals and make follow up of its implementation.


It is also promised by WHO personnel, Dr. Amare that WHO will try to continue supporting the intervention in collaboration with HDAMA. Dr. Amare said “As WHO is supporting the surveillance and reporting system in the region, it could make bed support if there is shortage and capacity building trainings if there is a gap in the future for either investors or government sectors”. Adding on this he made commitment to support and capacitate the task force. Participants’ picture taken at the end of the workshop.


 7. Workshop Outcomes


7.1 Raised Awareness

• Increased awareness among business people and investors on Leishmaniasis and its prevention mechanism


7.2 Commitment Ensured

• Improved commitment by investors to allot budget for bed net distribution and create awareness on Leishimaniasis prevention

• Increased commitment of media people to contribute its own share in creating public awareness about the disease;

• Increased attention given for the disease by the regional health bureau;

• Increased commitment by the health bureau to make follow up on the prevention and treatment activities for Leishmaniasis

• Strengthened capacity of regional communication office and mass media agency


7.3 System Established


After intensive discussion on establishment of the task force consensus was reached by the workshop participants to establish a “Regional Health Promotion and Communication task force” on priority health issues. As a result regional Health Promotion and Communication task force was established with full consensus. The composition of the task force is as follows:  1 Regional Health Bureau Chair,  Regional Communication Office Co-chair,  Health, Development and Anti Malaria Association Secretary, Mass Media Agency Member, Regional Council Member, Amhara Development Association Member,  World Health Organization Member, UNICEF Member, L10K Member, IFHP Member, Labor and Social Affairs Bureau Member, Regional Environmental Resources Management and Protection Member,  Ato Gibtsu Sisay Investors’ Representative Member.


The objectives of establishing

a. To support the regional health bureau in aligning and maintaining consistency of different health promotion/communication activities to the national and regional standards and priority issues

b. To harmonize the health promotion and communication activities of most prevalent health problems of the region;

c. To ensure technical consistency, clarity, accuracy and transparency in communication strategies, particularly in message development and timely dissemination of information;

d. To jointly work together, plan, coordinate and implement activities on identified health issues of concerns, awareness and advocacy campaigns, events, etc. that require complementarities of expertise, resources, and, etc.

e. To ensure that messages are fit to the best interest and use of beneficiary community and community level health promotion/communication agents.


The functions of the established taskforce will be to:

• Take stake of ongoing parallel health promotion/communication initiatives for collaboration and cooperation with other stakeholders to ensure consistency in strategy and messages;

• Identify what health promotion, advocacy and communication gaps and needs on prevention of major communicable diseases including neglected tropical diseases such as Leishmaniasis, Guinea worm,etc

• Develop a comprehensive health promotion/communication strategic plan based on the prevalent health problems in the region;

• Validate all messages for technical accuracy and consistency with the global, and National prescribed messages.

• Collaborate with and engage the media and professionals in orientations, briefings, and message dissemination to ensure message accuracy coordination and consistency in the timing of messages released to the public.

• Designate representative/s to attend in different meetings. 


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