Delivering Healthcare to the Last Mile

by Amref Health Africa

Ms. Tigist Molla is a committed and compassionate Midwife Nurse in Afar Region of Ethiopia, working relentlessly to provide health care in an area where services are extremely limited. Ms Molla was trained through Amref Africa’s A’agoa project, a Sexual and Reproductive Health five-year initiative to support pregnant women in remote areas. Using portable medical backpacks and portable ultrasound machines, Ms Molla works to reach the most vulnerable in hard-to-reach communities.

“My favorite part of the job is providing health services in the community I grew up in and, in particular, supporting pregnant women. It is so exciting for me to support the community I belong to. I know their culture, understand their language and many of their norms. It is also easy for me to help out and easy for them to open up and share.”

Before the project was launched in 2017, ultrasound devices were exclusive to specialized health professionals and confined mainly to hospitals. Now the program is being implemented in seven districts of the Afar Regional State, enabling Ms Molla and midwives like her to bring healthcare services to those hardest to reach.

Through her training and frequent clinical mentorship, Ms. Molla acquired the knowledge and skills to confidently refer high-risk mothers to higher level health facilities for early intervention. “The periodic mentoring and coaching provided by senior health professionals helped strengthen my skills and boost my confidence. I had no capacity or equipment to identify pregnancy anomalies before the training,” she says.

She is passionate about the need to reach communities where they live, regardless of location. “There is no place we can call unreachable. Communities live there, so it is reachable, and we can provide the services they need. That is exciting. We can travel to the remotest parts of Ethiopia. If more medical devices become available and health workers get the training we need to operate, we can widen our reach to support our communities.”

In addition to the necessary skills and equipment access, health workers working in rural and remote regions like Afar need also to be willing to live among the communities they serve, says Ms. Molla.

“As long as we are committed to working in the community and living with them, understanding what they need and engaging with them to change their situation, we can improve things. The capacity to do this work at the community level has really come as a surprise for me.”

Ms. Molla is committed to achieving Universal Health Coverage, realistic about the inequity currently preventing that from happening, and pragmatic about the ability to roll out ultrasound programs like hers on a wider scale.

“If more medical devices are available and health workers get the training to operate them, we can widen our reach and support our communities. I serve pastoral communities that lack even basic health services. They should be treated fairly to get essential services so that we can claim that we are achieving Universal Health Coverage.”

She believes that health services are a basic human right and should reach all communities, including those in remote areas. She has a practical message for decision-makers to help inform political commitments.

“I suggest they go down to communities and see what is lacking, see what the health workers lack in terms of resources that they can use to provide essential health services. We need more resources to reach more communities who live in places where there is no infrastructure. Decision makers must make a political commitment to address these issues”.

Article first published on

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