'Health Corridors': inclusiveness in reproductive health service delivery in Ethiopia and Tanzania

It is evident that sub Saharan countries portray low utilization rates and poor

accessibility to reproductive health services, especially amongst disregarded groups.

Current debate affirms strengthening decentralised reproductive health programmes

by integrating family planning and HIV/AIDS with gender and health rights. The

debate is further steered by broadening the spatial-biased concept of access to

health care to include various social dimensions. Against this backdrop, this study

examines the implications of facility-based reproductive health integrated services

(FBIS) and community-embedded health interventions (CBI) and explores the

notions of demand articulation and internalisation of rights in delivering and

demanding for reproductive health services.

This study adopted a mixed qualitative and quantitative method and conducted in

selected communities in the Amhara region, Ethiopia and Mwanza region, Tanzania.

In Ethiopia utilization of facility-based integrated services are found to be low

primarily due to cultural barriers associated with early marriage, female genital

mutilation, traditional abortion and self perception of low risk HIV infection.

Community-embedded health interventions are found to strategically breach cultural

barriers and increase access to health care through ‘health corridors’; this is, a

process by bringing non-clinical care, counselling and imparting knowledge on

health-related and rights issues directly to the homes of the community. In Tanzania,

whilst integrated facility-based services are relevant, complementing communityembedded

health interventions are found to be more crucial given that disregarded

groups are better reached through such ‘health corridors’. However, this process is

challenged most with the lack of cooperation and trust between implementing bodies

and the skewed community perception of reproductive health.

In the absence of a strong health system and limited resources, reproductive health

care is strengthened though integration of community-embedded interventions.

Understanding and investing in “health corridors” offer a socially and spatially

inclusive public health system and health service delivery.