Health Posts are simple two-room buildings, usually several miles from the nearest road.
At each post two Health Extension Workers - local women who have completed school and been away to do a one-year training course - are the first point of contact with the health care system for up to 5,000 people.
They provide health education, vaccination, family planning, and treatment for some diseases.
They are trained and equipped to deliver babies but now that there are midwives at the health centres the aim is to get women there to have their babies.
Tigiste (left) had been in her job for two years before the government found the money to provide a building for her and her colleague to work from.
In 2011 the main items of equipment, including a kerosene-fueled refrigerator for storage of vaccines and a delivery bed, had been provided by UNICEF.
However, there was no budget for furniture. Everything was stored in boxes on the floor and the only work surface was a large cardboard box (below).
The staff were making do without the furniture - most rural homes do not have much furniture so they are used to working on the floor.
It was the same in the other 12 Health Posts in Jidda. None had more than a desk and a chair or two, though each year a few more items were being found.
We paid for desks, chairs, tables, shelving and waiting benches for all 13 Health Posts to have a full set of furniture.
The district health staff provided the specification and checked that the furniture of the required standard; they and the communities transported the furniture to the health posts.
The furniture was made in local workshops. The photo below is the contract being signed and a down payment made; final payment was on delivery.
The HEWs said that their most urgent need was for consumables - disinfectants, cleaning materials, gloves and other disposable items.
The managers explained that the budget for these was inadequate and the health centres, where most treatment is carried out, were given priority.
We were reluctant to get involved in an open-ended need but the cost is small so we offered to fund a one-year supply of consumables for each Health Post.
Small payments that people make towards the cost of consumables and some drugs would then help to replenish stocks
In 2013 the furniture was there and the shelves had the paperwork for the countries first medical records system. We were told that consumables were no longer a big problem, though more would be good.
We had taken net curtains to replace the newspaper on the windows. Windows are a new thing in rural Ethiopia - most houses have holes in the wall with shutters so curtains for privacy often get forgotten.
With the furniture and supplies the room was very cramped because the staff were sleeping on the floor of one of the two rooms, making that room unavailable for its intended purpose.
Sleeping in the health post is in breach of the rules but is common practice and accepted as the best way of allowing them to do their work.
One of the problems of recruiting and retaining trained staff in remote communities is a shortage of suitable accommodation. The health extension workers come from rural communities but are often a long way from their homes.
In 2012 we started funding simple accommodation using the same local methods as for the Health Posts themselves. The community is providing local materials and manual labour (left).
We pay for a builder and 'bought in' materials including corrugated iron, nails, cement and windows. The local government has made the land available, provided the specification and 'signs off' the work on completion.
In 2013 Jenny Howard and the woreda Chief Executive formally opened the first building.
Accommodation will not only help the Health Post to function properly but will raise the status of these young women who are at the forefront of efforts to introduce the changes that will reduce child and maternal mortality and curb population growth.
SHEPEthiopia is a working name for the "Support for Health and Education Projects in Ethiopia", UK charity No. 1161261
Page updated 01/02/2018