Tiringo Tesfa has worked as a community health worker for seven years, providing care to her neighbors in the rural community of Afa Genaro in Ethiopia’s Benishangul-Gumuz region. “During this time, I’ve seen how the community places its trust in us, and being able to treat people and witness their health improve brings me immense happiness,” says Tiringo. “That sense of fulfillment drives me to work even harder to help others.”
Community health worker Tiringo Tesfa.
Like 70% of community health workers worldwide, Tiringo is a woman—and for these women, challenges like gender norms and the need to balance professional and domestic obligations can create barriers to success. To help dismantle some of these barriers, Last Mile Health is working alongside Ethiopia’s Ministry of Health to apply a gender responsive lens to training for Ethiopia’s all-female community health workforce. This means taking women’s unique needs into consideration and ensuring they are met, from structuring training schedules to allow women to spend time caring for their children, to supporting conversations with local political and religious leaders to help increase acceptance.
Central to Last Mile Health’s work is training that uses the blended learning approach and adopts a gender mainstreaming approach. “The training combines face-to-face and digital sessions we can complete from anywhere, which has allowed me to manage my time more effectively,” Tiringo explains. Before the Ministry of Health adopted Last Mile Health’s blended approach, training sessions took place in person over an extended block of time, requiring women to be apart from their families for days. “For community health workers with children, attending traditional training sessions can be challenging,” Tiringo shares. “However, with blended learning, mothers can use the free time they have after caring for their child and managing their household responsibilities to continue their learning.” Additionally, mothers can bring their children to trainings, and meals for both community health workers and their children are provided to allow them to focus fully on their education during the sessions.
Accessing blended learning resources on a tablet.
The blended training also makes resources more accessible to women across Ethiopia’s large and linguistically diverse population, with content translated into five regional languages and more translations in process. “There is a significant knowledge gap among female community health workers, particularly for those whose mother tongue is not Amharic or who struggle to speak Amharic,” says Tiringo.
For Tiringo, strong training has not only improved her skills and knowledge: it’s changed her outlook. “It has helped me build confidence in my abilities, especially as a woman in a field traditionally dominated by men,” she shares. “Overcoming self-doubt and proving my capability in such an environment has been empowering.”
Tiringo practices newborn care skills during an in-person training session.
Tiringo is passionate about helping women and girls access health services—and she believes women health workers are particularly well-suited to encouraging other women to seek care, especially on sensitive health topics. “It is crucial for female patients to have access to female health workers because it creates a sense of trust and comfort,” she says. “Female patients often see us not just as healthcare providers but as friends who can understand their experiences and challenges. We can empathize with their situations by putting ourselves in their shoes, which helps us connect with them on a deeper level.” Female community health workers also engage women’s husbands as they provide care, helping ensure they will be supportive.
An infant holding an immunization card during a visit to the health post.
Tiringo’s work can be difficult, but she’s driven by the knowledge that her work changes lives for women and children in Afa Genaro. “A mother once brought her child to me, who was suffering from pneumonia,” she recalls. “Fortunately, I had the necessary medication, and I treated the child with amoxicillin. When I followed up the next day, I saw the child was already recovering. The mother, who had lost her husband a few months earlier and had no income, couldn’t afford treatment for her child. Knowing I could provide care in such a difficult situation was incredibly fulfilling.”
Equipped with strong skills, Tiringo and more than 40,000 women in Ethiopia’s community health workforce are driving better health outcomes for women and children—one patient at a time. “Today, that child who recovered from pneumonia is two years old, and seeing them grow brings me immense joy,” Tiringo shares. “The family even named the child after me as a gesture of gratitude for saving their life, which is one of the most rewarding experiences of my career.”
