Project information

Training 200 HEW in Ethiopia on Cleft Lip & Palate

84% of Ethiopians live in rural areas and are severely under-served by health care. Smile Train have been providing 100%-free cleft lip and palate repairs since 2007. This project will train Health Extension Workers to recognise, advise and give much needed support to those affected by cleft.

March 2016 - April 2016

Charity information: Smile Train

Smile Train logo
  • Need


    Children in Ethiopia born with cleft lip and/or palate (CLP) are significantly disadvantaged. Although an est. 1.49 in 1,000 babies in Ethiopia are born with CLP, there is still great need for HEW to gain understanding and training on the problem. CLP babies are often considered a curse by Ethiopian families, sometimes abandoned or even killed as they are thought to bring hardships to families, crops and livestock. For the ones who survive, they are kept hidden away, denied a normal childhood.


    Smile Train will provide training for 200 HEW in March 2016 across 3 regions of Ethiopia. They will be equipped with dedicated knowledge on CLP including how to recognise cleft, understanding the social difficulties faced by the families, and how to support with challenges like feeding, breathing and speaking. HEW will be key to referring CLP patients to one of the 22 Smile Train Ethiopia partner hospitals for their free repair surgeries. They will change the futures of babies born with CLP.

  • Aims

    Aim 1

    To increase the level of knowledge of cleft lip and palate for 200 Health Extension Workers.


    » Conduct 3 individual training sessions in Somalia Region, Harar Region, and eastern parts of Oromia Region.

    What success will look like

    Success for the 200 HEWs will come when they pass the CLP training session and have a greater understanding of CLP.

    Aim 2

    To increase the number of CLP patients identified and referred for surgery.


    » Educate 200 HEW to recognise CLP, to advise families on caring for a child with CLP, & to arrange visits to Smile Train partner hospitals for surgery.

    What success will look like

    HEWs will be responsible for identifying CLP in their areas & keeping track of how many patients they help. Also be measured on the number of referrals to ST hospitals for surgery.

  • Impact


    This project will seek to increase the number of new-born babies and young children who are identified for free cleft surgeries in the next 3 years. This will be demonstrated by the average age of patients decreasing, with an aim to identify before they're 3 years old. This project will also aim to meet the great need to educate Ethiopian communities on CLP. Success will be measured by the number of families with CLP who are referred to ST and come forward within an 18 month period.


    An area of risk is ensuring all the Health Extension Workers are able to get to the location of the training. Many HEWs would be unable to afford their own travel. We have in place an agreement with local mini-bus firms in the regions who will transport the HEWs to the training centre. Further risks faced could be where local dialects are not spoken by the trainers. This has been mitigated by ensuring trainers are bi-lingual and/or translators are available in all regions.


    Our donors will receive written quarterly updates from the UK team, via email or post, on the status of this project. This will include case studies from HEWs and from children and their families affected by CLP. For significant supporters, face to face meetings or telephone calls will be arranged.

  • Budget

    Budget - Project Cost: £20,000

    Loading graph....
      Amount Heading Description
      £3,844 Transport Transporting HEWs to training location
      £11,352 Training Training sessions on CLP for 200 HEWs
      £4,804 Materials Posters, leaflets, images for HEWs to take away and use for identifying CLP children
  • Background


    Ethiopia is an eastern Sub-Saharan country, with an estimated population of 96 million. This project will provide training in Somalia Region, Harar Region and southern and eastern parts of Oromia. The health system in Ethiopia is weak and they face great challenges treating many health problems. Low socio-economic development across vast areas of these regions has led to CLP receiving very little attention from the health system.


    200 HEWs will benefit directly from this project through an increase in knowledge, understanding and the skills required to care for babies and children with CLP. Secondary beneficiaries will be those affected by CLP, including families and communities. HEWs will use their training to benefit local residents by educating them on CLP, sharing the message around caring for CLP patients, and how Smile Train are providing free surgeries in nearby hospitals.

  • Why Us?

    Why Us?

    Smile Train is the world's largest cleft charity, and we have partnered with hospitals in Ethiopia for over 8 years. We are currently partners with 22 hospitals, and 26 local Ethiopian surgeons based in these hospitals. We have successfully trained many medical teams across the country and have vast experience working with and training local groups, such as HEWs. Our focus on CLP has enabled us to become experts on both training medics and caring for patients affected by CLP.

    Read more about the Charity running this project.


    Dr. Esther Njoroge - Smile Train Regional Director, Africa

    Owner of the budget and overall supervision of Smile Train Africa programs.

    Sesnie Zemichael - Smile Train Program Manager, East Africa

    Sesnie is responsible for organising the training and implementing it across the three regions.

Smile Train's Model


Can cover the cost of one complete cleft surgery