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The Consortium of Reproductive Health Associations _CORHA_

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The Consortium of Reproductive Health Associations _CORHA_ Powered By Docstoc
					To All Organizations Working On SRH Issues

Dear/ Sirs

The Consortium of Reproductive Health Associations (CORHA) is a membership organization
of over ninety national and international non governmental organizations (NGOs). CORHA was
formed in 1995 as a loose affiliation of the few Ethiopian and international NGOs that were then
offering integrated MCH/FP/RH services in the country.

CORHA has functioned effectively as a facilitative consortium, providing technical assistance
and support to Ethiopian public sector and NGOs that offer reproductive health services for more
than a decade. During this period, CORHA has managed a comprehensive program despite
significant contextual challenge (delay in registration). As a result of its linkages, reputation and
influence, CORHA today plays central advisory and catalytic roles - interacting, coordinating,
and networking with a wide range of programs or policy developments affecting family planning
(FP) and reproductive health (RH) across the country. More important, CORHA has continued to
grow and gain the confidence, cooperation, and support of Ethiopia’s government, public and
private sectors and NGO service providers.

In its effort to promote greater coordination and collaboration among organizations that provide
RH services funding and otherwise, CORHA has been publishing the profile of Reproductive
Health Organizations in Ethiopia since 2002. In 2002 and 2005 CORHA was able to distribute
two publications sequentially. As it requires updating the information every two years, the
Consortium is planning to publish the third edition of the profile. In this regard, CORHA has
developed a questionnaire that will aid collection of pertinent information for the profile. Your
esteemed organization is therefore kindly requested to fill in the attached questionnaire and send
us within two weeks time.

If you have any quarries please do not hesitate to contact Ato Dejene Getahun and Ato Eyosiays
Woldekidan through telephone numbers 011 663 63 66/ 011 663 64 13/14.


Sincerely Yours



Tigest Alemu,
Executive Director, CORHA

N: B For easy access we have sent the electronic copy of the questionnaire to our members and
displayed in our website- www.corhaethiopia.org. Please fill the form and send it via our email
address: corha@corhaethiopia.org
    The Consortium of Reproductive Health Associations (CORHA)
   Profile of Sexual and Reproductive Health Service Organizations,
                    Funding and Government Agencies


1. Full name of the organization____________________________________

2. Acronym (If any) ___________________________

3. Type of organization. Please Tick the appropriate one
      International NGO_____
      Local NGO_____
      Any other, please specify (Government, Donors, UN Agency…)

4. Registration with MOJ (If applicable)
      Registration Number ________________________
      Month and Year of registration___________________
      Place of registration _____________________________
      Years of establishment in country of origin _______________ (for International NGO)

5. Involved in RH since (Month and Year) __________________________

6. Country of Organization’s Headquarter (In case of International NGOs)



7. Contact Person
               Name__________________________________________________
               Title____________________________________________________
               Telephone _____________________________________________
               P.O.BOX _______________________________________________
               Fax ____________________________________________________
               E-mail __________________________________________________
8. Full Address of the Organization
                     Region ____________________________________________
                     Zone ______________________________________________
                     Woreda/ Sub-city __________________________________
                     Kebele ____________________________________________
                     P.O.BOX ___________________________________________
                     Telephone _________________________________________
                     Fax ________________________________________________
                     E-mail _____________________________________________
                     Web site ___________________________________________
9. Full address (es) of Branch/field offices, if any

 Region                Zone            Woreda          Telephone   P O BOX   E-mail




10. Vision of the organization
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________

11. Mission of the organization
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________

12. Overall programmatic areas (programmatic focus) of the organization

   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
      13. Personnel status

      Offices                                   Staff position                                 Total


                      Management    Technical         CBRHAs       Other      Support
                                                                 Volunteers      staff

      Head office


      Branch/Field
      offices

      Total




      14. Current Reproductive Health Projects/Programmes in Ethiopia (by title,
           Region, Zone, Woredas and target population)

Reproductive Health Project    Region           Zone             woreda                  Total target
             Title                                                                        population
        15      Specify components on which the organization regularly works (e.g. FP, ARH, HTP, HIV/AIDS etc
                 Please Tick on the appropriate
                                       Types of reproductive health services provided
FP   please        ARH please       HIV/AIDS        Gender & HTP    Post abortion    MCH (ANC,      Reproductive   Others(please
Tick               Tick             please Tick     please Tick     care please     PNC…)           Organ          specify)
                                                                    Tick            please Tick     cancer
                                                                                                    please Tick
Clinical/Faci      Youth friendly   IEC/BCC         IEC/BCC         Service         Service         IEC/BCC
lity based         Service          intervention    intervention    provision       provision       intervention
Service            provision
provision
Community          Youth center     Care and        Service         Training        Training        Advocacy
based              development      Support         provision
service                             (HBC)
provision
Workplace          Training         VCT             Training        IEC/BCC         IEC/BCC         Research
service
provision
Training           IEC/BCC          ART             Advocacy        Advocacy        Advocacy        Training
IEC/BCC            Advocacy         PMTCT           Research        Research        Research        Diagnosis
                                                                                                    and
                                                                                                    Treatment
Advocacy           Research         Training        Women           Others(spec     Others(specif   Others(speci
                                                    empowerm        ify             y               fy
                                                    ent
Research           Others(specif    Advocacy        Legal
                   y)                               support and
                                                    counseling
Others(speci                        Research        Rehabilitatio
fy)                                                 n
                                    STI diagnosis   Others(speci
                                    and             fy
                                    treatment
                                    Others(speci
                                    fy)
        Note: FP- family Planning; ARH- Adolescent Reproductive Health; HTP -Harmful Traditional Practices;
              MCH- Maternal and Child Health Care, VCT -Voluntary Counseling and Testing, ART- Antiretroviral therapy
              Youth friendly service could be in a multipurpose youth center or in a health facility, PMTCT- Preventing
              Mother-To-Child-Transmission of HIV
16. Sources of funding (donors) for reproductive health programs (applicable to
   Consortium members)
      1) _____________________________________________________
      2) _____________________________________________________
      3) _____________________________________________________
      4) _____________________________________________________
      5) _____________________________________________________

17. New Reproductive Health program/project components in which the
   organization intends to engage in the future? (eg. HIV/AIDS, ARH, Poverty
   Reduction, Gender, Safe motherhood, PAC, Pap smear, HTP etc)
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________

18. Professional or any other affiliation that the organization is a member (e.g.
   CORHA, CRDA, NEWA, PANE etc)
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________
   ___________________________________________________________________________

19. Do you have a specific logo that describes your organization?
            Yes                            No

***If yes please send with this questionnaire or send it via our email address
corha@corhaethiopia.org

Profile completed by: _______________________________

Date of this Profile: _________________________________

Signature____________________________________________




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