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Supporting the Regional Health Bureaus in Ethiopia Zenebe Melaku, MD ICAP-Ethiopia

Supporting the Regional Health Bureaus in Ethiopia Zenebe Melaku, MD ICAP-Ethiopia. ICAP Guiding Principles. Integration with national AIDS control plans Capacity building for health systems and broad infrastructure support Involvement of PLWHA - adherence, social support

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Supporting the Regional Health Bureaus in Ethiopia Zenebe Melaku, MD ICAP-Ethiopia

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  1. Supporting the Regional Health Bureaus in Ethiopia Zenebe Melaku, MD ICAP-Ethiopia

  2. ICAP Guiding Principles • Integration with national AIDS control plans • Capacity building for health systems and broad infrastructure support • Involvement of PLWHA - adherence, social support • Integration of Prevention, Care & Treatment • Family-centered care (adults and children) • Multidisciplinary Team Approach • High quality services with program evaluation, operations research, and program improvement

  3. FMOH - National Road Map& ICAP Support ICAP- CU National Level - TA ICAP- CU Regional Road Map Implementation ICAP- CU Facility Level Implementation

  4. Characteristics of ICAP-E Program • National • Pediatrics; EID; TB-HIV; • PLWHA; MLDM • Four RHBs • Capacity Building/TA ICAP - Ethiopia Regional Univ. Comprehensive Site Level Support

  5. Oromiya : 29,118,188 Somali : 4,325,446 Dire Dawa : 388,731 Harari : 194,745 Total Population : 34 million Characteristics of ICAP-E Program

  6. Health Care System - Ethiopia • Policy • National Strategy • Guideline and • Training Curriculum FMOH RHB RHB RHB • Oversee Program Implementation and Monitoring H H HC HC HC

  7. Initial Step: • Needs assessment with RHBs • Identification of gaps • Critical Gaps Identified:- • Coordination and Strategic planning • Human Resource • Infrastructure • Systems

  8. Modalities of Support: • Two mechanisms: • Direct support: • Short/Medium term • Sub-agreement: • Medium/Long term

  9. Regional level Capacity Building – Coordination and Strategic Planning • TA in the development of regional annual plan • Regional Partners Forum • Joint Regional Planning and Review Meetings

  10. Building Regional Ownership through Participatory Planning A Key Strategy for Sustainability

  11. Regional level Capacity Building – Human Resource • Basic and ToT • Local/International Training: • Clinical • Program Mx • Financial Mx Multi-pronged Approach: • Program staff • Accountant • Data clerks…. Secondment/ Additional staff • Clinical, Program & Finance Mentoring • Access to Internet • Resource centers • Office furnitures ….. Enabling Environment

  12. Capacity Building: Human Resources (Training)

  13. Regional Capacity Building – Resource Center

  14. Regional level Capacity Building – Infrastructure – Training Centers Training Center with Video-conferencing Facility

  15. Regional level Capacity Building – Systems • Laboratory System: • Development of SOPs: Sample referral • Implementation of EQA systems • Monitoring and Evaluation System: • Data QA systems • Data use for CQI • Referral System: • SOPs for decentralization • Financial Management System: • Development of SOPs

  16. Key Achievements and the Way Forward • Increased scope of activities with increased funding (5X) Responsibilities handed over to the RHBs : • Annual review and planning meetings • Quarterly Supportive Supervisions • Hiring of supernumerary staff • Sample transport system • Management of minor renovations In the future: • Phased and Incremental Manner

  17. Challenges: • Human Resource: • Shortage • Work overload • Lack of staff motivation • High Staff Turn-over • Financial management system At All Levels

  18. Conclusions-Lessons learned • Regional level capacity building • Key strategy for successful transition • Requires commitment from government, availing HR and other required inputs • It requires longer time-frame • Phased and Incremental Manner • Attention: Maintaining the ‘Desired Quality’

  19. Thank You . Obrigado

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