Page 1


Tulane University

Center for Global Health Equity School of Public Health and Tropical Medicine In this Report 1. Background 2. Accomplishments

3. 4. 5. 6.

2.1 National Monitoring and Evaluation System Development and Capacity-Building 2.1.1 To Strengthen National M&E 2.1.2 To Strengthen Quality Improvement Processes in Health Facilities 2.1.3 To Support Universities in post-graduate programs to strengthen National M&E 2.1.4 Challenges 2.2 Electronic Health Records (EHR) 2.2.1 Development and enhancement of an Electronic Health Record System 2.2.2 Human Resource Information System (HRIS) Deployment and Decentralization of HRH Registration and Licensing 2.2.3 To support in Geographic Information System (GIS) 2.2.4 Challenges 2.3 Human Resources for Health Strategic Plan and Implementation 2.3.1 Strengthening pre-service medical Education 2.3.2 Development of Graduate course for Faculty Development 2.3.3 HRH Policy and Legal Frame Work and System Development 2.3.4 Challenges

Annual Performance Indicators Publications Posters and Presentations Recognitions

1 3 3 3 7 7 10 12 12

14 15 17 17 18 19 20 21

22 23 25 27

Tulane University, counting on its comparative advantage and on its credible track record has been working closely with the FMOH, the Regional Health Bureaus and higher learning institutions in various areas of health interventions in Ethiopia as it does elsewhere. ..................... Tulane has continued supporting the Federal Ministry of Health (FMOH) in the implementation of the National Plan and HMIS/M&E system.

.....................

As parts of its support health institutions in Ethiopia, Tulane University with PEPFAR/CDC funding has continued to facilitate the implementation of National Electronic Health Record (EHR) as a vital element in enhancing the quality of care in the health sector. ..................... Tulane University with PEPFAR/CDC funding has been working closely with Human Resource Development Directorate of FMOH and Health institutions and Professional Licensing Directorate of FMHACA to improve HRH and computerize the HRIS. ..................... Tulane has been directly involved in the design and also provided Technical Assistance for the scaling up of the national HMIS reform at 10 out of the 11 Regions of the country. ..................... With the support of Tulane University, the FMOH has successfully completed a information training manual and implementation guideline for the health extension supervisors. ..................... Tulane has continued to collaboration with Jimma University (JU) in Health M&E at MSc level training and expanded support to the collaborative International Center for M&E , Medical Education and supporting Pedagogical trainings for HIT colleges.

.....................

With Tulane support, a post-graduate training program in Biostatistics and Health Informatics at MSc level has been successfully launched at Mekelle University (MU) and the 1st Cohort have finalized the first year of training.

.....................

Tulane has supported St. Paul Hospital Millennium Medical College, the first Medical College under FMOH, from incorporation to strengthening the medical education.

.....................

Tulane University with PEPFAR support has provided technical assistance to the FMOH in the implementation of various aspect of the Draft HRH Strategic Plan covering periods of 2009-2020.


Acronyms AAICTDA

Addis Ababa Information, communication Technology Development Agency

HRM

Human Resource Management

HSDP

Health Sector Development Plan

AIDS

Acquired Immuno Deficiency Syndrome

ICT

Information Communication Technology

BPR

Business Process Re-engineering

IT

Information Technology

JU

CDC

Center for Disease Control

Jimma University

CPD/CME

Continuous Professional Development/ Continuous Medical Education

EFY

Ethiopian Fiscal Year

MNCH

Maternal Newborn and Child Health

eHMIS

Electronic Health Management Information System

MPI

Master Patient Index

MRU

Medical Registration Unit

EHNRI

Ethiopian Health and nutrition Research Institute

MSc

Masters of Science

EHR

Electronic Health Record

MU

Mekelle University

FMHACA

Food, Medicine, Healthcare Administration and Control Authority

NMEI

New Medical Education Initiative

FMOE

Federal Ministry of Education

PEPFAR

President’s Emergency Plan for AIDS Relief

FMOH

Federal Ministry of Health

PHEM

Public Health Emergency Management

GIS

Geographic Information System

PLWHA

People Living with HIV

GPS

Geographic Positioning System

HAPCO

HIV/AIDS Prevention and Control Office

HEW

Health Extension Workers

HIM

Health Information Management

HIT

Health Information Technicians

HIV

Human Immuno deficiency Virus

HMIS

Health Management Information System

HR

Human Resource

HRH

Human Resource for Health

HRIS

Human Resource Information System

LAN

Local Area Network

M&E

Monitoring and Evaluation

PST

Pre-Service Training

QI

Quality Improvement

RHB

Regional Health Bureau

RHSC

Regional Health Science College

SNNPR

Southern Nations Nationalities and People’s Region

TA

Technical Assistance

TB

Tuberculosis

TU

Tulane University

TVET

Technical and Vocational Education and Training

WSUS

Windows Server Updater Service


1. Background

In the last six years, Ethiopia with support from international and national health partners has been making commendable and encouraging progresses in the prevention, treatment, care and support of HIV/AIDs programs. Within such progress, there still remain greater needs to maintain and expand activities in the major core areas of HIV/AIDs interventions. Tulane University, counting on its comparative advantage and on its credible track record in the country has been working closely with the FMOH, the Regional Health Bureaus and higher learning institutions in various areas of health interventions in Ethiopia as it does elsewhere. Tulane’s support and involvement in health programs is built upon the principle of effective collaboration with each level of the health delivery system of the country including working together with local and international health partners towards building a responsive and sustainable system that is amenable for the effective and result driven implementation of health program in Ethiopia. Accomplishing the objectives set for Year 2 through effective implementation of the project elements and measuring the success of the achievements through outputs and performance measures, has enabled Tulane to make direct and measurable contribution to PEPFAR’s goals. Tulane’s technical assistance has been in-line and


consistent with the Ethiopian public health sector strategies in terms of supporting the overall M&E system that clearly include the scaling up of the HMIS/M&E, national health planning, quality improvement, building human capacity with a focus on the pre-service training at Masters level Health M&E, Biostatistics/Health Informatics, Diploma in Health Information Management and Medical Education. The support also included Electronic Health Record (EHR) that includes enhancing and deployment of EHR-SmartCare, eHMIS, HRIS manage and license, Geographic Information System (GIS), and Information Communication Technology (ICT) support. The other major area of support is in Human Resources for Health Strategic Plan and Implementation and it includes strengthening pre-service medical Education, Support for Faculty Development, and HRH Policy and Legal Frame Work and System Development.

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

2


2. Accomplishments

2.1 National Monitoring and Evaluation System Development and Capacity-Building Tulane has continued supporting the Federal Ministry of Health (FMOH) in the implementation of the National Plan and M&E system. The major accomplishments in this regard have been highlighted in some details under each objective. 2.1.1 To Strengthen National M&E 2.1.1.1 Support to Health Sector Strategic and Woreda planning Tulane has provided Technical Assistance (TA) for the Woreda based National Health Planning. TA is being provided to the national harmonization, planning and monitoring effort including the development and refinement of the core planning indicators at all levels including HIV/AIDs and Tuberculosis. Support included designing and standardization of planning templates, conduct training of supervisors and compilation of the national health sector plan (Core Plan). • TA is provided for the 2004 EFY Woreda based National Health Planning exercise based on the health sector priorities at the Federal level and detail


planning, particularly in 5 Regions: Tigray, Amhara, SNNP, Gambella and Addis Ababa Regions. •

Specific support to Regional Health Bureaus included extensive supervision, mentoring, coordinating and guiding Regional Health Bureaus to cascade the ongoing planning process to the Woreda level, mentoring of Regional and Woreda (district) staff, hospital and health center staff and compilation of planning data.

TA has also been provided for the design of M&E framework for the National Health Sector Development Plan (HSDP IV), including the revision of national reportable indicators definition.

2.1.1.2 Health Management Information System: Tulane has been directly involved in the design and also provided Technical Assistance for the scaling up of the national HMIS reform at 10 out of the 11 Regions of the country. As a result, encouraging results were demonstrated not only in the completeness and accuracy of data reporting, but more importantly, on the level of data utilization and on its well established links to the annual Woreda Plan. The major supports that were given to the FMOH and Regions in the implementation of HMIS during the reporting period include: •

Support and TA for conducting operational level supportive supervision and mentoring on site, which is an important requirement for the implementation of the national HMIS, has been provided for 1631 health centers, 86 hospitals, 436 Woreda Health Offices, 52 Zonal Health Departments, 10 Regional Health Bureaus, and the Federal Ministry of Health.

Technical assistance has been provided for the HMIS reform adaptation in to private health care facilitates and in the design of National Health Information Systems long term strategic plan. Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

4


• • • •

• • • • •

Training HMIS supervisors at Zonal and Woreda level to ensure sustainability of the reform. A total of 138 health professionals have been provided a detail and more advanced training on HMIS covering 5 regions. Training on HMIS was given for a total of 16,295 health professionals drawn from 25 Zones, 272 Woreda Health offices, 1299 HCs, and 24 Hospitals. Continuous mentoring and support was provided to health facilities on recording, compilation, reporting and ensuring data quality. The training and implementation of HMIS in hospitals is progressing well with the exception of Oromia and Somali Regions. In Somali 4/6 hospitals and 31/39 hospitals in Oromia have started implementing HMIS. It is expected that the remaining hospitals in these regions will complete training and start HMIS implementation within the next reporting period. Of the 10 RHBs, Tigray, Amhara, Benishangul, Gambella, Harari, Dire Dawa and Addis Ababa have finished the implementation of the HMIS. The Oromia Region has implemented HMIS in 15/18 Zones; Afar Region in 12/29 woredas and Somali Region in 6/10 Zones. It is expected that these regions will train and implement the HMIS at the end of the current Ethiopian fiscal year. TA was provided to FMOH for supportive supervision and data quality assessment of the new HMIS implementation; revision and alignment of indicators with the Health Sector Five years Development Plan and redesigning of the current HMIS reporting formats. TA has been provided in the design and implementation of private sector health information system. Moreover, support was provided to FMOH to project, quantify, cost as well as store and distribute HMIS tools (registers, tally sheets and various forms) to all Regions. Support has continued in checking the quality of quarterly reports and providing feedback to RHBs. During the reporting period, Tulane has supported the FMOH Planning and Finance and Medical Services Directorates.

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

5


2.1.1.3 Community Health Information System: With the support of Tulane University, the FMOH has successfully completed a training manual and implementation guideline for the health extension supervisors. Using this training and implementation manual based on HMIS, the trained supervisors provide on-the-job training to health extension workers. •

During the period, technical support was provided for the adaptation of the existing Family Folder and manuals to be used in the urban households. This adaptation is commensurate and is well inclusive of the different design of the health extension health program and the health service delivery packages for the urban households.

TU has provided technical assistance for the translation of the contents of the family folder into Somali language and also for translation services of the implementation Guideline from English into Amharic, Tigrigna and Oromiffa languages.

Additionally, technical assistance and support is given for training of 297 Rural HEW supervisors on Family Folder for participants from Tigray, Amhara, Oromia, Benishangul & Gambella and 72 rural woredas have been supported for the implementation of family folder in the reporting period from Tigray, Amhara and Oromia.

Furthermore, TU has provided technical support for operationalization of urban family folder in the selected pilot urban areas. To date 116 Woredas are implementing the community health information system.

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

6


2.1.2 To Strengthen Quality Improvement Processes in Health Facilities Tulane has continued supporting the Medical Services Directorate/FMOH to establish quality improvement processes within public hospitals. During this reporting period: • The QI training guide was completed and training conducted for 31 senior management and concerned health staff of Federal Hospitals. •

Implementation of quality improvement at St. Paul hospital was supported including onsite trainings and mentoring on QI to build the capacity of the hospital in QI concepts and methodologies.

TU organizes joint session on quality improvement for CDC implementing partners to implement quality improvement in each of the partners respective sites based on which QI for HIV services started to be implemented.

2.1.3 To Support Universities in post-graduate programs to strengthen National M&E 2.1.3.1 Support to Jimma University Tulane in collaboration with the FMOH and Jimma University (JU) had launched the first postgraduate training program in Health M&E at MSC level under Jimma University, the first of its kind in the country. The support to Jimma University’s MSc training program in M&E has continued since 2006 by availing professors for teaching of various academic courses and student supervision including course coordinators and administrative staff.

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

7


So far the program has produced over 140 graduates for the public sector of Ethiopia, including for capacity building of Jimma University, partner organizations and for the public sector of Tanzania and Liberia. • The 4th cohorts of 38 students, among which 7 were international students, 5 from Tanzania and 2 Liberia have successfully completed their training and have graduated in June 2011. •

TA and support was provided for supervising M&E MSc students in the preparation of dissertation, development of study protocols and data analysis for this batch.

Additionally the 5th cohorts of 16 students are enrolled in the program for the first time on only merit (not on quota bases) as agreed with FMOH among which 5 are international students from Tanzania.

The capacity of the M&E training program has been progressively built over the years since 2006 and currently the program is successfully managed by JU. Tulane has continued providing TA and selective institutional support to JU including expatriate and Tulane’s own teaching staff for course delivery and students’ supervision and external examination.

A library for the M&E postgraduate training program at Jimma University has been established.

Tulane in collaboration with Jimma has expanded the collaboration beyond the Master’s course to conduct Pedagogical training for faculty from all HIT schools, support to Medical Education and overall support to FMOH on HMIS/M&E training. e.g. together successfully trained HMIS focal persons from Oromia. Through this collaboration Jimma in this fiscal year opened the international collaborative center for M&E with Tulane and develop short training modules. Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

8


2.1.3.2 Support to Mekele MSc in Biostatistics/Health Informatics Program With Tulane support, a post-graduate training program in Biostatistics and Health Informatics at MSc level has been successfully launched at Mekelle University (MU). Tulane provided TA and support and has fully collaborated with MU for the development of competency-based curriculum that blended uniquely the two professions of Biostatistics and Health Informatics into one and this has been approved by the Senate of MU. • A three days workshop was organized at TU to discuss on the Biostatistics and health informatics masters program at Mekele University curriculum content, and was upgraded using comments provided by participants. •

A total of 32 students were admitted to the program among which 26 of them have begun their second year program.

TA and support was provided in provision of courses and supervise students during their practicum attachments. During the 4th quarter of this year, revision of the curriculum was supported and undertaken based on needs identified. In this, senior faculties from Mekelle University, and senior Tulane University staff have participated and supported the program.

TA and support was given in the development and conducting of entrance examination and the selection of students for the second cohort of Biostatistics and Health Informatics training program. As a result currently, 26 students are enrolled and are attending the first semester of the first academic year courses among which 2 are international students from South Sudan.

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

9


2.1.3.3 Support to the pre-service training program in HMIS TU in collaboration with the FMOH, FMOE, and RHBs, has introduced a new Level IV Health Information Management (HIM) training program since two years in fifteen Regional health science colleges that are aimed at producing Health Information Technicians, who are going to be the backbone for the Health Management Information System. During the last two academic years, 1,380 Health Information Technicians (students) from all Regions are enrolled in 15 TVETs. During the reporting period, • TU has organized Familiarization of HIT Modular training program on Modular organization and contents of year three level IV training program modules for 60 trainees from the 15 RHSCs (4 instructors from each these colleges: 2 from IT and other 2 from Health tracks). •

Additionally, pedagogical training/ training on teaching methodology is provided for a total of 45 participants (trainees) of Health and IT professional from these 15 RHSCS for four weeks at Jimma University.

In addition to these, all course modules prepared for this course is standardized and are on process for printing.

TU has also provided technical support to FMOH in the development of occupational standard for HIT.

TU has supported these RHSCs with ICT materials and education supplies.

2.1.4 Challenges •

The aggressive and numerous constructions of new health facilities by FMOH have delayed the complete scale up of the HMIS implementation

Delay on the delivery of complete HMIS materials for newly implementing health facilities especially patient forms, MPI card and some registers, shortage of HMIS printed materials.

BPR design process has not been finalized for few RHB and health facilities and this limited the employment of HMIS focal persons for HMIS implementation.

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

10


Resistance of programs and partners at health facilities to integrate medical records and advocating for parallel reporting. There is a significant amount of parallel reporting in regions. The parallel reporting is mostly program related. Though the data is collected from the same source the data discrepancy was noted to be significant.

High turnover of staff at all levels that creates a constant training gap and required continuous support on training. There is also high attrition rate of Information technicians from different health centers and woreda health offices

The trained HMIS supervisors at different Regions are not actively involved in providing technical support to the health facilities and woredas, mainly due to lack of budget at Regional level.

Even though HMIS focal persons are employed in majority of the health facilities that started the HMIS implementation, it is still a challenge in the regions, as not all have hired. This is one of the hurdles to the smooth and sustainable scale up process in few regions.

Travel and security problem particularly in Somali region makes it difficult for scale up of HMIS.

Printing of family health folder mainly for the urban health extension program has been delayed.

Some of the challenges related with HIT program were: lack of clear direction in the implementation of accelerated HIT program, Six Regional Health Science colleges from Oromia were not admitted HIT students for the second batch, and are in continual discussions with FMOH

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

11


2.2 Electronic Health Records (EHR) The adaption of information technology in the health sector and the implementation of electronic health records have become a predominant way of enhancing access to timely patient-care information. As parts of its support for the management of patient-level information in the health institutions in Ethiopia, Tulane University with PEPFAR/CDC funding has continued to facilitate the implementation of SmartCare-EHR as a vital element in enhancing the quality of care in the health sector. The SmartCare-EHR is developed to utilize basic telecommunication infrastructure (Ordinary Phone or CDMA) and computer to send/receive reports and software updates. 2.2.1 Development and enhancement of an Electronic Health Record System During this reporting period, •

Tulane University has continued to mentor and provide technical support for the EMR implementation in 15 hospitals (12 full EMR and 3 only at MRU)and 59 health centers and in 26 administrative health structures (10 Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

12


Sub Cities in Addis Ababa, 13 Woreda Health Office and 3 Zonal Health Department in east shewa): 4 Federal hospital, 5 hospitals in Addis Ababa, 1 hospital Dire-Dawa, 2 hospital Harari, 1 hospital in Tigray, and 2 hospitals in Oromia and 14 health centers in Dire Dawa and 4 health Centers in Harari, 15 health centers in Oromia and 26 health centers in Addis Ababa respectively. •

The eHMIS module has been redesigned based on the Federal Ministry of Health updated HMIS formats and utilize basic telecommunication infrastructure to send/ receive reports. In this fiscal year, the older version of eHMIS-SmartCare module has been updated to include additional information and features as per the request of FMOH. The updated version is being piloted in one zone of Oromia region. The zone is selected for its diverse topographic layout, existence of urban and rural sites to pilot test CDMA, dial-up and internet coverage and connectivity at various locations.

•

In this reporting year, 1,110 health professionals and IT staffs have been trained and mentored on the use of the EHR. The Federal Ministry of Health has mobilized partners to provide the required ICT equipments.

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

13


2.2.2 Human Resource Information System (HRIS) Deployment and Decentralization of HRH Registration and Licensing Human Resource for Health Information System (HRIS) is essential for decision making as it avails timely and accurate information about the size, composition, skill sets, training needs, and performance of the health workforce which is critical for informed decision making. HRIS has also been included as one of the major component of the FMOH HRH strategic plan. Tulane University with PEPFAR/CDC funding has been working closely with Human Resource Development Directorate of FMOH and Health institutions and Professional Licensing Directorate of FMHACA to improve and computerize the HRIS. As part of this process, HRIS software version 1 has been developed with consultations of FMOH and FMHACA leadership and other stakeholders. In line with the FMOH institutional arrangement, the software has two major components: HRIS-Manage and HRIS-License. In the year: • Version 1.0 of HRIS-Manage software has been deployed in Federal Ministry of Health, EHNRI, AAICTDA, all Regional Health Bureaus.

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

14


Similarly, HRIS-License version 1.0 has also been deployed at FMHACA and Seven RHB’s.

Prior to each deployment, assessment had been conducted on human resource and ICT infrastructure availability.

Based on the assessment, training and ICT infrastructure support has been provided including design and install expansion of LAN, installation, mentoring, retro-data encoding of HRIS-License.

In this reporting year, 167 HR professionals and IT staffs have been trained and mentored on the use of the HRIS-manage and HRIS-License.

2.2.3 To support in Geographic Information System (GIS) Tulane University is supporting the Ministry of Health through provision of technical and material supports for GIS to improve health care systems, infrastructure and the quality of health data for planning and management at the Woreda, regional, and national levels. As part of this, TA was provided to East Shewa Zone, as a site of excellence, to establish spatial database, that will help to acquire information on frequency, timing and geographic location of Epidemic diseases, community medical records and profile; show clear catchment area boundary; show physical locations of health facility and other infrastructures with associated non spatial attribute datasets; and show household locality for each health posts catchment area, with associated demographic datasets and received health extension packages. During the period, •

Training was given to 89 health extension workers from Oromia, Lummi Woreda, a model Woreda from East Showa zone of Oromia region on the overall basic computer operation, manually recording the GPS readings, GIS, and on the Family folder. Together with this, they were also trained on disease reporting using grid map.

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

15


In addition, 5 Addis Ababa Health Bureau staffs were trained on GIS and GPS. The scope of the training was to the level of data collection using GPS and other standard formats, data entry to computer and in use GIS from simple routinely performing statistical tasks to complex analysis.

Data cleaning, GPS readings for infrastructure services, household localities and geo-referencing of administrative boundaries have been done at health posts and Addis Ababa city administration health bureau.

TU has also provided 36 mini laptop computers to each of Health Posts in Lummi Woreda of East Shewa Zone. A GIS database is also established for 36 Health Posts at Lummi Woreda with intensive supervision and support. The woreda is fully covered with Computerized GIS database and the health extension workers are using the system to strengthen community Information system linked to Family Folder.

Similarly the spatial data collection at Adea and Boset Woreda, Oromia is accomplished. Data cleaning, GPS readings for infrastructure services, household localities and geo-referencing of administrative boundaries have been done also at these Woredas, at Adea (for 27 Health posts) and Bosset (for 34 health posts).

Geo-database for East Shewa zone and Addis Ababa health bureau has been established. The GIS databases are composed of spatial information regarding facility geographic distribution, provided services by each facility, livelihood situation, land cover and health extension service, administrative boundaries from region to Kebelle levels and information on geomorphology and climatic conditions.

TU providing technical support to establish a GIS database and training package to the EHNRI Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

16


2.2.1.8 To support FMOH and its Agencies in ICT Tulane has been supporting website for FMOH, EHNRI, HAPCO and Mekdim Ethiopia Association (PLWHA), Dire-Dawa, Harari RHB , Gonder University Medical School, and St. Paul’s Millennium Medical College. Technical Assistance was given to FMOH in different IT related issues including: • Installation of Internet content filter Proxy and firewall Server; • Migration of Domain Controller from old servers to new servers and other network performance tuning activities plus WSUS configuration; • Data Recovery, Network Setup, and sharing Peachtree software for finance team; • Installation all the necessary software for computers; and • 7 node InterCom System setup. 2.2.4 Challenges •

• •

EHR challenges-new people with no training, less commitment from the hospital administration, less willingness and motivation from the staffs, absence of ownership of the system by the facility. However, various efforts had been done in collaboration with FMOH and CDC to achieve the aforementioned achievements. Scheduled and non-scheduled electric power outage has delayed deployments and also obstacle few sites from daily operation of the EHR Financial limitation to integrate PHEM with eHMIS as per the FMoH requirement.

2.3 Human Resources for Health (HRH) 2.3.1 HRH Strategic Plan Implementation Tulane University with PEPFAR support has provided technical assistance to the FMOH for the development of the HRH Strategic Plan covering periods of 20092020 and the rolling out in the implementation of the HRH strategic plan. The major objective related to HRH was capacity building and TA focusing on the two arms of FMOH responsible for key HRH functions, Human Resource Management Directorate and Health Professionals and Facilities licensing directorate. The major areas of support includes : capacity building on Human Resource Management (HRM), Scale-up of Human Resource Information System (HRIS), TA on HRH planning and regulatory framework as well as supporting relevant assessments and Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

17


studies that aims in enhancing the retention and motivation of the health workforce. In addition, as part of HRH strategy implementation and support to Jimma Medical and Health Science College, TU has provided mini laptop and e-resources to 65 new medical graduates who will be assigned in underserved areas to enhance motivation and retention of these professionals and also strengthen ehealth /HMIS and Quality of services including HIV/ TB and MNCH. 2.3.2 Strengthening pre-service medical Education Expansion of medical education is one of the priorities given by the FMOH to meet the established need of Medical doctors in the HRH strategic plan. As part of this FMOH has launched a new medical education initiative and TU’s major support with this regard include the following: •

As part of strengthening of the PST of Medical Doctors, TU has supported assessment of the new medical education sites; to be opened under MOE and RHBs.

TU had seconded senior technical officer at the central level to assist in designing the new medical education initiative curriculum and coordinate implementation activities. In line with this, Tulane has supported curriculum review workshop at Adama, which involved 56 participants drawn from area experts, relevant stakeholders from FMOE, FMOH and professional society.

TU has supported development of draft Minimum resource standard to establish a medical college and development of legal and institutional frameworks including model Academic and Administrative Guideline to St. Paul Hospital Millennium Medical College.

TU has also supported the Medical and Health Science Education Council (FMOH, FMOE and Universities) to strengthen the planning and coordination process.

TU has supported Medical and Health Professional Council meeting with 104 participants. In line with this, Tulane University has supported a three weeks faculty development training on the NMEI curricula for 23 staffs at Adama. Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

18


2.3.3 Strengthening St. Paul’s Hospital Millennium Medical College St. Paul’s Hospital Millennium Medical College is an innovator in medical education and is the only medical college under FMOH and the only Medical college in the country which used integrated medical curriculum. The college uses integrated curriculum and has unique admission criteria which includes a quota of 30% to accept female candidates and 30% from disadvantage regions. The college is a Hub for the new Medical education in Ethiopia. As part of strengthening the medical education Tulane University has supported the college starting from development of relevant institutional and legal framework to establish the college to provision of educational materials and teaching aids as well as renovation of training sites. Major supports with this regard include: • Support has been provided in the development of Regulation to establish St Paul’s Hospital Millennium Medical University College (Adopted), • Renovation of class room and other student facilities • Provision of Books and teaching aids including skill lab supplies • Support in ICT 2.3.4 Development of Graduate course for Faculty Development Another related area of support, is post graduate training on medical education. There is an increasing demand both at international and national level for doctors responsible for clinical teaching to gain appropriate training and qualifications in medical educations that they acquire practical skills and techniques to become more

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

19


effective educators. Despite its importance, the Ethiopian situation showed that there are only 2-3 professionals who have taken this training. Thus, TU has been supporting training of faculties (medical doctors) in masters in medical education. The expectation is that once these professionals finalize their training- they will be supported to design a training program (curriculum) and launch post graduate medical education program; which will benefit all medical schools in the country. TU has supported post graduate masters training for: • One faculty from St. Paul’s Hospital Millennium Medical College, (trainee will finalize arrangement and exam in FY12) • One faculty member from Jimma Medical and Health Science College, and • One faculty member from Mekelle Medical College on medical education. 2.3.5 HRH Policy and Legal Frame Work and System Development TU is providing support at policy, system and implementation levels for strengthening HRH policy and legal frameworks for FMHACA in general and Health facilities and Professionals licensing Directorate in particular. Major support during the reporting period includes development of regulatory frameworks for Health Professional and institutions, although most of these are still on draft stage. The major regulations which are drafted/ adopted during the reporting period include: •

Health professionals Code of Conduct (Draft),

Regulation on Food, Medicine and Healthcare Administration and Control (Draft) - under this draft regulation CPD/CME has been put as a major requirement for re-licensing as well as St. Paul Millennium medical College Senate Legislation (Adopted).

Additionally TA was provided in the development of Concept note on Health Professions designation and Scope of Practice Directive and CPD / CME; with benchmarking of other country experience.

Furthermore, Technical assistance was provided to EFMHACA Branch Offices Administration including support to Addis Ababa City Health Bureau on health regulatory organ establishment regulation. Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

20


In addition to supporting development of regulatory framework for FMHACA, TU also provided support for automating the Health professionals and Facilities Licensing Information system. The application is developed as part of HRIS. Major activities performed during period with this regard include: • Deployment of HRIS-Licensing version at FMHACA; training of 28 relevant professionals from Federal and Regional Regulatory bodies; and •

Deployment HRIS-Licensing Application to 7 regions; where the licensing function is decentralized.

As part of the deployment process, computers and accessories were donated for each region and onsite training was provided.

2.3.6 Challenges • • •

Delay in the adaptation of draft legislation and institutional framework by regions for establishing medical schools. Delay in official endorsement of HRH Strategic plan by the government and turnover of staffs has constrained implementation of the Strategic plan Changes in organizational structure and occupational classification, lack of basic information in the paper based personnel information system, and large backlog data to be entered into the system were some of the challenges for scale up of HRIS. Delay in the adoption of draft legislation and guidelines for HRH policy and legal framework

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

21


National M&E Achieved

Number of organizations provided with TA

2,044

Number of individuals trained

16,587

Indicators: National M&E

EMR Achieved

Number of organizations provided with TA

100

Number of individuals trained

1,110

Indicators: National M&E

Human Resources for Health Achieved

Number of new health care workers who graduated from a pre-service training institution

38

3.Annual Performance Indicators

Indicators: National M&E


4. Publications Supported

1. HSDP IV Woreda Based Annual Core Plan EFY 2003 (version 1) 2. HSDP III Annual Performance Report EFY 2002 (version 1) 3. HMIS Display Charts 4. Urban Family Folder 5. Adama Health Profile Brochure 6. Report on the Proceedings and Results of the 12th Annual Review Meeting of HSDP 7. HSDP IV Woreda Based Annual Core Plan EFY 2003 (version 2) 8. HSDP III Annual Performance Report EFY 2002 (version 2) 9. FMoH Officials Governing Guideline 10. Ethiopia’s Health Sector: Booklet 11. HMIS Participant Manual One 12. HMIS Participant Manual Two 13. Medical Directory


14. Health Sector Development Program IV 15. Tulane Ethiopia Annual Report 16. Mekele University College of Health Sciences Brochure 17. Biostatistics and Health Informatics Masters Program Brochure 18. Jimma University School of Public Health and Medicine Brochure 19. St. Paul’s Hospital Millennium Medical College Brochure 20. Monitoring and Evaluation Masters Program Brochure 21. HRIS User Manual 22. Nineteen HIT Modules 23. Addis Ababa Town Health Sector Annual Performance Report 24. Oromia Region Health Sector Annual Performance Report 25. East Showa Zone Health Sector Annual Performance Report 26. Adama Town Health Sector Annual Performance Report 27. Bishoftu Town Health Sector Annual Performance Report 28. Harrari Region Health Sector Annual Performance Report 29. Mekelle Town Health Sector Annual Performance Report

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

24


5. Posters and Presentations


6. Recognitions


<

-

:

••••••

~

<,

l-IPJ

...a_a:

JIMMA

\1\nCtLt

UNIVERSITY Ref.No.

~:~ __

ill 6~ 1_3_0_C_T_7.0_11

_

With Best Regards,

~rt-

IPh.O) Fkre Lemessa \ ,

president

378~ 'ir +251-47 1111457 Fax: +251-471111450 1lOTJ h.rrr-A'Y E-mail: ero@ju.edu.et PBX:+251471111458 -60 +251471112040 JIMMA, ETHIOPIA website: http://www.ju.edu.et

Tulane University Center for Global Health Equity, School of Public Health and Tropical Medicine

Ethiopia Annual Report Project Year II

28


TI Report on Health Sector  

TI Annual Report

Read more
Read more
Similar to
Popular now
Just for you