Creating Centers of Excellence in Ethiopia: Country Ownership and Sustainability

By Hailu Tadeg, SIAPS Country Project Director for Ethiopia

Ethiopia’s public health system has undergone a remarkable expansion in the last five years.  The number of hospitals has increased from 116 in 2009 to 156 in 2014 with an additional 123 new hospitals  in the pipeline.  Additionally, the number of health centers has grown from 2142 to 3,335. This aggressive expansion in health care facilities has dramatically improved access to health care services.

Although the number of health care providers needed to serve a country of almost 90 million people is in short supply, the number of new graduates in various healthcare professions has increased significantly.  This is due primarily to the Ethiopian government‘s commitment to improving the public health system as one of its top priorities.  However, the quality of health care delivery remains a daunting challenge in Ethiopia.  In an effort to improve quality, Ethiopia’s Federal Ministry of Health (FMOH) has developed and implemented different types of interventions during the past five years to address some of the problems.

One of the tools used by the government to improve the quality of health care services is the Ethiopian Hospital Reform Implementation Guideline (EHRIG).  EHRIG, developed and published in May 2010 by the Federal Ministry of Health (FMoH), outlines a set of standards, grouped into thirteen chapters, that hospitals are required to meet in healthcare service delivery. EHRIG is designed to guide hospital managers and health providers in steering the consistent implementation of reforms in health services at hospitals throughout the country.

The pharmacy chapter, one of the 13 chapters making up EHRIG, has 12 standards of pharmacy services. The SIAPS Program in Ethiopia has partnered with FMOH in the development and implementation of the 12 key pharmacy standards in hospitals. SIAPS, in collaboration with FMoH and regional health bureaus (RHBs), has provided sustained and intensive technical assistance to 24 hospitals with the goal of creating centers of excellence to serve as demonstration and learning sites for other hospitals.

This year, working with the RHBs, SIAPS conducted an evaluation to determine the progress of hospitals in meeting the standards set out by EHRIG. Nine hospitals in four regions scored more than 90% in the targets set by EHRIG. These hospitals are being “graduated” from SIAPS technical assistance.

Mekelle Hospital has been designated as a Center of Excellence.
Mekelle Hospital has been designated as a Center of Excellence.

SIAPS, in collaboration with Tigray’s RHB, marked the first graduation ceremony of two of the hospitals in Tigray region—Mekelle and St. Mary Hospitals— on November 14, 2014. The graduation of the two hospitals was acknowledged by the Tigray RHB, represented by His Excellency Mr. Hagos Godify, and MSH Country Representative Negussu Mekonnen, through an award of a certificate of excellence to the hospital CEOs.

The certificate read: “This certificate is hereby granted to Mekelle Hospital/St. Mary Hospital in recognition of its excellent accomplishments in the implementation of Ethiopian Hospital Reform Implementation Guidelines-Pharmacy Chapter with the concerted support of the Tigray Regional Health Bureau and the U.S. Agency for International Development /Systems for Improved Access to Pharmaceuticals and Services (USAID/SIAPS) Program. This certificate is an assurance of the hospital’s capacity to serve as a model and provide support to other hospitals in improving quality of pharmacy services in the region.”

Through its systems-strengthening, collaborative, and results-oriented approach, SIAPS has made a significant difference in the transformation of Ethiopia’s hospital pharmacy services.  SIAPS works hand-in-hand with Ethiopia’s Ministry of Health, RHBs, the Pharmaceutical Fund and Supply Agency (PFSA), and other partners and stakeholders to create the sense of country ownership and focus on sustainability required to drive the performance of pharmaceutical services in the country with the overall goal of improving health outcomes of the Ethiopian people.