going to scale with effective community-based primary health care schleiff

CORE Group Fall Meeting 2017

Ethiopia Country Profile Total Pop. : ~ 100 million

Area: 1.1 million sq km

Rural population = 83%

9 regional states/2 city administrations

Diverse country with multi-ethnic

Primary health service coverage = 100%

Evolution of Ethiopia’s Health Sector

• Struggle to improve the health of Ethiopia’s population • In 1990, under-5 mortality rate in Ethiopia was 205/1,000 live births (Countdown to 2015, 2015)

• In 2009, over 3 million cases of Malaria and 150 000 case of TB (WHO, 2015)

• By 2015, remarkable progress in the health sector by achieving the Health related MDG 4, 5, and 6.

• Under-5 mortality rate cut by 2/3 to 68/1,000 live births, in 2012 (UNICEF, 2013)

• Reduced maternal mortality by 69% for the last 20 years (UNICEF, 2013)

• Reduced new HIV infections by more than 90% (UNICEF, 2013)

• TB and malaria cases also reduced

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"Health for All" through Primary Health Care

How was this achieved ?


Health Extension Program (HEP) • Introduction and full implementation of HEP since 2003 • HEP as a strategy to move towards universal health coverage • Community-based health care system focus on the effort • Through the HEP Ethiopia has become a leader throughout the world

in accelerating the achievement of ‘Health for All’ through the primary health care approach

• Ethiopia has achieved 95% health service coverage since 2003

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Ethiopian 3-Tiered Health System

General hospital 1- 1.5 million people

Health center

Primary hospital 60,000-100,000 pop

Health center 15000-25000 pop

Health post 3000- 5000 pop

Tertiary level

Secondary level health care

Primary level health care

Specialized Hospital

3.5- 5 million

URBAN

RURAL

How does this relate to the establishment of IIfPHC-E?


Visits from other countries • Ethiopia has been hosting ministers of health and other health

officials from countries throughout Africa and beyond: ➢Making it possible to learn firsthand how Ethiopia achieved these

remarkable results • During the past three years alone, ministerial-level health officials

from more than 50% of African countries have come to Ethiopia for this purpose: ➢ This has become very demanding for the FMOH

• The FMOH has also tried to provide ongoing follow-up support for these countries to put what they have learned into practices.

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Inauguration 1 February 2016

IIfPHC-E’s Staff

Professor Mengesha Admassu, Executive Director


Melody Kelemu, Training Officer

Tilahun Debebe, Training Officer

Dr. Seble Lemma, Research Officer

Emebet Zerfu, Resource Center Officer

Hiwot Tadesse, Office Officer

Luidina Abebe, Communiations Officer

IIfPHC-E’s Training Facilities


IIfPHC-E : Vision and mission

"Health for All" through Primary Health Care approach

• The vision of the Institute is to contribute to the revitalization of the

global movement of “Health for All’ through primary health care • The mission is to provide training on primary health care and to

conduct PHC research

12 "Health for All" through Primary Health Care

Objectives

• Provide short-term capacity-building trainings on identified needs for national and international trainees related to designing and strengthening PHC and community health programs

• Provide short-term trainings in line with the “transformation agenda’ of

the Government’s Health Sector Transformation Plan (HSTP) and woreda/district transformation

• Carry out need-based health systems implementation research on

PHC and community-based health programs;


Objectives, continued

• Organize forums to communicate research findings, policy changes, and other updates

• Serve as a resource center for the FMOH, its Regional Health Bureaus, and other institutions in Ethiopia and beyond

• Launch and issue an international journal on PHC


Overall Approach

• It is a collaborative endeavor led by the Ministry of Health of Ethiopia and supported technically by the Johns Hopkins Bloomberg School of Public Health

• The institute is hosted by the Ethiopian Public Health Institute.

• Initial funding has been provided by the Gates Foundation


Our Trainings



Trainees Purpose

Policy Makers Understanding the magnitude of the health problem and developing a political commitment for PHC implementation

Health Programmers Sharing of Ethiopian best practices on how to implement PHC at the community level

PHC Implementers Sharing of Ethiopian best practices and hands-on- training for PHC implementation and lessons from case studies

Health Officers Strengthening HSTP implementation and leadership capacity

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Trainees International or National How many at a time? How long?

Policy makers (lawyers, economic

advisors & parliamentarians)

International & national 25 3 days

(2 days of classes & 1 day of field visit)

Health programmers (regional, provincial, bureau heads)

International & national 25 2 weeks

(10 days of classes and 2 days of field visits)

PHC implementers (professionals at woreda and health centre levels)

International & national 25 6 weeks

(5 weeks of classes & 1 week of field visits)

Health officers national 25 2 weeks

Our Trainings:


Delegations and Field Visits

International trainees "Health for All" through Primary Health Care

Evaluation feedbacks from our trainees “The experience was very powerful. You thought us the concepts and we have something that we could

take back home; especially, the community aspect that

you were able to implement. You have been successful to

see the linkage.”

“Thank you for taking your time to lend your experience.

We did not know where to go if the Institute was not

established.

“We saw compassionate service and shared tasks at the health

center and the health post. When compared to that of yours,

our indicators were low. We need to re-visit our programs to

reach the same level.”

Thank you

“Health for all” through Primary Health Care!


going to scale with effective community-based primary health care schleiff

Healthcare