GHLI Programs in Ethiopia
The GHLI has extensive involvement with two health care programs in Ethiopia. The Ethiopian Hospital Management Initiative (EHMI) was launched in 2006 as a partnership between Yale, the Ethiopian Ministry of Health and the Clinton Health Access Initiative (CHAI) to improve the quality of care provided in Ethiopian hospitals through better management, systems and skills.
As part of this initiative, Yale-Clinton Fellows served as on-site mentors to hospital management teams in selected hospitals, piloting a series of locally-appropriate management tools and systems that culminated in the development of the Blueprint for Hospital Management. The Blueprint and associated standards, subsequently updated and expanded to form the Ethiopian Hospital Reform Implementation Guidelines (EHRIG), serves as a practical tool to strengthen key management systems and achieve basic standards in hospital operations.
In an effort to train CEOs and to establish health management as a profession in Ethiopia, Yale Global Health Leadership Institute faculty helped design and implement the first Master’s of Hospital Administration (MHA) degree program in Africa. Launched in 2008 at Jimma University and expanded to Addis Ababa University in 2010, the MHA is a two-year executive-style program that combines academic preparation, practical application in the hospital setting and continuous mentoring by Yale faculty and staff. As of 2011, more than 75 students and alumni have been trained in the MHA programs.
MHA candidate projects have led to great improvements in hospital quality, including: reduced delays in outpatient care and acute mental health admission; reduced length of inpatient stays and rates of post-surgical infection rates; and increased cleanliness and adherence to infection prevention standards.
The GHLI is also part of the Ethiopian Millennium Rural Initiative (EMRI). Sponsored by the Children’s Investment Fund Foundation and implemented by CHAI, EMRI provides financial support, technical assistance and equipment to enhance accessibility, utilization and quality of health services in 30 rural Primary Health Care Units.
A critical component of the EMRI program was the initiation and strengthening Prevention of Mother-to-Child Transmission (PMTCT) of HIV services at EMRI health centers. One method used to strengthen PMTCT services was the Fast Track program. Fast Track is a team-based change acceleration method that brings diverse groups of people to achieve clear goals. The approach has been used for over 20 years by General Electric, as well as other businesses and organizations to gain measurable results in a short time frame. The following video describes the PMTCT Fast Track program in further detail. Video link: Part 1, Part 2.
As the external evaluator of EMRI, GHLI combines qualitative and quantitative research methods to measure the overall impact of the project and identify factors of the design and implementation that are critical to the program’s success or failure.
GHLI has established data infrastructure to monitor health center performance on a number key indicators over time, built systems to ensure data quality and timely feedback to program implementers, conducted numerous qualitative interviews with health center staff and community members and worked with CHAI to build local capacity for program monitoring and evaluation.
Ethiopia has also participated as a delegation to the GHLI Conference.
Despite extensive poverty and limited resources, Ethiopia has made impressive strides in improving its health care system and can serve as a model for other countries seeking to make similar gains, a new paper by GHLI faculty and staff. This paper, published in the current issue of Global Health Governance, discusses the grand strategy that can be used to improve global health, using our work and research being done in Ethiopia as an example. Click here to read more.
