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

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 Critical Gaps Identified:-
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: At All Levels Financial management system
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