Quality Management in Ethiopia - HealthQual

HEALTHQUAL All Country Learning Network, WindhoekBy: Abiyou Kiflie Alemayehu (MD, MPH)Federal MOH/Tulane University-TAEQuality Improvement Advisor17-March- 2011

Country Profile

Country ProfileHealth Status• IMR = 77/1,000• CMR = 50/1,000• Under 5 MR = 123/1,000• MMR = 673/100,000• HIV Prevalence = 2.3%Source: 2007 population census

Health SystemFederalMinistry ofHealthSpecialized HospitalsRegulatoryHAPCO …RegionalHealthBureauGeneral HospitalsWoredaHealthOfficePrimary Hospitals (rural)Health Centers (both)Health Posts (rural)

Quality Improvement• Status of Implementation: Very Early• Approach– Uses the model for improvement• Measurement linked with improvement– Aims for implementing across allservices provided in the health facility

Development Process– 2007/8: technical working group (QM for HIV)established to harmonize and guide activities bymultiple partners that use different models• Framework developed• Baseline assessment done– 2009/10: Reform undergoes within the ministry• Shift from disease specific approach to general serviceviewHIV specific QM transformed to general service QM(and the TWG too)– Though process gets delayed some steps are started …

Current Status• Materials prepared and standardized• The materials are official documents of the ministry• Refining the materials undergoing taking inputs fromimplementation process• Initial 5 hospitals (pilot) gets training• Mentoring/Coaching process undergoing to get the hospitalsimplement as proposed

Responsibilities• Principle: “Quality Improvement is theresponsibility of every body”• Every body is responsible to improve the quality ofservice that it provides• Every unit, Every Individual needs to perform QI projects• A unit will be its own QI team: run QI cycles to improve itsown functions

Responsibilities• Every unit:• Will develop its own indicators/measures to be selfmonitored regularly• Prioritize issues to be projects• Implement QI cycles on the selected projects• Engage every individual in the unit• Report those indicators which needs to be reported All these encourages the team work in the unit

Responsibilities

Responsibilities• Practically:• Capacity?• Time?• Devotion/commitment?• An over all QM committee• To advise the hospital management• To provide technical support to the lower units and capacitybuilding• Special QI teams to be organized for cross cutting issues (ifno committee responsible)

አመሰግናለሁ - Ameseginalehu(Thank You)