ethiopian health and nutrition research institute - ianphi

ETHIOPIAN HEALTH AND NUTRITIONRESEARCH INSTITUTEA FIVE YEAR, BALANCEDSCORE CARD BASEDSTRATEGIC PLAN(2010-2015 G.C)For further information:-Phone: (251)-2751522/753470Fax: (251)-112754744/757722Email: ehnri@ethionet.etWebsite: www.ehnri.gov.etP.O.Box: 1242/5654Addis AbabaEthiopia1

TABLE OF CONTENTI. LIST OF TABLES ----------------------------------------------------------------------------------------- 3II. LIST OF FIGURES---------------------------------------------------------------------------------------------- 3III. ACRONYMS ----------------------------------------------------------------------------------------------------- 4III. FOREWORD-------------------------------------------------------------------------------------------1. EXECUTIVE SUMMARY---------------------------------------------------------------------------------------672. BACKGROUND------------------------------------------------------------------------------------------------- 102.1 Major Achievements of EHNRI in the Past Five Years----------------------------------------------------------- 152.1.1 Research and Technology Transfer--------------------------------------------------------------------------------- 152.1.2 Public Health Emergency Management (PHEM)----------------------------------------------------------------- 162.1.3 Public Health Laboratory Quality System------------------------------------------------------------------------- 162.1.4 Management and Leadership----------------------------------------------------------------------------------------- 183. DEVELOPMENT PROCESS OF THE STRATEGIC PLAN------------------------------------------------4. ORGANIZATIONAL ASSESSMENT------------------------------------------------------------------------18204.1 SWOT Analysis------------------------------------------------------------------------------------------------------------ 204.1.1 Pains----------------------------------------------------------------------------------------------------------------------- 204.1.2 Enablers------------------------------------------------------------------------------------------------------------------- 215. VISION, MISSION AND CORE VALUES---------------------------------------------------------------------- 225.1 Vision------------------------------------------------------------------------------------------------------------------------- 225.2 Mission----------------------------------------------------------------------------------------------------------------------- 225.3 Core Values-----------------------------------------------------------------------------------------------------------------226. STRATEGY----------------------------------------------------------------------------------------------------------236.1 Customer Value Proposition------------------------------------------------------------------------------------------- 236.2 Strategic Themes (Pillars) and Strategic Results----------------------------------------------------------------- 246.2.1 Pillar –I. Excellence in Research and Technology Transfer---------------------------------------------------- 246.2.2 Pillar –II. Excellence in Public Health Emergency Management---------------------------------------------- 266.2.3 Pillar –III. Excellence in Public Health Laboratory Quality System------------------------------------------- 276.2.4 Pillar –IV. Excellence in Management and Leadership---------------------------------------------------------- 276.3 Strategic Results----------------------------------------------------------------------------------------------------------- 286.4 Strategic Perspectives---------------------------------------------------------------------------------------------------7. STRATEGIC OBJECTIVES---------------------------------------------------------------------------------------28302

8. STRATEGIC MAP------------------------------------------------------------------------------------------------429. PERFORMANCE MEASURES--------------------------------------------------------------------------------- 4410. INITIATIVES AND SCOPE/CONTENT-----------------------------------------------------------------------5711. Budget ------------------------------------------------------------------------------------------------ 8312. APPENDICES--------------------------------------------------------------------------------------------------- 108APPENDIX I. DETAIL SWOT PEST ANALYSIS---------------------------------------------------------------- 108APPENDIX II: STAKEHOLDER AND COLLABORATIOR ANALYSIS-------------------------------------- 111APPENDIX III: COLLABORATORS AND AREA OF COLLABORATION......................................... 113APPENDEX IV. PARTICIPANTS OF THE STRATEGIC PLANNING PROCESS----------------------------115I. List of TablesTable 1. Customer value proposition from different angles------------------------------------- 23Table 2. Strategic Themes and Results-------------------------------------------------------------- 28Table 3. List of strategic objectives under each respective theme------------------------------ 41Table 4. List of performance measures under each objective----------------------------------- 44Table 5. List of initiatives and scopes/contents under each performance measure------ 57Table 6. Cost Estimated/Required Budget (Birr)-------------------------------------------------- 83II. List of FiguresFig. 1 EHNRI’s Performance House---------------------------------------------------------------------- 29Fig.2. Strategic Map---------------------------------------------------------------------------------------- 433

III. AcronymsAAU -------------------------- Addis Ababa UniversityABC ------------------------- Activity Based Costing with HIV/AIDSAHRI------------------------- Armuer Hansen Research InstituteAIDS------------------------- Anti-Immuno Deficiency SyndromeANC-------------------------- Antenatal CareART ------------------------- Antiretroviral TherapyAWD ------------------------ Acute watery DiarrhoeaBPR -------------------------- Business Process ReengineeringBSC -------------------------- Balanced Score CardBSS -------------------------- Behavioural Survey & SurveillanceCDC ------------------------- Centre for Disease Prevention and ControlDDT-------------------------- DichlorodiphenyltrichloroethaneDPT-------------------------- Diphtheria, Pertussis and TetanusEARI ------------------------ Ethiopian Agricultural Research InstituteEDHS ----------------------- Ethiopian Demographic and Health SurveyEHNRI----------------------- Ethiopian Health and Nutrition Research InstituteENI -------------------------- Ethiopian Nutrition InstituteEOC-------------------------- Emergency Operation CenterEORI ------------------------ Essential Oil Research InstituteEPA-------------------------- Environmental Protection AuthorityEPRP------------------------- Emergency Preparedness and Response planEQA ------------------------- External Quality AssessmentERF -------------------------- Emergency Response FundFELTP ---------------------- Field Epidemiology and Laboratory Training ProgramFIND ------------------------ Foundation for Innovative New DiagnosticsFMOH ----------------------- Federal Ministry of HealthFSNRD ---------------------- Food Science and Nutrition Research DepartmentGD---------------------------- General DirectorGDP -------------------------- Gross Domestic ProductGF ---------------------------- Global FundGOE ------------------------- Government of EthiopiaHACCP --------------------- Hazard Analysis & Critical Control PointsHBV-------------------------- Hepatitis BHCV-------------------------- Hepatitis C\HEP -------------------------- Health Extension PackageHIV--------------------------- Human Immuno Deficiency VirusHIVDR----------------------- Human Immuno Deficiency Virus Drug ResistanceHMIS ------------------------ Health Management Information SystemHRM&GSD ---------------- Human Resource Management and General Service DirectorateHSDP ------------------------ Health Sector Development ProgramHSRD ------------------------ Health System Research DirectorateIBC --------------------------- Institute of Biodiversity ConservationILRI--------------------------- International Livestock Research InstituteINDRD ---------------------- Infectious & Non-infectious Disease Research DirectorateIT ----------------------------- Information TechnologyJICA-------------------------- Japan International Cooperation AgencyLIS ---------------------------- Laboratory Information System4

MoAD ------------------------ Ministry of Agricultural DevelopmentMODS------------------------ Microscopic–Observation Drug-SusceptibilityMoFED ---------------------- Ministry of Finance and Economic DevelopmentMoST------------------------- Ministry of Science and TechnologyNA----------------------------- Not AvailableNGO’s ----------------------- Non Governmental OrganizationNNP -------------------------- National Nutrition ProgramNNS -------------------------- National Nutrition StrategyNRIH ------------------------ National Research Institute of HealthNTRL ------------------------ National Tuberculosis Reference LaboratoryNVI --------------------------- National Veterinary InstitutePBS---------------------------- Population Based SurveyPEST-------------------------- Political, Economical, Social and Technological AnalysisPFMED ---------------------- Plan, Finance, Monitoring & Evaluation DirectoratePHE -------------------------- Public Health EmergencyPHEM ----------------------- Public Health Emergency ManagementPHEMC ---------------------PHEMDGDO --------------Public Health Emergency Management CenterPublic Health Emergency Management Deputy GeneralDirector OfficePLWHA---------------------- People living with HIV/AIDSPM --------------------------- Privative MaintenancePMTCT---------------------- Public Health Emergency Management Technical ForcePR---------------------------- Progress ReportPRO ------------------------- Public Relation OfficeRDT ------------------------- Rapid Diagnostic TestRHB ------------------------- Regional Health BureauRLCBD --------------------- Regional Laboratory Capacity Building DirectorateRR---------------------------- Research ReportRTTDGDO------------------ Research and Technology Transfer Deputy General DirectorOfficeSERO ------------------------ Scientific & Ethical Review OfficeSOP -------------------------- Standard Operation ProcedureSPM-------------------------- Strategic Planning ManagementSTI --------------------------- Sexually Transmitted InfectionsSWOT------------------------ Strength, Weakness, Opportunity and Threat AnalysisTB --------------------------- TuberculosisTMMRD -------------------- Traditional & Modern Medicine Research DirectorateTOR-------------------------- Term of ReferenceTOT ------------------------- Training of TrainersTTRTD --------------------- Technology Transfer & Research Translation DirectorateTTF -------------------------- Technical Task ForceUNDP ----------------------- United Nation development ProgramUNICEF -------------------- United Nations International Children’s Education FundVDPD ----------------------- Vaccine and Diagnostic Production DirectorateWB --------------------------- World BankWHO ------------------------- World Health Organization5

I. ForewordThis strategic plan, which is developed in line with the principles of Balanced ScoreCard, is believed to enhance the activities of the Institute through addressing majorpublic health priority areas with sustained clear focus, momentum and coordination toexcel in the Institute’s core activities with measureable performance and set targets.The preparation of this strategic plan has consulted the HSDP and other national andinternational relevant documents. Views of the concerned EHNRI’s staff members andopinions of stakeholders and partners have been also incorporated in the identificationof most critical issues for the entire five-year plan of the Institute.In order to fulfill the mission and vision of the Institute, this strategic plan is mainlygeared towards the improvements of problem solving research, public healthemergency management, national public health laboratory network, and managementand leadership. It is also envisaged to work closely and foster partnerships andcollaborations with all concerned stake holders of the health sector.I believe that the initiation of such a new and comprehensive strategic plan anddirection, essentially a dynamic process, would give all our partners as well as staffmembers of the Institute the opportunity to get hold of reference points as well as feelthe sense of commitment to realize shared vision.Finally, I take the pleasure to express my gratitude to the Institute’s Strategic PlanDevelopment Team for their unreserved effort in the preparation of the document.Tsehaynesh Messele Ph DDirector General,EHNRI6

1. Executive SummaryThe Ethiopian Health and Nutrition Research Institute (EHNRI) was established under theRegulation No.4/1996 following the merger of the former National Research Institute ofHealth (NRIH), the Ethiopian Nutrition Institute (ENI) and the Department of TraditionalMedicine under the Ministry of Health. The primary objective of the Institute is to conductresearch on priority areas of health and nutrition problems and contribute to the nationaleffort of disease prevention and control.Recently, through Business Process Reengineering (BPR), the EHNRI has undergonestructural transformation with the formation of two core processes; namely Research andTechnology Transfer and Public Health Emergency Management. The vision and mission ofEHNRI have been clearly defined to fulfill its mandate as the newly envisioned EthiopianPublic Health Institute that will emphasize public health and nutrition research, as well aspublic health emergency management. EHNRI is also mandated to produce vaccines for majorinfectious diseases and to improve public health laboratory system at a national scale.This five-year strategic plan was initiated by EHNRI management and has been developed inaccordance with the Balanced Score Card (BSC) principles. Based on the mission and vision ofEHNRI, the environmental scan and the customers’ value propositions, four strategic themes,also referred to as pillars were identified as follows: Research and Technology Transfer,Public Health Emergency Management, Public Health Laboratory Service and Managementand Leadership. In order to achieve these strategic results, 17 strategic objectives wereformulated. The objectives are continuous action-oriented for the improvements required torealize the strategic results. Each objective was designed with performance measures andinitiatives according to the four prospective of BSC.7

The strategic plan for Research and Technology Transfer addresses public health researchpriority areas in infectious and non infectious diseases, food science and nutrition, traditionalmedicine, environmental health, hygiene and occupational hazards and health systems. Asthe need for non biomedical research increases, the strategic plan for Research andTechnology Transfer also focuses on health systems. Added to these, as the need of nonbiomedical research in health is an essential area to be dealt with, research undertaking inhealth system has been given due emphasis.Vaccine production for major infectious diseases, production of diagnostic reagents and kitsthrough technology transfer, promotion of indigenous knowledge in traditional medicine, andthe development of locally consumed food items are among the strategic directions of EHNRI.The Public Health Emergency Management pillar focuses on disease outbreaks and nutritionalemergencies with emphasis on risk-based preparedness and capacity building. The strategicplan for Public Health Emergency Management also emphasizes early detection and responseto public health emergency threats.Additionally, EHNRI has made strong and sustained efforts to coordinate and shareinformation. Many of the activities identified in the strategic plan are assumed to establishstrong, functional coordination and collaboration as well as timely and appropriateinformation dissemination to all concerned.The Ethiopian national laboratory system is also a strategic priority. EHNRI will supportlaboratories through capacity building, quality assurance programs, infrastructuredevelopment, training and maintenance. EHNRI will conduct regular monitoring andevaluation of laboratory services in an effort to improve services and meet acceptablelaboratory standards. As a result, EHNRI aims to develop an affordable and sustainablesystem, whereby quality laboratory services are accessible to all Ethiopians while alsoproviding reliable and high-quality results to guide and support clinical decision makingthroughout the country.Effective management of the BSC system and placing priority on human resourcedevelopment are necessary for the successful implementation of the strategic plan. The8

udget breakdown set for different activities planned to be addressed during the five-yearperiod is also shown in the document in detail.The development of the BSC strategic plan for 2010-2015 was developed in line with thepriority areas of the Health Sector Development Program (HSDP IV). The BSC strategy wascreated to provide a forum to discuss and address health promotion and disease preventionamong policy makers, health care professionals, researchers and the community. The BSCstrategy promotes opportunities that encourage collaboration among national andinternational partners working to address health problems in accordance with Ethiopia’sneeds and priorities.9

2. BackgroundThe major health problems in Ethiopia emanate largely from a number of complex andinterwoven factors, which include low socioeconomic status, unique socio-cultural attitudesand practices, and geographical setting of the country. Although the majority of prevailingdiseases are preventable, they are ubiquitously distributed throughout the country, causingconsiderable suffering and death. A high population growth rate of about 2.9 % per year,typically influenced by cultural and religious attitudes, greatly contributes to the increasinglychallenging health needs in Ethiopia.According to regularly documented evidence by the Federal Ministry of Health (FMOH),infectious diseases account for 60-80% of health problems and are major causes of morbidityand mortality in Ethiopia. More specifically, HIV/AIDS/other STIs, malaria, tuberculosis, acuterespiratory infections and diarrheal diseases are among the ten top causes of morbidities andmortalities.Data from vital health indicators demonstrate exceedingly high annual death rates amongchildren and child bearing women that are attributable to infectious diseases. Women andchildren constitute about two-third of the entire population. The Ethiopian DemographicHealth Survey (EDHS) 2005 reported 123 per 1,000 deaths of children under the age of fiveand 673 maternal mortality deaths per 100,000 live births, However, these data showed areduction in deaths for children (166 per 1,000) under the age of five and mothers (978 per100,000 live births).As disease causing agents alter, it is necessary to reexamine past and current disease controlstrategies to most effectively respond to evolving disease causing agents. As drug resistantstrains of microorganisms develop, the treatment of many infectious diseases becomesincreasingly challenging. The emergence of multidrug resistant strains of bacteria such asMycobacterium tuberculosis, Streptococcus pneumonia, Staphylococcus aureus, Neisseriagonorrheae, Shigella spp, among many others is a serious challenge. Additionally, the vectormosquito, Anopheles gambiae s.l, is becoming increasingly resistant to DDT while Plasmodiumfalciparum has already developed resistance towards the once curative drug. Lack of adequate10

evaluation on currently used drugs and a systematic surveillance of drug resistance on majorinfectious diseases in Ethiopia calls for an immediate action.Millions of Ethiopian people suffer from hunger, disease, environmental degradation, andother related problems. Ethiopia has one of Sub-Saharan Africa’s highest rates ofmalnutrition; almost 57% of under-five mortality in Ethiopia is related to severe and mild tomoderate malnutrition. There are several underlying causes for malnutrition in Ethiopia;among the main causes are inadequate access to food, inadequate care for mothers andchildren, insufficient health services and unhealthy living environments. In addition tomacronutrient malnutrition, micronutrient deficiencies of vitamin A, iron and iodine are alsomajor nutritional problems of public health significance.The per capita calorie supply, as indicated by some surveys is less than 70% of therecommended daily requirement. According to EDHS 2005, the national average prevalencefor stunting is 47%,, approximately 38% of the children are underweight and 11% of thechildren are wasted. Studies on breast-feeding and weaning practices revealed that theproblem of early stunting in Ethiopia is mainly due to delayed introduction of complementaryfoods in the first year of life. Therefore, there is a need to improve the prevailing nutritionalstatus and ensure the general well being of the population.Food, nutrition, and health security are complementary. Data from the EDHS 2005 indicatethat households with adequate food and nutrition status are often less because of inadequatemicronutrients, maternal knowledge=, about child care, health services and sanitation.For the last few years, efforts to improve nutrition of women and children in Ethiopia werenot harmonized, were fragmented and sectors were duplicating efforts. Since 2008, theGovernment of Ethiopia (GOE) committed itself to address the nutritional problems of thecountry. To realize this, the Ethiopian Government had developed the National NutritionStrategy (NNS) to use as a guiding framework to develop a harmonized and cohesive responseto this urgent nutrition situation. Consequently, the National Nutrition Program (NNP) waslaunched in 2009 to reduce the burden of malnutrition through harmonized, comprehensive,11

large scale national efforts. The NNP is expected to contribute to a significant reduction in theproportion of Ethiopians suffering from malnutrition and poverty.In spite of the GOE efforts to introduce modern health care delivery systems to ruralpopulations, most people living in rural areas rely more heavily on traditional, indigenouscare delivery systems than on modern health care delivery systems. Indigenous, traditionalmedicine is used largely because it is easily available, inexpensive and generally trusted. Therecent WHO report indicates that traditional medicine is extensively used for primaryhealthcare (90%) in Ethiopia, the highest figure recorded so far. Traditional medicineremains an omnipresent reality in the life among the majority of Ethiopia’s population,reflecting considerable cultural continuity and persistently poor accessibility and quality ofmost modern health services.Because traditional medicine is so widely practiced throughout Ethiopia, it is not onlyimportant to understand indigenous medicinal practices, but it is also necessary to document,inventory and conserve traditional medicinal knowledge. Ethiopia has remarkable medicomagicalliterature which has little parallel in Africa. The country’s rich sources of medicalhistory comprise of medical texts, medico-magical scrolls, referred to as “gadle,” or live ofsaints, chronicles and traditional medicine lore. These sources have not been systematicallystudied; it is therefore recommended that these sources of cultural and historical medicinalinformation are studied to develop an understanding and to ensure access to such resources.The GOE has formally recognized the value of traditional medicine in the health systemthrough the development of series of policies promoting the traditional medicine in thecountry. Despite the development of these policies, it is difficult to enable the practice oftraditional healing because legal and regulatory frameworks, including registration fortraditional medicines and traditional health practitioners do not exist.In Ethiopia, epidemic-prone diseases pose serious public health threats in many parts of thecountry. Disease outbreaks, such as malaria, measles, meningitis, relapsing fever, acutewatery diarrhea, acute respiratory tract infections and severe malnutrition continue to occur.12

Meanwhile, prevailing chronic problems due to deep-rooted poverty are coupled withrecurrent disasters, such as droughts, famine and flood. Such instability and diseaseoutbreaks result in significant social, economic and crises. And pose constant challenges to theprovision of health security for the people of Ethiopia.Emergence and outbreaks of infectious diseases externally influenced the Ministry’s publichealth activities from 2005-2009. Among national and international concerns were avianinfluenza, due to its pandemic potential, natural disasters and social trends affecting the riskof disease emergence and outbreak.The Public Health Emergency Management (PHEM) is one of eight core processes selected bythe Ministry during BPR –based restructuring process in 2009. The PHEM primarily aim toidentify and select unusual public health events on a timely basis and to promptly respond toarising public health emergencies; as well as to ensure recovery in the aftermath of incidents.The PHEM core process will help to determine health risk management which can bestcontribute to preventing and preparing of disasters in Ethiopia. The PHEM core process wasalso designed to maximize collaboration to manage health emergencies and epidemics.Furthermore, the PHEM process aims to strengthen FMOH’s leadership role to ensure thecollaboration and coordination among sectors in the area of risk reduction, informationexchange and response to emerging diseases. The FMOH is mandated to provide leadershipin setting norms and standards and developing and endorsing policies and regulation toensure that health services are not below the accepted standards. The FMOH, expects thatissues related to protecting public health in Ethiopia will be visibly shared by all sectors andnot left to be shouldered by one MinistryThe Government of Ethiopia has also planned to realize its health policy through a series ofHealth Sector Development Programs (HSDP). By and large, the public health and nutritionproblems of the country are complex. The Government recognized the need to institute amore cost effective and efficient health care system that will contribute to the overallsocioeconomic development of the country. Among these being, rural and, sustainable13

development, poverty reduction, capacity development strategies and civil service reformprograms.The first of the series of programs, HSDP-1, was developed for the years covering 1990 to1994 E.C. HSDP-1 was comprised of eight major components:A. Health care delivery and Quality of CareB. Health Facility Rehabilitation and ExpansionC. Human Resources DevelopmentD. Strengthening Pharmaceutical ServicesE. Strengthening Health Sector Management, Management Information Systems,Information,F. Education and CommunicationG. Health care FinanceH. Monitoring and Evaluation.The HSDP-2 covered 1995 to 1997 E.C, and was a continuation and scaling up of the HSDP-1. .It is further characterized by the introduction of the new Health Extension Package (HEP).The HEP provides a package of essential services for disease prevention and targetshouseholds at the Kebele level through a trained cadre of health workers. HSDP-3 wasundertaken from 1998 until 2002 E.C. The HSDP-3 served as a comprehensive national planand also as a guiding framework for regions and woradas to. Plan and implement healthSector development activities. The major goals of HSDP-3 were to improve maternal health,reduce child mortality and combat HIV/AIDS, malaria, TB and other diseases. Ultimately,HSDP-3 aimed to improve the health status of the Ethiopian people and to achieve theMillennium Development Goals.The National HSDP is designed to comply with the overall health policy and to emphasize theprevention and control of diseases such as HIV/AIDS, malaria, TB, nutritional problems andemerging diseases. The Ethiopian Health and Nutrition Research Institute (EHNRI) serves asthe leading research and service component of the Ministry of Health. EHNRI contributes tothe health development strategy and functions to achieve objectives set forth throughout the14

HSDP by strengthening medical laboratories in Ethiopia, providing referral laboratoryservices and conducting applied research on health and nutrition.2.1 Major Achievements of EHNRI in the Past Five Years2.1.1 Research and Technology Transfer• Numerous research activities in the fields of infectious diseases, nutrition andtraditional medicine have been conducted, resulting in copious peer reviewedpublications in both national and international journals. Some HIV/AIDS, malaria andTB research and surveillance findings have provided information of national relevancefor control efforts. Other findings have provided base line data or useful inputs to theformulation of wider projects to be carried out nationally.• As the package for global elimination of polio, a collaborative surveillance of polio wasconducted by EHNRI, the Japanese International Cooperation Agency (JICA), the WorldHealth Organization (WHO) and the Local and International Rotarians.• EHNRI is fulfilling a leadership role in the accelerated facilitation, coordination andimplementation of NNP. Under the NNP, EHNRI prepared several reports, includingthe nutrition communication frame work, nutrition training needs assessment andhuman resource need for nutrition. Additionally, EHNRI has been preparing for theimplementation of operational research.• A national survey capturing vitamin A, iodine and iron deficiencies was conducted toexamine the nutritional status of people living with HIV/AIDS (PLWHA), who did notstart ART in order to provide them nutritional counselling. Accordingly, nowadays asimilar research is ongoing in PLHWA who have already started ART.• Research on investigating traditional medicine is gaining interest among researchers.EHNRI collaborated with 45 traditional healers to conduct joint research on traditionalmedicine and therapies in Ethiopia. However; due to the problems related to theimplementation of bilaterally signed memorandum of understanding, the study could15

not be continuing. One of the main reasons for the disruption of the research was thereluctant of traditional healers to submit herbal remedies based on the signedagreement. It is in fact, planned by the traditional and modern medicine researchdirectorates to reinitiate and strengthen the collaborative research efforts between theInstitute and registered traditional healers individually or through their associationthat can facilitate the cooperation.• Through the support from international organizations, such as the WHO and WorldBank, laboratories are becoming better equipped with both human resources andsupplies.2.1.2 Public Health Emergency Management (PHEM)Since its recent inception, the PHEM process has already undertaken the following activities:• Establishment of PHEM system ranging from the central to community levels.• Provide trainings and other technical support to regions on the management of publichealth emergency.• Provide logistic, vaccine and medical supplies during outbreaks and epidemics anddispatch disease investigation teams to the affected areas.• Launched EFLTP Masters program in cooperation with Addis Ababa University (AAU)and the Centre for Disease Control and Prevention (CDC) to satisfy the need ofepidemiologists in the nation.2.1.3 Public Health Laboratory Quality System• The Public Health Laboratory Service has been and continues to work collaborativelywith CDC to conduct national surveillance studies of HIV/AIDS, STI and TB. The twoagencies are also working collaboratively to strengthen laboratories at the central andregional levels.16

• EHNRI has made significant progress in developing its capacity in order to support thenational laboratory system and to bring ART laboratory services to health facilitiesthroughout the country. Automated analyzers have been installed and are functionalin 118 laboratories to conduct ART monitoring. Additionally, more than 350 healthcentre laboratories are now receiving ART monitoring laboratory services through thereferral linkage system. Different specialized laboratory tests, such as DNA-PDR, viralload and TB liquid culture has been introduced to regional laboratories; the majority ofthese labs are currently providing monitoring and referral linkage services.• EHNRI has rolled out various trainings for several laboratory testing. For instance, aTraining of Trainers (TOT) for regional laboratories has been facilitated. In addition,EHNRI conducted external quality assessment (EQA) programs that have beenimplemented for rapid tests, CD4, clinical chemistry and haematology, AFBmicroscopy, malaria and DNA-PCR. Furthermore, the Institute has undergone severalchanges to improve its capacity to fulfil a leadership role in public health laboratoryservices. Among these, the formation of a Regional Laboratory Capacity BuildingDirectorate, which is in charge of developing the country’s laboratory network can bementioned.• Based on the consensus reached between the Ethiopian Ministry of Health and theFoundation for Innovative New Diagnostics (FIND), which is a Geneva-based nonprofitorganization, a Memorandum of Understanding was signed between EHNRI andFIND aiming to establish a state-of-the-art National Tuberculosis Reference Laboratory(NTRL) on 29th January 2008. The NTRL is comprised of one laboratory in aSpecialized TB Hospital (St Peter’s) and four Regional Tuberculosis ReferenceLaboratories). FIND, in collaboration with WHO, has established a Regional Lot TestingLaboratory for Malaria Rapid Diagnostics Tests (RDT) at EHNRI. This laboratory hasbeen functioning since February 2009 and has the capacity to carry out rapid and highqualityperformance evaluation of RDT that have been received from African countriesfor further investigation. This centre also provides a secondary storage and retestingof RDT services to ensure that they remain function until the expiration dates.17

2.1.4 Management and LeadershipEHNRI has undergone institutional restructuring in line with Business Process Re-engineering(BPR) to improve and expand its role in national health development. The vision, missionand strategic objectives of the institute have been clearly stated and organizational structurewhich is required to accomplish its expanding new responsibilities have been made. Morespecifically, EHNRI is mandated to conduct public health emergency management, establishand maintain quality laboratory systems and craft a research priority on public healthproblems.3. Development Process of the Strategic PlanThe Strategic planning process is aimed to produce a document that enables EHNRI toaddress public health and nutrition issues. In this five year strategic planning process, theBalanced Score Card (BSC) management and planning system has been used as an instrument.In order to design planning templates and to guide the development of the plan a team, whichcomprises eight professionals of the Institute was formed by the management of the Institute.To substantiate the draft strategic plan, relevant inputs were taken from documents andexperiences at EHNRI, HSDPs, FMOH guidelines and other records. EHNRI staff members fromvarious fields have been participated in brainstorming sessions to provide necessary inputand expertise. In order to align the five year strategic planning of the Institute with theupcoming HSDP 4, the group participated in 5-day retreat program, which is organized byFMOH , to engage in detailed discussions with various FMOH’s agencies.Ahead of its completion, the document was disseminated to all concerned bodies and aworkshop, which took three days and organized by the institute, to collect the input. Inputs ofthe workshop, which was found to be constructive, have been incorporated into the finalstrategic plan of the Institute.18

The BSC framework utilized a nine-step approach to success. These nine steps were employedto guide the development of the strategic plan and are outlined below:Step one: Assessment of the organization and climate and analysis of customer andstakeholdersStep two: Formulated the value of customer proposition, strategic themes (also referred to aspillars,) strategic results and perspectives. This information was used to formulate objectives.Step three: High level objectives were translated into strategic objectives. Unlike other SPMobjectives, the objective in the BSC embodies continuous action-oriented improvement.Step four: The strategic objectives were linked in causal effect relationships to produce astrategic map of the institute. The map shows how the organization creates value to both thecustomers and stakeholders.Step five: Indicators and targets were developed to measure and monitor progress beingmade towards the objectives. Different kinds of measures were developed for each strategicobjective. The corresponding targets for each measure were set.Step six: Strategic initiatives. Strategic initiatives are formulated. Short term or long termprojects were assigned to each strategic objective. Projects were prioritized based on theHSDP, and their potential to significantly impact organization and provide benefits. For everyinitiative, the activities, descriptions, deliverables and resource requirements were included.Since there is no explicit costing mechanism in the BSC system, Activity Based Costing (ABC)was used in this planning development. As a result of step six, EHNRI’s organizationalbalanced score card system was built. The remaining three steps are important for the rolloutand implementation of the plan.Step seven: Automate the score card to improve communication within the organization. Thisstep was not considered in the development of this plan.Step eight: Cascading refers to the alignment with the organizations shared vision. The term,“cascading” functions to make the strategy actionable by both directorates and individuals. Inthis strategic plan document, cascading was incorporated only at the tier two, or directorate,level.19

Step nine: Evaluation is essential to track the success of the implemented plans. In step eight,an evaluation plan was developed. Through continues monitoring and evaluation necessarychanges to the strategic elements will be ensured.4. Organizational Assessment4.1 SWOT AnalysisSWOT, customer and stakeholder/collaborator analysis were analysed in detail. These are shown inappendix I. The list below illustrates the pains and enablers identified by the SWOT analysis.4.1.1 PainsAmong the identified points of concern, five most critical issues (pains) were selected to beaddressed in order to achieve the objectives set for the plan period.A. Lack of strategic thinking• A shared vision between management and staff is lacking.• There is a lack of focus on problem solving public health research• Programmatic areas need to be prioritized.• There is failure to achieve overall goals and objectives.• Activities were limited to short term planning.B. Limited capacity in conducting research, research output dissemination and publichealth emergency management,If these issues are not properly addressed, the likely consequences will be:• High level scientific Professionals skill will remain low.• Quality and scope of research, public health laboratory services and emergencyresponses will be adversely affected.• Limited contribution to the improvement of public health and nutrition.• Limited community benefit from health research.• Limited international collaboration.20

C. Failure to prevent and control recurrent epidemics and minimize associated health,social and economic crisis.Lack of appropriate health management system.• Lack of skilled manpower.• Compromised performance.• Inadequate monitoring and evaluation.• Inefficient budget utilization in some programs• Lack of financial resources in other programs• Staff attritionD. Poor quality assured laboratory services:• Limited capacity of laboratories to provide ranges of test services• Lack of awareness in quality system management• Lack of proper documentationE. Limited implementation capacity of regions for PHEM• Slow implementation of BPR at national and regional level• Varying implementation levels of the new system among regions.4.1.2 EnablersThe following are the enablers obtained from the SWOT and PEST analysis to achieve theobjectives set for the plan period.• The implementation of BPR• Long years of research experience• Presence of committed host government support• Continuous support from development partners• Establishment of PHEM system and structure• Initiation of the EFLTP program• Strong capacity to support the national laboratory system21

5. Vision, Mission and Core Values5.1 Vision“To see healthy, productive and prosperous Ethiopians”.5.2 Mission“To protect and promote the health of the Ethiopian people by addressing priority publichealth and nutrition problems through problem-focused research, public health emergencymanagement, establishing and maintaining a quality laboratory system.”5.3 Core Values• Customer satisfaction: We serve our customers to their best satisfaction with respect andcourtesy.• Creativity and innovation: We believe in creative and innovative thinking to address publichealth problems.• Evidence based decision: We generate high quality research findings for evidence baseddecisions.• Research ethics and professional commitment: We work with integrity and do no harm topatients and keep the maximum benefit of research to them.• Transparency and communication: We are reachable, accessible and open tocommunication.• Continuous learning and improvement: We recognize scientific and technical staff as ourmost important resources and therefore we believe in learning, growth and excellence.• Collaboration and partnership: We are committed for scientific collaboration andpartnership.• Team work: We work as a team in harmony with maximum knowledge sharing.• Accountability: We focus on results.22

6. Strategy6.1 Customer Value PropositionTable 1 Customer value proposition from different anglesPRODUCT/SERVICEDELIVERED TOCUSTOMERSResearch basedinformationVaccineBiologicalproductsFood productsEarly warningand healthevent monitoringinformationPHE response,rehabilitationand recoveryStrengthenregional labcapacityReferral labserviceATTRIBUTE IMAGE RELATIONSHIPThe products/ servicesthat EHNRI provideshas the followingfeatures:• High efficacy• Problemsolving,• Authenticresearch• Timeliness• Proactively• Quality assuredLab.Service/settingThe image thatEHNRI wants tocreate upon thecustomers has thefollowingcharacteristics:• Problemsolver• Scientific• CitizensfocusedThe relationship thatEHNRI aims to achievewith the customers canbe expressed as:• Passionate• Professional• Cooperative• Dependable• Accessible23

6.2 Strategic Themes (Pillars) and Strategic ResultsThe strategic themes also referred to as ‘pillars of excellence,’ build the foundation of theinstitute. EHNRI must excel in the four pillars listed below in order to meet its vision, missionand the expectation of its internal and external customers. A strategic result was formulatedfor each pillar of excellence.EHNRI’s Four Pillars of Excellence are:A. Excellence in Research and Technology TransferB. Excellence in Public Health Emergency ManagementC. Excellence in Public Health Laboratory QualityD. Excellence in Management and Leadership6.2.1 Pillar I. Excellence in Research and Technology TransferEvidence based information about the public health in Ethiopia is severely lacking. Problemsolving research that is aligned with priority areas and that satisfies ethical standards isneeded to generate high quality scientific information. At present, national data on diseaseburden, distribution, type, and transmission dynamics of various infectious diseases arelimited. Knowledge about the prevalence of non-infectious diseases and environmental riskfactors, as well as occupational hazards is extremely limited. Few reports have been writtendescribing antimicrobial resistance levels of various drugs used against infectious diseases, aswell as limited reports about insecticides used to control disease vectors. Clinical trials areneeded to improve existing preventive measures and to validate available diagnostictechniques. The impact of disease reduction, elimination and/or eradication strategies shouldbe assessed and an evaluation of immunization programs for vaccine preventable diseasesand other interventions should be conducted. Furthermore, an investigation of genetic andimmunologic features of human-pathogen interactions would help scientists to understanddisease initiation, progression or protection in light of current scientific and technologicaldevelopments that provide powerful tools to generate valuable information for diseasecontrol efforts.24

Nutritional problems are also major public health concerns that necessitate furtherunderstanding to implement appropriate intervention measures. Micronutrient interventionsneed to be assessed, monitored and evaluated; including community nutrition interventionprograms. These intervention programs necessitate systematic investigation to control anderadicate malnutrition in Ethiopia. The combined effect of nutrition and infectious and noninfectiousdiseases is virtually unknown. To prevent micronutrient and macronutrientdeficiencies, evaluation of food products and fortification of foods, are necessary. Foodsecurity and safety studies will be conducted to enhance access to safe food amonghouseholds and to facilitate the export of safe food commodities.There is a crucial need of scientific evidence from pre-clinical and clinical studies to justify theuse of traditional medicine in the official health care delivery system. Traditional medicinerequires more research to ensure the efficacy, safety and quality of traditional medicines forthe prevention and cure of diseases. The ultimate goal will be to generate evidenced basedinformation and develop scientifically standardized traditional medicine products that willcomplement modern medicine.Non-biomedical research is also necessary to understand and improve the health system. Byfocusing on social factors and medico legal aspects of health, as well as the organizationalstructure and process, health human resource and health service delivery systems and cost ofthe health care.The transfer and adoption of technological methods is important to make thefinished/unfinished products available. Technology transfer and adoption enables theefficient use of resources and ensures a sustainable supply of required products. For example,vaccine production is one major process of technology transfer. More deaths of children aredue to vaccine preventable diseases. Through the implementation of these vaccine productionprograms, the local production of essential vaccines would prevent the need to importvaccines and reducing unnecessary costs. In addition to that, the local production of vaccineswould minimize interruption of regular supplies and avoid emergency delivery delay in the25

event of epidemics. Other biological products used for disease diagnosis and therapy will beproduced through the transfer of technology that can be applied at the local level.There is widespread agreement that health services research should be more accessible anduseful to policy makers and other key stakeholders at all levels. The connection betweenhealth researchers and important target audiences will be strengthened. Information needsof end users will be identified and mechanisms for promoting effective researchdissemination will be developed.6.2.2 Pillar – II. Excellence in Public Health Emergency ManagementThe public health system is continually challenged by recurrent and unexpected diseaseoutbreaks. Ethiopia is facing the challenges of managing the health consequences from naturaland human made disasters, emergencies, crises and conflicts. These problems continue todisrupt the health care system. Successful detection and response to these challenges isbecoming increasingly complicated. Ethiopia’s public health infrastructure requires adequateattention and allocation of resources to be sufficiently prepared, enable early detection, and torespond and recover rapidly from the impacts of these challenges.Public Health Emergency Management (PHEM) is the process of anticipating, preventing,preparing for, responding to and recovering from the impact of epidemics and healthconsequences of natural and manmade disasters. The PHEM is one of eight core processadopted by the Ministry of Health and one in which EHNRI aims to excel. The result of thisstrategic team is to protect the community from health consequences posed by public healthemergencies.Investigations of diseases are now more complex in nature than they were in the past becauseof a variety of new pathogens, risk factors and outbreaks. These diseases cross jurisdictionand national boundaries; often raising political and economic concerns. The ability to quicklyrecognize and respond to widely dispersed disease outbreaks is a challenge to the publichealth system, particularly in an era of increasing natural disaster, global population mobility,emergence of new infectious agents and the wide distribution of manufactured foods.26

6.2.3 Pillar –III. Excellence in Public Health Laboratory Quality SystemLaboratory standardization for integrated diagnosis of diseases will be necessary for all levelsof the laboratory system to define the services required at each facility. This can be donethrough infrastructure upgrades, trainings, quality assurance, equipment maintenance, supplychain initiatives, and other strategies to assist the regional laboratories and upgrade theirability to provide laboratory services for integrated diseases. Standardization and buildingcapacity at the regional and federal laboratories will enhance their abilities and quality inperforming specialized and referral tests, and implement Regional External QualityAssessment Scheme. Different guidelines, manuals, SOPs and formats have to be developed tostandardize the laboratory system and standards will be set such that all critical health issuescan be addressed by Ethiopia’s laboratory system.6.2.4 Pillar –IV. Excellence in Management and LeadershipEHNRI is responsible for carrying out various duties in terms of public health research,emergency management, and public health laboratory development at a national scale. Thismandate requires a functioning and efficient management system. To improve themanagement system of EHNRI, the Institute necessitates organizational restructuring tostreamline work flow. In this strategic plan, managerial issues were prioritized and have beenincorporated into the strategic plan according to BSC principles.27

6.3 Strategic ResultsTable 2. Strategic Themes and ResultsStrategic ThemesExcellence in research and technologytransferExcellence in Public Health EmergencyManagementExcellence in public health laboratoryquality SystemExcellence in Management and leadershipStrategic ResultsEvidence based informationand research productsProtected citizens from the healthconsequences of emergenciesImproved quality assured laboratory serviceEfficient management system6.4 Strategic PerspectivesThe Balanced Scorecard Strategic perspectives represent the different views of theorganization. These help to ensure that strategies and measures are balanced. Perspectivesare the different performance directions in which the strategic results are approached(translated into a more actionable strategy). The strategic perspectives selected in thisstrategic plan document are customers, internal process, finance, learning and growth.The figure below summarizes the vision, mission, core values, perspectives and strategicpillars of the institute, and is called the promise house of EHNRI.28

THE HOUSE OF EHNRIVISIONTo see healthy, productive and prosperous EthiopiansClientCommitmentMISSION“To protect and promote the health of the Ethiopian people byaddressing priority public health and nutrition problems throughproblem focused research, public health emergency management,establishing and maintaining quality laboratory system”Collaboration Change TrustSTRATEGIC THEMESCustomersInternalProcessFinancialRESEARCHANDTECHNOLOGYTRANSFERPUBLICHEALTHEMERGENCYMANAGEMENTPUBLICHEALTHLABORATORYQUALITYSYSTEMMANAGEMENTANDLEADRSHIPLearning &GrowthFig. 1 EHNRI’s Performance House29

7. Strategic ObjectivesThe below stated 17 strategic objectives to be achieved in the coming five years areformulated. These objectives are believed to make the backbone of EHNRI and clearly outlinethe work that needs to be done in order to achieve the set forth strategic results.OBJECTIVE 1: Improve evidence-based decision makingInformation generated from infectious and non infectious disease, nutrition, traditionalmedicine, environmental risk factors, occupational hazard and health system research will beproperly documented at the central level. All evidence-based information will be interpreted,organized and disseminated in a proper manner for appropriate use by policy makers,stakeholders and the community.OBJECTIVE 2: Increase the availability of vaccines, supplementary foods and otherbiological productsThe local production of vaccines and other biological products through technology transferwill ensure that sufficient quantities are available. The importation of vaccines that are usedin immunization programs in Ethiopia is limiting in terms of cost and delivery time. Delays indelivery can be a matter of life and death; especially at a time when there are diseaseoutbreaks. Through increased technology transfer, human resource development andfinancial capacity, EHNRI will be able to produce other biological products, such as anti sera,conjugates, nutritional products and formulated traditional medicines on a large scale thatwill be made available to the communities in need.OBJECTIVE 3: Improve PHE communication response, rehabilitation and recoveryThe strengthening of PHEM communication response, rehabilitation and recovery aims toearly verification of outbreaks and epidemics, and the ability to contain and rehabilitatecommunities and health systems.30

Communication response:• Communicate information about daily and weekly activities, risk of given events, altersor warning messages to all stakeholders.• Provide the public, public officials and key partners with needed health and riskinformation during and after events of public health emergencies. These lines ofcommunication will inform the community and stakeholders about potential healthrisks and recommended actions.Rehabilitation:• Conduct rapid assessments and investigate outbreaks (epidemiological, laboratory andenvironmental).• Implementation of control, preventive and supportive measures, including casemanagement, quarantine and isolation, mass prophylaxis and environmentalmanagement.Recovery:• Identify the extent of damage caused by an incident, conduct thorough post-eventassessments.• In coordination with relevant stakeholders, determine and provide support forrecovery and restoration activities to minimize future loss from a similar event.OBJECTIVE 4: Improve and maintain quality assured laboratoriesLaboratory accreditation will be a significant milestone for the provision of quality laboratoryservices and will ensure the implementation of quality system management standards. Theimplementation of the laboratory accreditation process will improve the quality of diseasediagnosis, prevention and curative services at individual and community levels.Obtaining national and/or international accreditation of laboratories at tiers throughout thesystem as a means of improving and ensuring adherence to high quality standards and31

activate the accreditation process for laboratories. The presence of quality-assured laboratoryservices in Ethiopia will not only strengthen case management but also support decisionmaking and epidemic response.OBJECTIVE 5: Improve national disease, nutrition and environmental survey andsurveillance dataThrough improved survey and surveillance data, EHNRI aims to reduce maternal, infant andchild mortality and to generate information on resistant infections. The occurrence ofdifferent diseases, infections and their levels of resistance will be studied through periodicalor one time surveys. Surveying the trends of major priority diseases, such as HIV, TB, malariaand other viral and bacterial diseases, will help to design programs aimed at reducingmortality and morbidity, build capacity and effectively allocate human, material and financialresources. Survey and surveillance data will also aid policy makers at the national, regionaland woreda levels to implement tools and mechanisms developed to reduce mortality andmorbidity. More specifically, survey and surveillance data generated for microbial andinsecticide resistance will help to facilitate the development of cures and prevent the spreadof resistant infections throughout communities. Surveys collecting data on nutritional,traditional medicine and other related issues will be performed to identify their contributionsto improving public health at the community level. . Micronutrient deficiency data are alsovital to ensure the health of the public and will be used to determine the magnitude ofnutritional deficiency diseases in Ethiopia. The level and magnitude of micronutrientdeficiency in Ethiopia needs to be clearly identified and reliable information is needed todevelop micronutrient interventions.OBJECTIVE 6: Increase problem solving research on disease, nutrition, traditionalmedicine and modern drugsThe objective in this area will focus on research that will be vital to improve diagnosis andintervention of infectious and non infectious diseases. New or existing diagnostic techniqueswill be developed or evaluated before their wide use is made available throughout thecountry. Clinical trials of newly developed medicines and alternative traditional treatmentswill be investigated. A national-level evaluation of nutritional intervention strategies will becarried out at research level prior to their implementation. The development or evaluation of32

new vaccines and biological products, such as immunoglobulin, among others that arenecessary for disease management will be investigated. Host parasite relationships usingmodern immunological and molecular biological techniques will be addressed. Researchdevelopment in genomics will be strengthened to enrich information obtained fromsurveillance projects and other similar undertakings. Research will be conducted toinvestigate the conventional causes and genetic factors for changes in vector-based diseasetransmission for major disease vectors.OBJECTIVE 7: Improve research on health system and intervention evaluationThe expansion and decentralization of health services programs require continuousmonitoring and evaluation. As such, the generation of evidence-based information on healthand health-related systems is essential. Evidence-based information on health and healthrelatedsystems are vital to the improvement of Ethiopia’s health care delivery system at thecommunity level. Evidence based information can be achieved through operational researchon the delivering capacity, quality and accessibility of the health system. Assessing healthservice capacity (human resources, infrastructure, material and financial), accessibility(physical and service) and quality will help to efficiently identify, address and improveexisting gaps. These data will ascertain the impact health service programs may have inreducing infection and disease burden or mortality and morbidity at the community level.The assessment and information generation of environmental and occupational hazards willalso increase community awareness in the occurrence, protection and handling of hazardousmaterial for both health care workers as well as the community.OBJECTIVE 8: Enhance the production of vaccines and standardize plant-basedmedicine and food productsTechnology transfer of research findings developed in other courtiers is an important areathat will contribute to improved public health of the nation. The transfer of vaccineproduction technology will enable the local production of vaccines with given standards forquality and will make vaccines available in country at low cost. Similarly, the production ofvital biological products and diagnostic kits through technology transfer will reduce cost andenhance Ethiopia’s ability to provide diagnostic services in sustained manner.33

OBJECTIVE 9: Improve PHE early warningThe aim of early warning is to provide advance information of an incoming threat in order tofacilitate the adoption of measures to reduce its potential health impact. However, not allemergencies and disasters are equally susceptible to early warning.This objective aims to develop an Integrated Public Health Surveillance System that willcombine communicable disease surveillance, nutrition surveillance and monitoring of healthevents from many other hazards. The Integrated Public Health Surveillance Systems willprovide advanced information of an incoming threat through alert networks, periodicwarnings via written or electronic bulletins to all responsible bodies to mitigate potentiallyadverse health impacts facilitate the adoption of measures. This will lead to the possiblemechanism for the early detected and identified public health emergencies.Integrated disease surveillanceSurveillance is the continuous systematic collection, analysis, interpretation, anddissemination of health data for the purpose of describing and monitoring health events,setting priorities, and assisting the planning, implementation, and evaluation of public healthinterventions and programs. Understanding and use of public health surveillance will assisthealth workers at the Woreda level and health units to set priorities, plan interventions,mobilize and allocate resources, detect epidemics early, initiate prompt response toepidemics, and to evaluate and monitor health interventions. Public health surveillance alsohelps to assess long term disease trends.Nutrition surveillanceNutrition surveillance is the continuous collection and analysis of nutritional status data. Thisinformation provides warning of impending crisis and aids in policy development andprogrammatic decision making aimed at improving the nutrition status of the population.This ongoing analysis generally employs methods distinguished by their practicality,uniformity; and frequently their rapidity, rather than complete accuracy. The main purposeof nutrition surveillance is to detect changes in trends, distributions of diseases or events inorder to initiate investigative or control measures.34

Laboratory surveillanceThe detection and control of intentional and natural outbreaks and epidemics of infectiousdiseases require rapid and specific identification of pathogens and their source of infection.To enable this, PHEM offices at different levels need to create strong linkages among thenational, regional and health facility laboratories. Surveillance of diseases and events fromlaboratories is critically important to early detect the occurrences of unusual increases.Laboratories will also investigate any change to the environment that increases the risk oftransmission or dissemination of diseases and events through environmental tracking.Event monitoring/ surveillanceEvent-based surveillance is the organized and rapid capture of information about events thatpose potential risks to public health. This information can be rumours and other ad-hocreports transmitted through formal channels, such as established routine reporting systems,and informal channels, such as media, health worker and nongovernmental organizationsreports, including:• Events related to the occurrence of disease in humans, such as a cluster of cases of adisease or syndromes, unusual disease patterns or unexpected deaths, as recognizedby health workers and other key informants in the country.• Events related to potential exposure for humans, such as events related to diseases anddeaths in animals, contaminated food products or water, and environmental hazardsincluding chemical and radio-nuclear events.OBJECTIVE 10: Improve Risk identification and PHE preparednessRisk identification and PHE preparedness may be strengthened by assessing and determiningthe nature and extent of risk through an analysis of potential hazards. An evaluation ofexisting risk conditions and the environment on which they depend is necessary. Based onidentified risks, improving detection preparedness and prevention and response capabilitiesfor existing and emerging epidemic-prone diseases of national and international concern aswell as other events is crucial. The major activities are:35

Improve risk identification and managementThe aim of vulnerability analysis is to establish a database that focuses on the expected effectsof potential hazards, relief needs and available resources. These analyses should become thebasis for maintaining and updating an essential informational tool for development planningpurposes. Vulnerability assessment utilizes structured data collection geared towardsunderstanding the levels of potential threats, needs and immediately available resources.Vulnerability analysis is a continuing, dynamic process of assessing hazards and risks thatcould threaten the population and the system. Assessing vulnerabilities also helps todetermine how to respond.Improve human resource and physical capacityBased on the risk assessment output, capacity building activities shall be carried out in orderto effectively mitigate, prepare for identified risks and respond to any occurrence of PHEevents. Capacity building activities include: producing enough capable human resources andestablishing and/or strengthening systems related to PHEM (Surveillance system,Communication, Logistics etc).The human resource capacity building component involves: Coordinated training of PHEMleaders in the Field Epidemiology and Laboratory (FELTP) masters program and training oftrainers of the PHEM at the national level. These trainings will be further cascaded throughRHBs to Woredas and to all health workers who are engaged in PHEM activities. Building thephysical capacity, either through establishing new systems or strengthening already existingsystem, at all levels is critical component of the PHEM system. The Emergency Response Fund(ERF) system also needs to be established. Following an emergency, the PHEM centre relieson donor contributions to undertake emergency/ epidemic response activities. Contributions,however, can often be unreliable, uneven and late. Early and predictable funding is essentialto prevent situations from spiralling out of control, saving resources and, more importantly,saving lives. An ERF will be established at the national level and is essential to ensure thatfunds are available immediately in response to disasters and emergencies. The fund provides36

an easy and centralized way to support the Canter’s life-saving efforts duringoutbreaks/epidemics in the country.Improve the logistics management systemThe logistics management system focuses on stockpiling drugs, vaccines (Buffer stocks), PPE,EHK, medical supplies required for prevention and control of epidemics and nutritionalsupplements. This system has to be augmented with securing funds for related operationalactivities. This includes efficient mobilization & utilization of resources.Preparation and distribution of documentsShort and long term plans, guidelines, manuals, formats, procedures and protocols should beprepared and distributed to all health workers concerned; especially to the lowest levels.OBJECTIVE 11: Enhance laboratory quality systemLaboratory standardization for integrated diagnosis of diseases will be necessary for all levelsof the laboratory system to define the services required at each facility. This can be donethrough infrastructure upgrades, trainings, quality assurance, equipment maintenance, supplychain initiatives and other strategies to assist the regional laboratories and upgrade theirabilities to provide laboratory services for integrated diseases. Standardization and capacitybuilding of the regional and federal laboratories will enhance their abilities to perform qualityspecialized and referral tests, as well as to implement the Regional External Quality AssessmentScheme. Different guidelines, manuals, SOPs and formats have to be developed to standardizethe laboratory system. Standards will be set such that all critical health issues that can beaddressed by Ethiopia’s laboratory system.All laboratories will be included in external quality assessment schemes at the national andregional level through improving laboratory standards and participate them with differentquality assurance systems such as external quality assessment schemes which increase theconfidence of health care practitioners to use laboratory data.37

Objective 12: Strengthening the diagnostic capacity of laboratoriesIt is essential to provide support to regional, federal and peripheral laboratories in order toenable them to accomplish their responsibilities. Laboratory support includes infrastructureupgrades, training programs, quality assurance programs, laboratory equipment maintenanceand other strategies that will assist the laboratories and improve their ability to providelaboratory services for integrated diseases. However, a significant gap remains between theircurrent state and laboratory standards; fulfilling these gaps will play a great role inestablishing and strengthening public health laboratory services in the country. Thesesystems will be reviewed to identify opportunities for integration. A robust sample referralnetwork will allow the country to achieve the vision of a tiered laboratory network withstrong linkages between each level, regardless of the sample type.OBJECTIVE 13: Improve efficient mobilization & utilization of resourcesThe mobilization of financial and material resources from different funding organizations andgovernments will facilitate public health and nutrition research as well as the technologytransfer process. Additionally, an efficient logistic and procurement system will beestablished and a proper follow up mechanism for resource utilization will be in place.The duplication of research would unnecessarily deplete the country’s meager resources.There is a need to conduct research through efficient use of human, financial and materialresource as well as time. Upon review of international and national activities, harmonizationof partnerships will augment the efficient use of limited resources. Priority areas for Ethiopiawill be identified and biomedical and other related research activities will be conducted inareas that have not previously been covered. The efficient production, harmonization andutilization of research products can help to improve the health of the community withreduced cost.Several preconditions have to be maintained in order to improve the equipment andconsumable procurement system; among procured items are chemicals, reagents and othersupplies. To ensure proper procedures and processes are followed, there is also a need to38

strengthen the monitoring and evaluation of both ongoing and planned research programsand projects. In the case of deficiencies, a plan needs to be in place to proceed with correctivemeasures and the potential for increased research partnership.The ERF is essential to ensure that funds are available immediately in response to disastersand emergencies. The Fund provides an easy and centralized way to support the Centre’s lifesavingefforts during outbreaks/epidemics in the country. Whether in response to a headlinedisaster or disease outbreaks, the ERF permits the centre to respond rapidly and equitably tosave lives.OBJECTIVE 14: Improve human resource management.This includes calibrating employees capacity through upgrading their knowledge and skill, onjob training and mentoring. Designing appropriate and full package career structure andincentive mechanisms and also creating conducive working environment will be given aspecial attention.OBJECTIVE 15: Improve the project management systemIn the past, the management system did not adequately address priority areas amongcommunities, nor did it solve problems caused by major diseases and infections of publichealth importance. Therefore, the research and project management system for prioritydiseases, including the issue of nutrition, needs to be addressed. A comprehensive systemthat produces relevant, high quality and applicable data for problem solving is needed.Developing a capacity continuously for the sustainable improvement of the programs issignificant. The improvement of public health and nutrition research systems at differinglevels will aid health care programs to develop methodologies and mechanisms. Health careprograms need to assess problems, identify gaps, analyze causes of problems and gaps,interpret and disseminate results. Either operational or basic researches generate evidencebasedinformation that would be used for the prevention, control and treatment of diseasesand infections. To strengthen research capacity and reduce duplication, setting the researchagenda is helpful to reinforce national and international partnerships.39

Research designs, ethical consideration of the research participants, proper use of laboratoryanimals and scientific considerations will be given priority to put public health orientedresearches in place.OBJECTIVE 16: Strengthen the capacity of technical facilitiesTechnical facilities need to be strengthened nationally in order to meet needs and to deliverproducts to the public and Technology transfer. It is also a key to the production of vaccines,supplementary nutrition, formulated traditional medicines and anti sera. The ability forEthiopia to produce its own technologies may be achieved through the transferring oftechnology from abroad, developing technology at a national level or transferring technologydown to the health care delivery points. Technology transfer may also be further supportedby the development of human resource for the adopted technologies. Future use of technologytransfer could support the establishment of a national research data base that could facilitatedissemination and availability of information.Objective 17: Enhance coordination and collaborationThrough this objective coordination and collaboration with local and international partners will bestrengthened to maximize efforts on health research, public health emergency management andpublic health laboratory quality service in line with the strategic plan document.40

Table 3. List of strategic objectives under each respective themePerspective List of Objectives ThemesCustomerInternalprocessFinanceLearning andGrowthObjective 1: Improve evidence based research outcomesfor policy decision makingObjective 2: Increase the availability of vaccines, plantbasedmedicines, complementary foods and otherbiological productsObjective 3: Improve PHE communication, response andrecoveryObjective 4: Increase and maintain quality assuredlaboratoriesObjective 5: Improve national survey and surveillancedata on disease, nutrition and environmental problemsObjective 6: Increase problem solving research ondisease, nutrition, traditional medicine and moderndrugsObjective 7: Improve research on health system andintervention evaluationObjective 8: Enhance the production of vaccines,standardized plant based medicine and food productObjective-9.Improve PHE early warningObjective-10. Improve risk identification and PHEpreparednessObjective 11: Enhance laboratory quality systemObjective 12: Improve the diagnostic capacity oflaboratoriesObjective 13: Improve efficient mobilization & utilizationof resourcesObjective 14: Improve human resource managementObjective 15: Improve project management systemObjective-16: Strengthen the capacity of technicalfacilitiesObjective-17. Enhance coordination and collaborationResearch and technologytransferPublic Health EmergencyManagementPublic Health LaboratoryServiceResearch and TechnologyTransferPublic Health EmergencyManagementPublic Health LaboratoryServiceManagement andLeadership41

8. Strategic MapThe strategic map below presents a visual representation of the strategy employed by EHNRI.The map illustrates how the Institute plans to achieve its mission and vision by means of alinked chain of continuous improvements. It is a diagram that describes how the Institutecreates values by connecting strategic objectives in explicit cause and effect relationships witheach other in the four BSC objectives.42

STRATEGIC MAPVISIONTo see healthy, productive and prosperous EthiopiansMISSION“To protect and promote the health of the Ethiopian people by addressing priority public health and nutrition problems throughproblem focused research, public health emergency management, establishing and maintaining quality laboratory system”CustomerPerspectiveImprove evidence basedresearch outcomes for policydecision making(1)Increase the availability ofvaccines, plant basedmedicines , complementaryfoods and other biologicalproducts(2)Improve PHEcommunication, responseand recovery(3)Increase and maintainquality assuredlaboratories(4)InternalProcessImprove national survey andsurveillance data on disease ondisease, nutrition andenvironmental problems(5)Increase problem solvingresearch on disease,nutrition and traditionalmedicines(6)Improve research onhealth system andintervention evaluation(7)Enhance the production ofvaccines, standardized plantbased medicines and foodproducts(8)Improve PHE earlywarning(9)Improve riskidentification and PHEpreparedness(10)Enhance laboratoryquality system(11)Improve the diagnosticcapacity of laboratories(12)FinanceImprove efficient mobilization and utilization ofResources(13)Learning andGrowthImprove human resourcemanagement(14)Improve projectmanagement system(15)Strengthen the capacity oftechnical facilities(16)Enhance coordinationand collaboration(17)Fig.2. Strategic Map43

9. PERFORMANCE MEASURETable 4. List of performance measures under each objectiveIndicator Type ofMeasureFormula DataSourceUnit ofMeasureBaselineOBJECTIVE 1: Improve evidence based research outcomes for policy decision makingNumber ofresearchoutcomes forpolicy changesNumber ofNationalrelevantresearchoutcomesdisseminated(technicalreports)Number ofresearchfindingsdisseminatedPlan (in EC)2003 2004 2005 2006 2007Output - RR No 5 2 2 2 2 2Output - RR No 40 25 30 35 40 40Output - RR NO 75 19 21 24 28OBJECTIVE 2: Increase the availability of vaccines, plant based medicines, complementary foods and otherbiological products.Number of Output - RR No 30,000 85,000 100,000 120,000 140,doses of availed000cell culturebi iNumber ofdoses of availedcell culturerabies vaccinefor human useOutput - RR No 10,000 10,000 10,000Number of Output - RR No 5000 5000 5000doses of availedNumber of Output - RR No 20000 2000 2000doses of availedNumber of Output Dose 1,00Number of Output - RR No 31,500 37,500 39,000 40,5doses of Antisera00forrabiesNumber ofbottles of trans-Output - PR No 0 1000 1000 - - -44

IndicatorNumber ofregionallaboratoriesstrengthened toproduce transisolatemediaNumber ofcomplementaryfoods availedNumber ofstandardizedplant basedhuman andveterinarymedicinesType of Formula Data Unit of BaselinePlanMeasureSource Measure2003 2004 200520062007Output - PR No 0 5 - 7 7 7Output - RR No NA 1 1Output - RR No NA 3OBJECTIVE 3: Improve PHE communication, response and recoveryPercent ofHealth PRhealth eventscommunicatedeventscommunicated/totalto relevant Output% NA 80 90 95 100 100number ofbodies withinidentifiedspecifiedperiod.healtheventsPercent of Riskprofilescommunicatedto relevantbodies withinspecifiedperiod.OutputRiskprofilescommunicated/totalnumber ofidentifiedriskPR% NA 60 80 90 100 10045

IndicatorProportion ofPHE withprevention andcontrol measuresinitiated within48hrs ofidentification ofrisk andcharacterizationof threatsProportion ofrehabilitated andrecoveredaffectedpopulationand/or healthsystem aftermajor PHEType ofMeasureOutputOutputFormulaPHE withprevention andcontrolmeasuresinitiatedwithin48hrs/totalnumberofidentifiedrisks andcharacterizedthreatsNumberofaffectedcommunity and /orhealthsystemrecoveredto totalaffectedcommunities andhealthsystemDataSourcePRPRUnit ofMeasureBaselinePlan2003 2004 200520062007Time 24hrs 6hrs 3hrs 3hrs 3hrs 3hrs% NA 100 100 100 100 10046

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007OBJECTIVE 4: Increase and maintain quality assured laboratoriesNumber of-Quality assured(Accredited)laboratoriesOutputPR No 039 79 158 249 345OBJECTIVE 5: Improve national survey and surveillance data on disease, nutrition and environmental problemsNumber of antimicrobial andinsecticideresistanceSurveysOutputconducted onpriority diseases/vectors- RR No 2 5 4 3 1 7Number ofnationalsurveys/ Outputsurveillanceson infectiousand noninfectiousdiseases- RR No 3 8 8 8 9 6Number ofnationalsurveys on Outputenvironmentalrisk factors onpublic health- RR No 0 4 3 1 2Number ofnationalOutputsurveys/surveillanceson nutrition andtraditionalmedicine- RR No 1 8 5 6 7 147

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007OBJECTIVE 6: Increase problem solving research on disease, nutrition and traditional medicine and modern drugsNumber ofevaluationsconducted toimprovediagnostictechnologies Output - RR No 1 6 5 7 9 6Number ofevaluationsand studiesconducted toimprove foodprocessingtechnologiesand quality Output - RR No 0 2 3 1 2 3Number ofresearches oninfectiousdiseases,communitynutrition andtraditionalmedicines Output - RR No 200 8 4 6 6 5Number ofstudies onclinical trialsandpreventivemeasures Output - RR No 0 0 0 2 2 3OBJECTIVE 7: Improve research on health system and intervention evaluationNo of healthsystem/interventionevaluationconducted Output - RR No 2 2 3 3 3 348

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007OBJECTIVE 8: Enhance the production of vaccines, standardized plant based medicine and food productNumber ofvaccinesproducedthroughtechnological transfer Output - RR No 1 1 1 1 1Number ofvaccinesproducedfrom localisolates Output - RR No NA 3Number ofstandardized plantbasedmedicinesdeveloped Output - RR No. 0 3 3Number ofstandardized foodproductsdeveloped Output - RR No. 0 2 1Number ofindigenousfoodstechnologiesdocumented Output - RR No NA 1Number offoodcomposition tablesand dietarymenu-developedNumber ofdifferentexperimental animalsproducedOutputOutputRR No 0 2 1 1- PR No 10,000 5,0005,500 6000 6500 700049

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007OBJECTIVE-9. Improve PHE early warningPercent ofweeklysurveillancereports thatare receivedcompleteand timelyat PHEM-CProcessCompleteand timelyreportreceived /totalreportreceivedPR % 80 80 90 90 90 9050

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007OBJECTIVE-10. Improve risk identification and PHE preparednessPercent ofthreats/ risksmapped andcommunicated outputto the Regionsand partnersPercent ofidentifiedrisks withEPRPpreparedProportion ofPHE withadequatestockpiles ofdrugs andmedicalsupplies asper theguidelineProportion ofPHE specificguidelinesdeveloped anddistributedNumber ofhealthprofessionalstrained onmanagementof publichealthemergenciesoutputOutputInputInput -Number ofidentifiedthreats, riskmapped andcommunicated/Total numberof risks, threatsidentifiedNumber ofidentified riskswith EPRP /No.of identifiedrisksNumber of PHEidentified withadequate stockof supplies/Number ofidentified risksNumber of PHEspecificguidelinesdeveloped anddistributed /Identified Publichealth threats,risksPR % 0 25 50 75 100 100PRPRPRPR% 30 50 100 100 100 100% 90 100 100 100 100 100% 25 50 100 100 100 100No 47 287 280 260 260 28751

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007OBJECTIVE 11: Enhance laboratory quality systemNumber of-developedand revisedguidelines,OutputPR No 14manuals andformat types9 8 11 10 11Number of Output -laboratorieswithPR No 0 20 20 25 30 40Number of Output -laboratoriesPR No 100 100 120 120 130 140e al atedOBJECTIVE 12: Improve The diagnostic capacity of laboratoriesNumber of Output -enabledlaboratoriesPR No 120 50 75 80 85 95forspecializedand referralservicesProportion of Output - PR No 420 40 50 75 75 90laboratorieslinked forART referraltestsNumber of Output -trainedpersonnelPR No 6301402 1481 1655 1740 1816Proportion of Output Number oflaboratorieslabs gettinggettingservice/Totalcurativenumber of PR % 80 84 90 95 97maintenanceProportion ofpreventivemaintenanceservicesprovidedNumber ofiodized saltqualitycontrollaboratoriesstrengthenedOutputlaboratoriesPMprovided/PMexpectedOutput -PR % 0 20 35 60 70 90PR No 0 7 7 14 14 -52

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007OBJECTIVE 13: Improve efficient mobilization & utilization of resourcesProportionof mobilizedOutput Actualmobilizedplannedresources asresourceper plan/theRR % 20 100 100 100 100 100Proportionofperformancecompliancein line withthe standardOutputresourceNumber ofissueshandled asper setstandards/Totalnumber ofissueshavingstandardsRR % 100 100 100 100 100 100OBJECTIVE 14: Improve human resource managementNumber of Output -employeedevelopedwith Longterm & shortPR No NA 55 62 77 77 66termtrainingprogramsProportionofOutput Number ofEmployeesEmployeesRecruited/Recruited astotal requestPR No. NA 80 85 90 95 100per therequestProportionofEmployeesRetainedOutputNumber ofemployeesretained/Number oftotalpermanentlyrecruitedemployeesPR % 89 92 92 95 98 9853

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007OBJECTIVE 15: Improve project management systemProportionofresearcheswith publichealthrelevanceoutput Number ofoperationalresearchesof nationalrelevance /totalnumber ofRR %Number ofNational andinternationalresearchpartnershipestablishedNumber ofMonitoringconductedNumber ofEvaluationconductedresearchesOutput - RR No.Output - PR No.Output - PR No.50 70 100 100 100 1001 1 1 1 1- 6 6 6 6 6- 1 154

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007OBJECTIVE 16: Strengthen the capacity of technical facilitiesNumber ofdevelopedtechnicalcapacities forvaccineproductionOutput - RR NoNumber of Output - RR NodevelopedNationalcapacity forbiologicalproductsNumber of Output - RR Nodevelopednational databaseNumber of Output - RR Nodevelopedtechnicalfacilities1 1 1 1 10 1 1 1 10 1 2- 6 3 3 3 3Number ofdevelopedresearchoutcomesdisseminationsystemOutput - RR No1 1 1OBJECTIVE-17. Enhance coordination and collaborationProportion ofNumber ofPHEMparticipationstakeholdersin at least 9involved in atmeetingsleast 9 of theInputmonthly/Total PR % 50 80 100 100 100 100meetings ofnumberthe PHEMTTFexpected tobe involved inPHEM TTF55

IndicatorType ofMeasureFormulaDataSourceUnit ofMeasureBaselinePlan2003 2004 2005 2006 2007Number ofnational andinternationalresearchpartnershipestablishedProportion ofresearchpartnershipmaintainedOutput - PR No.OutputNumber ofpartnershipmaintained/Number ofresearchcollaborationsestablishedPR %26 30 40100 100 100 100 100 10056

10. Initiatives and Scope/ContentTable 5. List of initiatives and scopes/contents under each performance measureInitiative Scope/content Responsible UnitTarget (in EC)20032004200520062007OBJECTIVE 1: Improve evidence based research outcomes for policy decision makingPerformance Measure-1. Number of research outcomes for policy changePreparingpolicy briefsDevelopment of policy briefs for diseaseprevention and controlsTTRTD No 2 2 2 2 2Performance Measure-2. Number of national relevant research outcomes disseminated (technical reports)DisseminatingdifferentnationallyrelevantresearchreportsSending different research outcomes reportsfor stakeholdersAllDirectoratesNo 25 30 35 40 40Performance Measure-3. Number of research findings disseminatedDisseminateresearchResearch findings presented on national andinternational conferenceAllDirectoratesinformation Research findings disseminated on peerAllreviewed journalsDirectoratesResearch findings disseminated through the Allinstitute’s News letterDirectoratesResearch findings disseminated through Web AllsiteDirectoratesNo 3 5 7 10No 10 10 10 10No 2 2 3 4No 4 4 4 457

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007OBJECTIVE 2: Increase the availability of vaccines, plant based medicines, complementary foods andothers biological productsPerformance Measure-1. Number of doses of availed cell culture rabies vaccineAvailing rabies Rabies vaccine VDPD Dose 25,000 85,000 125,000 120,000 140,000vaccinedistributionPerformance measure 2: Number of doses of availed prophylactic rabies vaccinesAvailingProphylactic VDPD Dose 10,000 10,000 10,000prophylacticrabies vaccinesrabies vaccinedistributionPerformance measure 3: Number of doses of availed meningococcal meningitis vaccineAvailingmeningitis vaccinemeningococcalmeningitisvaccinedistributionVDPD Dose 1,000,000Performance Measure 4. Number of doses of availed Anti-sera for rabiesAvailing Anti-serafor rabiesDistribution ofanti-sera forVDPD Dose 31,500 37,500 39,000 40,500rabiesPerformance measure 5:Number of bottles of trans-isolate media distributedProduce andINDRD bottles 1000 1000 - - -distribute Transisolate mediaPreparing anddistribution oftrans-isolatemedia to healthfacilitiesPerformance Measure- 6:Number of regional laboratories strengthened to produce trans-isolate mediaStrengthenregionallaboratories toproduce TI mediaConduct TOTon how toproduce TImediaINDRD No 14 16 16 16Qualityassessment ofTI mediaproduced byregional labsINDRD No - 7 7 7Performance Measure -7: Number of complementary foods availedDevelopment ofcomplementaryfoodsFSNRD No 1 1Preparation ofmanual fordevelopment ofcomplementaryfoods58

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Performance Measure -8: Number of standardized plant based medicines for human and veterinary useNumber ofstandardized plantbased medicines forhuman and veterinaryusePrepare and avail full-fledgeddocument of production andother pharmaceutical details onformulated plant basedmedicines for human useTMMRD No 2Prepare and avail full-fledgeddocument of production andother pharmaceutical details onformulated plant basedveterinary medicineTMMRD No 1Objective-3. Improve PHE Communication, response and recoveryPerformance Measure 1. Percent of health events communicated to relevant bodies within specifiedperiod.Timely dispatch ofalert and /orwarningEquip regional PHEM heads withcommunication toolsPrepare and distribute weeklydisease or event reports (bulletin)Disseminate information to thepublic after the occurrence of PHEAlert stakeholders after 30 minutesof case investigationCreate and update roster ofpartners and stakeholders thatrequire communicationPHEMC No 11 11 11 11 11PHEMC No 52 52 52 52 52PHEMCPHEMCPHEMCHour 12 6 1 1 1% 50 90 90 90 90% 60 100 100 100 10059

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Performance Measure 2. Percent of Risk profiles communicated to relevant bodies within specifiedperiod.Risk communication Communicate risk profile PHEMCwith aversion/minimizing action after% 100 100 100 100 100assessment to relevantstakeholdersPerformance Measure 3. Proportion of PHE with prevention and control measures initiated within 48hrs ofidentification of risk and characterization of threatsOutbreak investigation Verification of PHE rumours PHEMCand mitigationwithin 3hrs from initial% 100 100 100 100 100notificationConfirm suspected disease PHEMCoutbreaks with laboratory% 80 80 80 90 90investigationInstitute preventive and PHEMCcontrol measures foridentified risks and% 100 100 100 100 100characterized threatsPerformance Measure 4. Proportion of rehabilitated and recovered affected population and/or health systemafter major PHERecovery andRehabilitationAssess the health impact ofmajor event /emergenciesLiaison with offices/agencies that work onrehabilitation activitiesProvide psycho-socialsupportRehabilitating affectedhealth systemPHEMC%PHEMC %PHEMC %PHEMC %30 50 75 90 100100 100 100 100 100100 100 100 100100 100 100 10010010060

Initiative Scope/content Responsible UnitOBJECTIVE 4 : Increase and maintain quality assured laboratoriesTarget (in EC)2003 2004 2005 2006 2007Performance Measure-1. Number of quality assured (accredited) laboratoriesEnablingEnabling labs to WHO/AFRO RLCBD No 20 40 80 120 160laboratories to fulfilWHO/AFROAccreditation scheme Star 1Enabling labs to WHO/AFRO RLCBD No 16 20 50 80 120accreditationschemeAccreditation scheme Star 2Enabling labs to WHO/AFRO RLCBD No 3 17 20 35 45Accreditation scheme Star 3Enabling labs to WHO/AFRO RLCBD No 2 7 10 15Accreditation scheme Star 4Enabling labs to WHO/AFRO RLCBD No 1 4 5Accreditation scheme Star 5Accreditation oflaboratories withother internationalaccreditations (JCI)Assessment of laboratories by theinternational accreditation bodyRLCBD No 1 4 5Accreditation of labswith nationalaccreditation bodyAssessment of laboratories by RLCBD No 80 100 120 160national accreditation bodyCertification of laboratories RLCBD No 80 100 120 160OBJECTIVE 5: Improve national survey and surveillance data on disease, nutrition andenvironmental problemsPerformance Measure 1: Number of anti microbial & insecticide resistance surveys conducted onpriority diseases /vectorsConduct antimicrobialConduct early warning indicators INDRD No 1 1 1 1 1andinsecticidalfor HIVDRConduct prevention monitoring for INDRD No 1 1 1resistance surveys HIVDRConduct threshold survey for HIVDR INDRD No 1 1 1Conduct national TB drug resistance INDRD No 1 1surveyConduct national malaria drug INDRD No 1 1resistance surveyConduct national drug resistance INDRD No 1 1survey on other bacterial diseaseCarry out post-marketing survey onnorfloxacillin & ciprofloxacillinbrandsTMMRD No 1National insecticide resistantsurveyINDRD No 1 161

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Performance Measure 2: Number of national surveys/surveillances on infectious and non infectiousdiseasesConduct different National TB prevalence INDRD No 1nationalsurveysurveys/surveillanceson infectious and noninfectious diseasesNational ANC/PMTCT HIVsurveyINDRDINDRDNoNo111National PopulationBased Survey (PBS) forHIV, HBV and HCVNational BehaviouralSurvey and surveillanceHIV(BSS)INDRD No 1 1National malaria survey INDRD No 1 1National surveillance on INDRD No 1 1 1 1 1HIV/TB co-infectionNational sero-survey onmost-at-risk populationfor HIVINDRD No 1 1Conduct AIDS relatedmortality surveyNational virologicalsurvey on polio, measlesand RubellaNational survey onInfluenza and otherrespiratory viruses.National survey onRotavirusNational survey onneglected diseases such asonchocercheasis,fliariasis, relapsing feverEntomological survey onmosquitoes and otherpotential vectors fordisease transmissionNational survey on level &determinants of otherzoonotic diseasesINDRD No 1INDRD No 1 1 1 1 1INDRD No 1 1 1 1 1INDRD No 1 1 1 1 1INDRD No 1INDRD No 1 1INDRD No 162

Initiative Scope/content Responsible Unit63Target (in EC)2003 2004 2005 2006 2007Conduct different National survey of rabies INDRD No 1nationalvirus in Ethiopiasurveys/surveillances National survey on level INDRD No 1 1on infectious and noninfectious diseasesand determinants ofbreast and cervicalcancerNational survey on level INDRD No 1and determinants ofdiabetics, asthma andhypertensionPerformance Measure 3: Number of national surveys/surveillances on environmental risk factors onpublic healthConduct surveys on Conduct survey onINDRD No 1 1environmental riskfactors on publichealthOrgano-chlorine PesticidePollution & exposure inthe environment.Conduct survey onINDRD No 1occupational health risk/noise pollution inselected work areasStudy on the occurrence INDRD No 3 1 1and exposure ofenvironmental,occupational hazards forhealth and toxicchemicals andcontaminants.Investigate reduction INDRD No 1strategy for contaminatedenvironmental riskfactors for health.Conduct household wellwater quality assessmentINDRD No 1Performance Measure 4: Number of national surveys/surveillances on nutrition and traditionalmedicineConduct differentnational surveys &surveillances onConduct survey on heavymetals contamination infood and waterINDRD No 1 1nutritionFSNRD No 1Conduct National NutritionProgram (NNP) end linesurveyConduct National iodinedeficiency disorder (IDD)evaluation surveyFSNRD No 1

Initiative Scope/content Responsible Unit64Target (in EC)2003 2004 2005 2006 2007Conduct National vitamin A FSNRD No 1deficiency (VAD) surveyConduct National iron FSNRD No 1deficiency anaemia (IDA)surveyConduct National zinc FSNRD No 1deficiency disorder (ZDD)surveyConduct National mycotoxin FSNRD No 1survey on ground-nut andspicesConduct evaluation on FSNRD No 1 1 1 1National Nutrition Program(CBN)Conduct National food FSNRD No 1consumption surveyStudy on breast feeding and FSNRD No 1complementary feedingtrend at national levelNational nutrition programoperationalresearchesFSNRD No 3 3 3 3Conduct different National survey on TMMRD No 1national survey &surveillance ontraditional medicineknowledge, attitude andpractice of thecommunity, traditionalhealth practitioners andmodern healthpractitioners towardstraditional medicine.OBJECTIVE 6: Increase problem solving research on disease, nutrition and traditional medicine andmodern drugsPerformance Measure -1: Number of evaluations conducted to improve diagnostic technologiesEvaluation of new Evaluation of rapid test INDRD No 1 1diagnostickits for HIVtechnologiesEvaluation of rapid test INDRD No 1kits for rabiesScaling up of rabies INDRD No 1 5 7 4diagnostic services inregional laboratoriesEvaluation of MODS for INDRD No 1M. TuberculosisEvaluation of diagnosis INDRD No 1methods of tuberculosisin childrenEvaluation of mobile CD4testing deviseINDRD No 1

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Evaluation of rapid test INDRD No 1 1kits for malariaEvaluation of diagnostic INDRD No 1technology for theidentification of recentHIV infectionEvaluation ofINDRD No 1 1 1 1 1molecular/immunological platform (for additional5 diseases)Evaluation of rapid test INDRD No 1 1kits for HBVPerformance measure 2: Number of evaluations and studies conducted to improve food processingtechnologies and qualityEvaluation of food Effective method of FSNRD No 1processingprocessing and promotingtechnologieslocally availablemicronutrient rich foodsIdentify and evaluate new FSNRD No 1food processingtechnologies that can beused at community levelDetermination of shelf life FSNRD No 1 1 1 1 1of foodsStudy on fortification of FSNRD No 1essential nutrients incomplementary foodsStudy on imported premix for FSNRD No 1fortification and existingfortified food products inEthiopiaPost harvest qualityevaluation and improvementof coffeeTMMRD No 1 165

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Performance Measure -3: Number of researches on infectious diseases, community nutrition and traditional medicineIdentifying health Immunological, virological INDRD No 1 1 1 1 1related problems andtheir biologicalcausesand bacteriologicalconsequences oftuberculosis and HIV coinfectionStudy the associationINDRD No 1between infectious and noninfectious diseasesDetermine the impact of INDRD No 1disease co-infections ondiagnosis and treatmentMolecular epidemiology on INDRD No 1 1 1HIV, TB and malariaMolecular epidemiology of INDRD No 1rabies virus in EthiopiaStudy on acute wateryINDRD No 1 1diarrhoea (AWD)Investigation andmanagement of anunidentified liver disease inNorth-western TigrayTMRD No 1Identification of foodsafety and nutritionalproblems forinterventionStudy on hazard analysisand critical control points(HACCP) of municipalitywaterStudy on hazard analysisand critical control points(HACCP) of selected foodindustryStudy on the role ofnutrition in chronic healthproblems (Hypertensionand diabetics diseases)Study on the interaction ofnutrition and majordiseases ( HIV, malariaand TB)Iodine retention study oniodated saltStudy on safety ofvegetables grown in Addisand its surrounding areasFSNRD No 1FSNRD No 1FSNRD No 1FSNRD No 2FSNRD No 1FSNRD No 166

Initiative Scope/content Responsible UnitIdentification ofnutritionalproblems forinterventionScientificevaluation oftraditionalmedicinesPrevalence and drugresistance patterns of S.concord among children inselected orphanages andhealth institutions in AddisAbaba, EthiopiaStudy on health effect offluoride intake andmitigation mechanismPhytochemical, efficacyand safety study ontraditionally usedmedicinal plants usedagainst leishmaniasisPhytochemical, efficacyand safety study ontraditionally usedmedicinal plants usedagainst tuberculosisPhytochemical, efficacyand safety study ontraditionally usedmedicinal plants usedagainst asthma and/ordiabeticsPhytochemical, efficacyand safety study onselected medicinal plantsused against diarrhoeaPhytochemical, efficacyand safety study ontraditionally usedmedicinal plants used totreat rabiesDocumentation oftraditional medicalknowledge andpreparation ofpharmacopoeiaFSNRD No 1FSNRD No 1INDRD No 1Target (in EC)2003 2004 2005 2006 2007TMMRD No 1TMMRD No 1TMMRD No 1INDRD No 1TMMRD No 167

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Performance Measure -4: Number of studies on Clinical trials and preventive measuresIdentifyingEfficacy study of bed net INDRD No 1appropriate drugs and insecticide on vectorand vaccines for controltherapeutics andConduct advanced clinicalinterventionmonitoringINDRD No 1Conduct vaccine trial on INDRD No 1priority diseasesConduct drug trial on INDRD No 1priority diseasesConduct clinical trial on TMMRD No 1formulated plant basedmedicines againsthypertensionConduct clinical trial on TMMRD No 1formulated plant basedmedicines againsthelminticsConduct clinical trial onformulated plant basedmedicine against malariaTMMRD No 168

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007OBJECTIVE 7: Improve research on health system and intervention evaluationPerformance Measure-1: Number of health system/intervention evaluation conductedConduct Identify barriers to andHSRD No 1research onhealth system& heathrelatedinterventionsopportunities for successfulhealth extension programimplementation at urban,rural and pastoralistcommunitiesMaternal and Child HealthHSRD No 1(ICCM)Assessment of health careHSRD No 1delivery and quality of care:Coverage and delivery of ANCservicesFacility based retrospective HSRD No 1study on non communicablediseaseEvaluate referral systemHSRD No 1linkage at different levels ofhealth facilitiesIdentify the most effectiveHSRD No 1individual, family andcommunity level interventionsfor preventing, treating mentalillnessEvaluate the methods toHSRD No 1enhance the protection ofprivacy and confidentiality inhealth care delivery.Assess the existing practices of HSRD No 1health workforce developmentand identify the best approach.Evaluation on the coverage of HSRD No 1vaccination programsStudy on delivery andHSRD No 1utilization of rabies vaccineHealth facility assessment HSRD No 1Basic health supplies tracking HSRD No 1and stock management studyAssessment of the healthHSRD No 1system and policyenvironment as criticalcomplement to trackingintervention coverage formaternal and child healthCustomer satisfaction surveyat selected health facilitiesHSRD No 169

InitiativeScope/contentResponsibleUnitTarget (in EC)2003 2004 2005 2006 2007OBJECTIVE 8: Enhance the production of vaccines, standardized plant based medicine and foodproductPerformance Measure 1: Number of vaccines produced through technological transferProduction ofrabiesvaccineProduction ofMeningococcal vaccinesProduction ofPentavalentvaccinesProduction ofanti-sera forrabiesProduce cell culturerabies vaccine foranimal useMass production ofcell culture rabiesvaccines for animaluseProduce cell culturerabies vaccine forhuman useMass production ofcell culture rabiesvaccines for humanuseMass production ofFermi rabiesvaccine for animaluseMass production ofFermi rabiesvaccine for humanuseProducetrivalent(A,C&W135) MeningococcalvaccinesMass production oftrivalent(A,C&W135) MeningococcalvaccinesProduce DTPvaccinesTransfertechnologies toproduce Hib andHebProduce rabiesanti-seraVDPD No 1VDPD Dose 30,000 60,000 100,000 120,000 140,000VDPD No 1VDPD No 10,000 10,000 10,000VDPD Dose 5,000 5,000 5,000VDPD Dose 20,000 20,000 20,000VDPD No 1VDPD Dose 1,000,000VDPD No 1VDPD No 1VDPD No 170

InitiativeScope/contentResponsibleUnitTarget (in EC)2003 2004 2005 2006 2007Performance Measure 2: Number of vaccines produced from local isolatesDevelopingvaccine fromlocallycirculatingrabies virusstrainsGenerate candidaterabies vaccinestrainVDPD No 2Developmentof snake anitvenumfromlocallyavailablesnake speciesProduction of snakeanti- venum fromlocally availablesnake speciesVDPD No 1Performance Measure 3: Number of standardized plant based medicines developedProduce plantbasedmedicineproducts forhealthpromotionDevelopment ofplant basedproducts againstmicrobial infectionof skinDevelopment ofplant based waterclarifying productDevelopment ofplant basedproducts againstlivestock skinparasitesDevelopment ofplant basedmosquito larvicidalproductTMMRDTMMRDTMMRDPerformance Measure 4: Number of standardized food products developedProduce food Development of food FSNRD No 1products for products using lesshealthexploited food cropspromotionFSNRDDevelopment ofcomplementary foodfor childrenNoNoNoNo1 111 111 171

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Performance measure 5: Number of indigenous food technologies documentedDocumentation of Documentation of FSNRD No 1indigenous food indigenous food ofethnic groupsPerformance measure 6: Number of food composition tables and dietary menu developedDevelopment of Expansion andFSNRD No 1food compositiontable and dietaryupdating of foodcomposition tablemenusDevelopment ofdietary menus formajor healthdisorders forinstitution andindividualsFSNRD No 2 1Performance measure 7: Number of different experimental animals producedProduction ofdifferentexperimentalanimals forexperimentProduce differentexperimental animalsINDRD No 5,000 5,500 6,000 6,500 7,000OBJECTIVE 9: Improve PHE early warningPerformance Measure 1: Percent of weekly surveillance reports that are received completeand timely at PHEM-CQuality datamanagementUse of informationtechnologyTOT for surveillancedata managers on thereporting formatsand datamanagementEquip PHEM officeswith communicationequipmentsAvail reportingformats at all levelIntegrate the weeklyreporting with thenew HMIS softwareat woreda levelPHEMC No 22 22 22 22 22PHEMCPHEMCNo 11 11 11 11 11% 100 100 100 100 100PHEMC % - 20 30 50 6072

Initiative Scope/content Responsible UnitOBJECTIVE 10. Improve risk identification and PHE preparednessTarget (in EC)2003 2004 2005 2006 2007Performance Measure 1. Percent of threats/ risks mapped and communicated to theRegions and partnersRiskVulnerability assessment andmanagement risk mapping of the majorpublic health emergenciesImplement prophylaxis and/ orprevention activities for therisks identified accordinglyConduct risk managementtrainingsPerformance Measure 2. Percent of identified risks with EPRP preparedPre-planning Prepare EPRP based on the100 100PHEMC %identified risksPrepare the annual nationalrequirement / contingency PHEMC No 2planPerformance Measure 3. Proportion of PHE with adequate stockpiles of drugs and medicalsupplies as per the guidelineStockpiling ofresourcesIdentify PHE that requirestockpiles of drugs and medicalsupplies every yearStock analysis and identifygaps for those list of PHEfrequentlySecure the drugs, vaccines, andmedical supplies for the gapsidentifiedPHEMC No 1 1 2 2 2PHEMC % 100 100 100 100 100PHEMC No 1 1 2 2 2100 100 1002 2 2 2PHEMC year 1 1 1 1 1PHEMC month 6 3 3 3 3PHEMC % 90 90 90 100 10073

InitiativeScope/contentResponsibleUnitTarget (in EC)2003 2004 2005 2006 2007Performance Measure 4. Proportion of PHE specific guidelines developed and distributedAvail relevantguidingdocumentsIdentify priority disease thatrequire a detailed and separateguideline and update/preparethe guidelines for the identifiedPHEEnsure printing anddistribution to the RHBsPHEMC No 2 2 2 2 2PHEMC % 100 100 100 100 100Performance Measure 5. Number of health professionals trained on management of public healthemergenciesHumanresourceIn partnership withuniversities and otherNocapacitybuildingpartners, coordinate thetraining of Masters degree inPHEMC20 40 40 40 13Field Epidemiology (FELTP)Train regional PHEM staff onNoPHEMCPHE including guidelines287 280 260 260 287OBJECTIVE 11: Enhance Laboratory Quality SystemPerformance Measure – 1: Number of developed and revised guidelines, manuals and format typesDevelop and EQA guidelines for integrated RLCBD No 3 2 3 2 2revisediseases (malaria, HIV, TB, …)laboratory Laboratory quality manual RLCBD No 1 1 1 1 1quality system Laboratory referral linkage RLCBD No 1 1 1guidelines, manualmanual,RLCBD No 4 5 6 7 7standards andformatsEstablishmentof system fornationallaboratoryaccreditationStandardizingtrainingsSOPs, Job aids, Reporting andrecording formats for HIV, TB,Malaria, etc… diseases(assumption: 7 packages fordifferent diseases)Establish accreditation body RLCBD No 1Establish national laboratory RLCBD No 1 1quality standardNeed assessment andRLCBD No 1 1 1prioritization of lab trainingsDevelop/revise training RLCBD No 3 3 4 4 5curriculum and modulesDevelop/revise training RLCBD No 1 1guidelinesPerformance Measure-2. Number of laboratories with standard data management systemEstablishingdatamanagementsystemDevelop and distributedatabase for EQA, training andequipment maintenance tolaboratoriesRLCBD No 6 8 10 11 1374

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Establish Lab Information System RLCBD No 20 20 25 30 40(LIS) software for hospitallaboratoriesPerformance Measure-3. Number of laboratories evaluated with External QualityAssessment SchemeIncreaselaboratoriesparticipated inEQAImporting and distributing panelsamples of different tests tolaboratoriesPreparation of different test paneltypesSupportive supervision of EQAparticipating laboratoriesRLCBD No 100 120 120 130 140RLCBD No - 2 2 1 1RLCBD No 50 60 60 75 80OBJECTIVE -12: Improve the diagnostic capacity of laboratoriesPerformance Measure-1. Number of enabled laboratories to provide special and referralservicesEnabling Providing ART machines to Health RLCBD No 150 100 50 75 50laboratories toperformcentresEnabling central, regional and RLCBD No 7 2 3 2 2special andreferral testsfederal laboratories to performreferral tests (TB liquid culture,viral load, DNA PCR, epidemicprone disease diagnosis…)Enabling regional laboratories to RLCBD No 7 2 3 2 2implement regional externalquality assurance (REQAS) for thelaboratories at their regionPerformance Measure -2: Proportion of health facilities linked to ART referral laboratoriesStrengtheningreferral linkageRLCBD No 60 75 80 95 100Strengthen laboratories withlaboratory networking (Logisticand IT technology: Fax, computer,Internet …)Mapping of health facilitylaboratories for referraltests(using geographicalinformation system /GIS/)RLCBD No 75 95 100Performance Measure -3: Number of trained personnelConducting Training of laboratory personnel RLCBD No 85 100 120 130 135prioritizedtrainingson integrated disease diagnosisTraining of laboratorymanager/supervisors onlaboratory managementRLCBD No 85 100 120 130 135Training of laboratory personnelon quality management systemRLCBD No 100 120 140 160 20075

Initiative Scope/content Responsible UnitConductingprioritizedtrainings76Target (in EC)2003 2004 2005 2006 2007Training of laboratory personnel RLCBD No 85 100 120 130 135on equipment preventivemaintenanceIn-service training of biomedical RLCBD No 20 30 40 40 40engineers on the currentlyavailable integrated laboratoryservice equipment (n=11 regionsincluding the 2 administrativecities)Training of laboratory personnel RLCBD No 20 23 24 24 25on specialized tests like viral loadand deoxyribonucleic acidpolymerase chain reaction (DNAPCR)Training on epidemic prone RLCBD No 85 100 120 130 135diseasesTraining on gap analysis and RLCBD No 85 100 120 130 135comprehensive accreditationsupport of laboratoriesTraining on microbiological RLCBD No 25 30 50 55 60diagnosis (culture & sensitivity)In-service training of laboratory RLCBD No 85 100 120 130 135personnel on occupational healthand safetyTraining on laboratory sample RLCBD No 25 25 25 25 25handling and transportationRegular coaching and supervision RLCBD No 6 8 11 11 11of in-service trainings at regionsPre-service training on ART RLCBD No 600 600 600 600 600monitoring and integrated diseasediagnosis for 5 UniversitiesTraining on TB liquid culture RLCBD No 16 20 20 20 20TOT training on ILED microscopy(for TB, malaria and othersdiagnosis)RLCBD No 80 25 25 25 25Performance Measure -4: Proportion of laboratories getting maintenance servicesProvision ofmaintenanceservicesResponse to service andmaintenance requirements oflaboratoriesRLCBD No 80 84 90 95 97Service agreements withmanufacturers/vendors forautomated analyzersEstablish regional maintenancecentresRLCBD No 3 2RLCBD No 5 2

InitiativeScope/contentResponsibleUnitTarget (in EC)2003 2004 2005 2006 2007Performance Measure -5: Proportion of preventive maintenance services providedProvisionofmaintenance servicesProvision of preventivemaintenance services to majorlab equipmentsRLCBD No 20 35 60 70 90Performance Measure-6. Number of iodized salt quality control laboratories strengthenedStrengthenpublichealthlaboratories foriodized saltqualitycontrolEnabling public healthlaboratories to control thequality of iodized saltFSNRD No 7 7 14 14 -OBJECTIVE-13: Improve efficient mobilization & utilization of resourcesPerformance Measure -1. Proportion of mobilized resources as per planEstablish Mobilization of resources for RTTDGD % 100 100 100 100 100efficientresourcemobilizatioresearch and technologytransferMobilization of resource forOPHEMDG % 100 100 100 100 100n system Public health emergencymanagementDOMobilization of resources for RLCBD % 100 100 100 100 100public health laboratoryserviceMobilization of resources formanagement and leadershipPFMED % 100 100 100 100 100Establishefficientprocurement systemEstablishemergencyresponsefund (ERF)Install finance software PFMED No 1Develop operational annual PFMED No 1 1 1 1 1procurement planEstablishing stock data base PFMED No 1Prepare and revise purchasing PFMED No 1 1guidelinesLegislate the establishment ofthe ERFPHEMC % 100 - - - -Preparation of utilization SOP PHEMC % - 100 - - -Secure the fund PHEMC Birr10,000,00010,000,00015,000,00015,000,00010,000,00077

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Performance Measure -2: Proportion of performance compliance in line with the standardRegulatingimplementation of allactivities of theInstituteConduct audit andinspectionConduct anticorruptionfollow upRegulate legalcompliance of activitiesAuditServiceAnticorruptionOfficerLegalservice% 100 100 100 100 100% 100 100 100 100 100% 100 100 100 100 100OBJECTIVE 14: Improve human resource managementPerformance Measure -1. Number of employee developed with Long & short term trainingprogramsDevelopingprofessionals withlong term trainingTrain Employeestrained in MSc ( MPH,MD+ MPH, MA) andPhD ProgramsTrain Employees withshort term trainingsHRM&GSDNo 15 22 27 27 16HRM&GSD 40 40 50 50 50NoPerformance Measure -2. Proportion of Employees Recruited as per the requestFilling Vacancies with Recruiting Employees HRM&GSD 80 85 90 95 100Employeesas per the request%Performance measure 3: Proportion of employees retainedRetaining the skilled Review CareerHRM&GSD No 1manpower’s in the StructureinstituteProduce and implement HRM&GSD No 1 1Incentive guidelineExpand Transport HRM&GSD % 50 70 80 90 100Service coverageContinue existing HRM&GSD % 100 100 100 100 100canteen subsidyConstruct Sport and HRM&GSD No 3 3 2 1 1other healthyrecreational facilitiesentertainment78

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007OBJECTIVE 15: Improve project management systemPerformance Measure -1. Proportion of researches with public health relevanceEvaluating the Scientific and ethical proposals SERO % 95 98 100 100 100scientific andethical standardssubmitted according to thestandards set by SEROof researches Follow-up of scientific andethical progress of researchSERO % 100 100 100 100 100Public healthoriented researchprojectsprojectsPrioritize projects with publichealth research agendaSERO % 70 80 90 95 95Performance Measure -2. Number of National and international research partnershipestablishedEstablishingpartnershipEstablishingpartnership/collaborativeNo 1 1 1 1research activitiesPerformance measure -3: Number of Monitoring conductedMonitoring Conduct quarterly monitoring PFMED No 4 4 4 4 4research projects, of projectslaboratory quality Conduct SupportivePFMED No 1 1 1 1 1building and PHEM Supervision(SS)activitiesConduct annual review meeting PFMED No 1 1 1 1 1Performance measure -4: Number of Evaluation conductedEvaluation of Conduct the process evaluation PFMED No 1research projects, of the institute 5 years’ SPMlaboratory service Conduct the summativePFMED No 1and PHEMevaluation of the institute 5activitiesyears’ SPM79

Initiative Scope/content Responsible UnitOBJECTIVE 16: Strengthen the capacity of technical facilitiesTarget (in EC)2003 2004 2005 2006 2007Performance Measure -1. Number of developed technical capacity for vaccine productionVaccine production Develop quality-control VDPD No 1capacity buildinglab for vaccineproductionDevelop vaccineVDPD No 1production facilities forMeningitisDevelop vaccineVDPD No 1production facilities forDTPDevelop vaccineVDPD No 1production facilities forHib and HeBPerformance Measure -2. Number of developed National capacity for biological ProductsDevelopment ofTransfer biologicalVDPD No 1 1 1 1biological products for products productiondiagnosis andtechnologyinterventionPartnership withVDPD No 1 1 1 1international withappropriate companiesPerformance Measure -3. Number of developed national databaseDeveloping databases Establishing research TTRTD No 1databaseEstablishing public RLCBD No 1health laboratorydatabaseEstablishing Publichealth emergencymanagement databasePHEMC No 180

Initiative Scope/content Responsible UnitPerformance measure 4: Number of developed technical facilitiesEstablish andEquip the EOC with IT andmaintain emergency communication toolsoperation centre needed(EOC)Ensure the full functionalityof the EOCBuild IT capacity ofthe InstituteBuild technicalfacilitiesTarget (in EC)2003 2004 2005 2006 2007PHEMC % 90 100 - - -PHEMC % 60 100 100 100 100Modernize the IT system of IT % 100 100 100 100 100the InstituteImprove library service PRO No 1Building training facility PFMED No 1Building laboratory animal INDRD No 1breeding facilitiesStrengthening ofTMMRD No 1herbarium , botanicalgarden and conservation ofmedicinal plantsStrengthening andINDRD No 1equipping of InsectariesBuilding stock ware-house PFMED No 1Build Bio-safety Strengthen laboratory HR No 1 1 1 1 1systemsafety system&GSDBuild safe laboratory HR No 1sewerage system&GSDDevelop dangerousPFMED No 1chemical disposal systemPerformance Measure -5. Number of developed research outcomes dissemination systemDevelop research Development of a scientific TTRTD No 1dissemination tools journal of the institutePublish scientificnewsletterTTRTD No 1 2 4 4 481

Initiative Scope/content Responsible UnitTarget (in EC)2003 2004 2005 2006 2007Objective-17. Enhance coordination and collaborationPerformance Measure 1. Proportion of PHEM stakeholders involved in at least 9 of the monthlymeetings of the PHEMTTFStrongcoordinationandcollaborationEstablish multidisciplinarycoordinating team (PHEM TTF)to handle PHEPHEMC % 100 - - - -Prepare TOR for the taskforce PHEMC % 100 - - - -Conduct monthly meetings toNoPHEMCreview activitiesSign memorandum ofNounderstanding with keyPHEMC4 5 - - -stakeholders12 12 12 12 12Performance Measure 2. Number of national and international research partnershipestablishedEstablishingpartnershipEstablishingpartnership/collaborativeresearch activitiesGD No 10 20 30 40 50Performance measure 3: Proportion of research partnership maintainedMaintainingpartnershipsGD % 100 100 100 100 100Maintaining national andinternational researchpartnerships82

11. BUDGETInitiativesTable 6. COST ESTIMATED/REQUIRED BUDGET (Birr)Content/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 1: Improve evidence based research outcomes for policy decision makingPerformance Measure-1. Number of research outcomes for policy changePreparing policybriefsDevelopment of policy briefs for diseaseprevention and controls240000 240000 240000 240000 240000total budget240000 240000 240000 240000 240000Performance Measure-2. Number of National relevant research outcomes disseminated (technical reports)Disseminatingdifferent nationallyrelevant researchreportsSending different research outcomes reports forstakeholders_ _ _ _ _Performance Measure-3. Number of research findings disseminatedDisseminate researchinformationResearch findings presented on national andinternational conferenceResearch findings disseminated through on peerreviewed journalsResearch findings disseminated through theinstitute’s News letterResearch findings disseminated through websiteand mass media80,000 80,000 80,000 80,000 80,00080,000 80,000 80,000 80,000 80,00080,000 80,000 80,000 80,000 80,00025,000 25,000 25,500 25,500 25,500total budget265,000 265,000 265,500 265,500 265,500Page 83

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 2: Increase the availability of vaccines, plant based medicines, complementary foods and others biological productsPerformance Measure-1. Number of doses of availed animal rabies vaccineAvailing rabies Rabies vaccine distribution _ _ _ _ _vaccinetotal budget_ _ _ _ _Performance measure 2: Number of doses of availed prophylactic rabies vaccinesAvailingprophylactic rabiesvaccinesProphylactic rabies vaccine distribution _ _ _ _ _total budgetPerformance measure 3: Number of doses of availed meningococcal meningitis vaccineAvailing meningitis meningococcal meningitis vaccine_ _ _ _ _vaccinedistributiontotal budget_ _ _ _ _Performance Measure-4. Number of doses of availed Anti-sera for rabiesAvailing Anti-sera Distribution of anti-sera for rabies _ _ _ _ _for rabiestotal budget_ _ _ _ _Performance Measure -5:Number of tubes of trans-isolate media distributedProduce and Preparing and distribution of trans-isolate122,000 22,500distribute Transisolate mediamedia to health facilitiestotal budget122,000 22,500Performance Measure- 6:Number of regional laboratories strengthened to produce trans-isolate mediaStrengthen regionallaboratories toproduce TI mediaConduct ToT on how to produce TI media 40,000 42,000 43,000 44,000 49,000Quality assessment of TI media produced byregional labstotal budget14,000 14,000 105,000 105,000 105,00054,000 56,000 148,000 149,000 154,000Page 84

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Performance Measure 7: Number of complementary foods availedDevelopment ofcomplementaryfoodsPreparation of manual for development ofcomplementary foods60,000 60,000total budget60,000 60,000Performance measure 8: Number of standardized plant based medicines for human and veterinary useNumber ofstandardized plantbased medicines forhuman andveterinary usePrepare and avail full-fledged document ofproduction and other pharmaceutical details onformulated plant based medicines for humanPrepare and avail full-fledged document ofproduction and other pharmaceutical details onformulated plant based veterinary medicinetotal budgetObjective-3. Improve PHE Communication, response and recoveryPerformance Measure 1. Percent of health events communicated to relevant bodies within specified period.100,00050,000150,000Timely dispatch ofalert and /or warningEquip regional PHEM heads withcommunication tools 1,500,000 1,500,000 1,500,000 1,500,000 1,500,000Prepare and distribute weekly disease or eventreports (bulletin) 26,000 26,000 26,000 26,000 26,000Issue information to the public after the100,000 100,000 100,000 100,000 100,000occurrence of PHEAlert stakeholders after 30 minutes of case25,000 25,000 25,000 25,000 25,000investigationCreate and update roster of partners and0 0 0 0 0stakeholders that require communicationtotal budget1,651,000 1,651,000 1,651,000 1,651,000 1,651,000Page 85

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Performance Measure 2. Percent of Risk profiles communicated to relevant bodies within specified period.Risk communication Communicate risk profile with aversion/minimizing action after assessment to relevantk hTotal ld budget100,000 100,000 100,000 100,000 100,000100,000 100,000 100,000 100,000 100,000Performance Measure 3.Proportion of PHE with prevention and control measures initiated within 48hrs of identification of risk andcharacterization of threatsOutbreakVerification of PHE rumors within 3hrs frominvestigation and initial notificationmitigation Confirm suspected disease outbreaks with180,000 180,000 180,000 180,000 180,000laboratory investigation 100,000 100,000 100,000 100,000 100,000Institute preventive and control measures foridentified risks and characterized threats 180,000 180,000 180,000 180,000 180,000Total budget460,000 460,000 460,000 460,000 460,000Performance Measure 4. Proportion of rehabilitated and recovered affected population and/or health system after major PHERecovery andRehabilitationAssess the health impact of major event/emergencies 132,000 396,000 528,000 660,000 792,000Liaison with offices /agencies that work onrehabilitation activities 0 0 0 0 0Provide psycho-social support100,000 100,000 100,000 100,000 100,000Rehablitate affected health system500,000 500,000 500,000 500,000 500,000total budget732,000 996,000 1,128,000 1,260,000 1,392,000Page 86

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 4: Increase and maintain quality assured laboratoriesPerformance Measure-1. Number of Quality assured (Accredited) laboratoriesEnablinglaboratories to fulfilEnabling labs to WHO/AFRO Accreditationscheme Star 1 100,000.00 200,000.00 400,000.00 600,000.00 800,000.00WHO/AFROaccreditation schemeEnabling labs to WHO/AFRO Accreditationscheme Star 2 80,000.00 100,000.00 250,000.00 400,000.00 600,000.00Enabling labs to WHO/AFRO Accreditationscheme Star 3 15,000.00 85,000.00 100,000.00 175,000.00 225,000.00Enabling labs to WHO/AFRO Accreditationscheme Star 4 - 10,000.00 35,000.00 50,000.00 75,000.00Enabling labs to WHO/AFRO Accreditation - - 5,000.00 20,000.00 25,000.00Accreditation oflaboratories withother internationalaccreditations (e.gAccreditation of labswith nationalaccreditation bodyAssessment of laboratories by the internationalaccreditation body0 0 5000 20000 25000Assessment of laboratories by nationalaccreditation body 5000 5000 5000 5000 5000Certification of laboratoriestotal budget0 400000 500000 600000 800000200,000.00 800,000.00 1,300,000.00 1,870,000.00 2,555,000.00Page 87

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 5: IMPROVE NATIONAL SURVEY AND SURVEILLANCE DATA ON DISEASE, NUTRITION, TRADITIONAL MEDICINE &ENVIRONMENTAL PROBLEMSPerformance Measure 1: Number of anti microbial & insecticide resistance surveys conducted on priority diseases /vectorsConduct antimicrobialsurveyConduct early warning indicators for HIVDR 200,000 220,000 240,000 260,000 280,000Conduct prevention monitoring for HIVDR 600,000 660,000 720,000Conduct threshold survey for HIVDR 330,000 360,000 390,000Conduct national TB drug resistance survey 80,000 88,000Conduct national malaria drug resistance survey 1,000,000 1,100,000Conduct national drug resistance survey onother bacterial diseaseCarry out post-marketing survey onnorfloxacillin & ciprofloxacillin brandstotal budget200,000 220,000110,000 22,0002,520,000 242,000 1,260,000 260,000 2,798,000Page 88

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Performance Measure 2: Number of national surveys/surveillances on infectious and non infectious diseasesConduct different National TB prevalence survey 20,000,000nationalNational ANC/PMTCT HIV survey 5,000,000 5,500,000surveys/surveillanceson infectious and National Population Based Survey (PBS) for50,000,000non infectious HIV, HBV and HCVdiseasesNational Behavioural Survey and surveillance 15,000,000 15,000,000HIV(BSS)National malaria survey 1,000,000 1,000,000National survey on HIV/TB co-infection 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000National sero-survey on most-at-risk population 15,000,000 15,000,000for HIVConduct AIDS related mortality survey 5,000,000National virological survey on polio, measles 500,000 500,000 550,000 550,000 600,000and RubellaNational survey on Influenza and other3,000,000 3,000,000 3,500,000 3,500,000 4,000,000Nationali tsurveyion Rotavirus 150,000 150,000 150,000 200,000 200,000National survey on neglected diseases such as1,000,000onchocercheasis, fliariasis, relapsing feverEntomological survey on mosquitoes and other300,000 500,000potential vectors for disease transmissionNational insecticide resistant survey /timing/ 400,000 600,000National survey on level & determinants of600,000other zoonotic diseasesNational survey of rabies virus in Ethiopia 800,000National survey on level and determinants of600,000 800,000breast and cervical cancerNational survey on level and determinants of1,000,000diabetics, asthma and hypertensionTotal budget57,050,000 61,550,000 14,000,000 29,150,000 22,900,000Page 89

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Performance Measure 3: Number of national surveys/surveillances on environmental risk factors on public healthConduct surveys onenvironmental riskfactors on publichealthConduct survey on Organochlorine PesticidePollution & exposure in the environment.Conduct survey on occupational health risk/noise pollution in selected work areasStudy on the occurrence of and risk factor forenvironmental and occupational hazards forInvestigate reduction strategy for contaminatedenvironmental risk factors for health.800,000 200,000 800,000 200,000100,000 100,000800,000 500,0001,000,000Conduct household well water quality150,000 150,000assessmentTotal budget1,850,000 350,000 900,000 1,200,000 500,000Performance Measure 4: Number of national surveys(/surveillances) on nutrition and traditional medicineConduct differentnational survey &surveillance onnutritionConduct survey on heavy metals contamination 500,000 800,000in food and waterConduct National Nutrition Program (NNP) end line3,900,000surveyConduct National IDD evaluation survey 300,000Conduct National VAD survey 350,000Conduct National IDA survey 300,000Conduct National ZDD survey 350,000Conduct National mycotoxin survey on ground-nut200,000and spicesConduct evaluation on National Nutrition Program 200,000 200,000 200,000 200,000(NNP)Conduct National food consumption survey 250,000Study on breast feeding and complementary feeding 200,000 64,000trend at national levelEstablishing nutrition database (reports) 175,000 175,000 125,000 125,000National nutrition program-operational researches 2,177, 500 2,177, 500 2,177, 500 2,177, 500Conduct differentnational survey &surveillance ontraditional medicineNational survey on knowledge, attitude andpractice of the community, traditional healthpractitioners and modern health practitionerstowards traditional medicine.Total budget129,720 155,664 171,2301,454,720 894,664 1,146,230 4,775,000 800,000Page 90

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 6: INCREASE PROBLEM SOLVING RESEARCH ON DISEASE, NUTRITION AND TRADITIONAL MEDICINEPerformance Measure -1: Number of evaluations conducted to improve diagnostic technologiesEvaluation of new Evaluation of rapid test kits for HIV 1,000,000 1,000,000diagnostic Evaluation of rapid test kits for rabies 500,000technologies Scaling up of rabies diagnostic services inregional laboratories144,000 3,176,000 784,000Evaluation of MODS for M. tuberculosis 1,000,000Evaluation of diagnosis methods of tuberculosis 404,000 404,000 404,000 404,000 404,000in childrenEvaluation of mobile CD4 testing devise 300,000Evaluation of rapid test kits for malaria 800,000 900,000Evaluation of diagnostic technology for the1,000,000identification of recent HIV infectionEvaluation of molecular/immunological100,000 100,000 100,000 100,000 100,000platform (for additional 5 diseases)Evaluation of rapid test kits for HBV 200,000Total budget1448000 7,480,000 1,488,000 1,404,000 1,504,000Performance measure 2: Number of evaluations and studies conducted to improve food processing technologies and qualityEffective method of processing and promoting40,000locally available micronutrient rich foodsEvaluation of foodprocessingtechnologiesIdentify and evaluate new food processingtechnologies that can be used at at community level30,000Determination of shelf life of foods 50,000 50,000 50,000 50,000 50,000Study on fortification of essential nutrients in100,000complementary foodsStudy on imported premix for fortification and50,000existing fortified food products in EthiopiaPost harvest quality evaluation and improvement of 161,200 111,200 111,200 111,200 61,200coffeeTotal budget311,200 211,200 161,200 161,200 181,200Page 91

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Performance Measure -3: Number of researches on infectious diseases, community nutrition and traditional medicineIdentifying health Immunological, virological and bacteriological 4,000,000related problem and consequences of tuberculosis and HIVtheir biological coinfectioncausesStudy the association between infectious and3,000,000non infectious diseasesDetermine the impact of disease confections on2,000,000diagnosis and treatmentMolecular epidemiology on HIV, TB and5,000,000 6,000,000 8,000,000malariaMolecular epidemiology of rabies virus in3,000,000EthiopiaStudy on acute watery diarrhea (AWD) 800,000 800,000Investigation and management of an600,000 700,000unidentified liver disease in North-westernTigrayIdentification of food Study on hazard analysis and critical control points10,000 10,000safety and nutritional (HACCP) of municipality waterproblems for Study on hazard analysis and critical control points30,000intervention (HACCP) of selected food industryStudy on the role of nutrition in chronic health50,000problems (Hypertension and diabetics diseases)Study on the interaction of nutrition and majordiseases ( HIV, malaria and TB)Iodine retention study on iodated salt 35,000 35,000Study on safety of vegetables grown in Addis 30,000and surrounding areasPrevalence and drug resistance patterns of S.175,000Concord among children in selected orphanagesand health institutions in Addis Ababa, Ethiopia5,000,000Study on health effect of fluoride intake andmitigation mechanism450,000Page 92

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Scientific evaluationof traditionalmedicinesPhytochemical, efficacy and safety study ontraditionally used medicinal plants used againstleishmaniasisPhytochemical, efficacy and safety study ontraditionally used medicinal plants used againsttuberculosisPhytochemical, efficacy and safety study ontraditionally used medicinal plants used againstasthma and/or diabeticsPhytochemical, efficacy and safety study onselected medicinal plants used against diarrhoea856,000 881,680 908,130 935,374 963,436500,000 500,000 400,000 400,000 200,000561,000 200,000 92,80050, 000 100, 000 40, 000 40, 000 20, 000Phytochemical, efficacy and safety study ontraditionally used medicinal plants used to treatrabiesDocumentation of traditional medicalknowledge and preparation of pharmacopoeia120,000 30,00020,000 30,000 100,000Total budget6,021,000 7,906,680 18,420,930 12,895,374 1,323,436Performance Measure -4: Number of studies on Clinical trials and preventive measuresIdentifying Efficacy study of bed net and insecticide on1,000,000appropriate drugs vector controland vaccines for Conduct advanced clinical monitoring 200,000 200,000 200,000therapeutics and Conduct vaccine trial on priority diseases 500,000intervention Conduct drug trial on priority diseases 500,000Conduct clinical trial on formulated plant based 108,929 1,068,429 393,429 168,425 168,425medicines against hypertensionConduct clinical trial on formulated plant based 856,000 941,600 1,035,760 1,139,336 1,253,239medicines against helminticsConduct clinical trial on formulated plant based 1,145,000 1,259,500 1,385,450 1,523,995 1,676,394medicine against malariaTotal budget2,109,929 3,469,529 4,014,639 4,031,756 3,098,058Page 93

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 7: IMPROVE RESEARCH ON HEALTH SYSTEM AND INTERVENTION EVALUATIONPerformance Measure-1: Number of health system/intervention evaluation conductedConduct research on Identify barriers to and opportunities for500,000health system &heath relatedinterventionssuccessful health extension programimplementation at urban, rural and pastoralistcommunitiesMaternal and Child Health (ICCM) 500,000 1,000,000 1,000,000Assessment of health care delivery and qualityof care: Coverage and delivery of ANC services500,000Facility based retrospective study on non 100,000communicable diseaseEvaluate referral system linkage at different200,000levels of health facilitiesIdentify the most effective individual, family400,000and community level interventions forpreventing, treating mental illnessEvaluate the methods to enhance the protection300,000of privacy and confidentiality in health caredelivery.Assess the existing practices of health500,000workforce development and identify the bestapproach.Evaluation on the coverage of vaccination500,000programsStudy on delivery and utilization of rabies250,000vaccineHealth facility assessment 600,000 900,000Basic health supplies tracking and stock500,000management studyAssessment of the health system and policy300,000environment as critical complement to trackingintervention coverage for maternal and childhealthCustomer satisfaction survey at selected health300,000facilitiesTotal budget1200000 3100000 1800000 950000 1300000Page 94

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 8: ENHANCE THE PRODUCTION OF VACCINE, STANDARDIZED PLANT BASED MEDICINES, FOOD PRODUCTS ANDOTHER BIOLOGICAL PRODUCTSPerformance Measure 1: Number of vaccines produced through technological transferProduction of rabiesvaccineProduction ofMeningococcalvaccinesProduction ofPentavalent vaccinesProduce cell culture rabies vaccine for animaland human useMass production of cell culture rabies vaccinesfor animal useMass production of cell culture rabies vaccinesfor human useMass production of Fermi rabies vaccine foranimal useMass production of Fermi rabies vaccine forhuman useProduce trivalent(A,C&W135) MeningococcalvaccinesMass production of trivalent(A,C&W135)Meningococcal vaccines800,000 550,0001,500,000 2,000,000 500,000 1,500,0001,650,000Produce of DTP vaccines 4,600,000 7,000,000 19,900,000 3650000Transfer technologies to produce Hib and Heb 2,300,000 3,200,000 9,000,000Production of antiseraProduce rabies anti-sera 3,600,000 2,700,000 3,600,000 2,450,000 7,400,000for rabiesTotal budget6,900,000 16,850,000 15,200,000 28,250,000 29,350,000Performance Measure 2: Number of vaccines produced from local isolates and anti Snake VenumDeveloping vaccinefrom locallycirculating rabiesvirus strainsDevelopment ofsnake anit- venumfrom locallyavailable snakespeciesGenerate candidate rabies vaccine strain _ 2,000,000 1,000,000 1,000,000 1,000,000Production of snake anti- venum from locallyavailable snake species1,000,0007,000,0001,800,000 1,200,0007,650,000_ 500,000 500,000 500,000 500,000Page 95

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Performance Measure 3: Number of standardized plant based medicines developedProduce plant basedmedicine productsDevelopment of plant based medicine againstmicrobial infection of skin 118,533 64,300 64,300 64,300 64,300for health promotion Development of plant based water clarifying 116,046 177,651 71,536productDevelopment of plant based products against 814,000 838,420 863,572 889,479 916,164livestock skin parasitesDevelopment of plant based mosquito larvicidalTotal budget102,7101,151,289 1,080,371 999,408 953,779 980,464Performance Measure 4: Number of standardized food products developedProduce food Development of food products using less exploited40,000products for health food cropspromotionDevelopment of complementary food for children 60,000Total budget0 40,000 0 60,000 0Performance measure 5: Number of indigenous food technologies documentedDocumentation ofindigenous foodDocumentation of indigenous food of ethnic groups 33,000Total budget33,000 0 0 0 0Performance measure 6: Number of food composition tables and dietary menu developedDevelopment of food Expansion and updating of food composition100,000composition table tableand dietary menus Development of dietary menus for major healthdisorders for institution and individuals20,000 10,000Total budget20,000 10,000 0 100,000 0Page 96

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Performance measure 7: Number of different experimental animals producedProduce different experimental animals 195,000 260,000 325,000 390,000 525,000Production ofdifferentexperimental animalsfor experimentTotal budget195,000 260,000 325,000 390,000 525,000OBJECTIVE 9: IMPROVE PHE EARLY WARNINGPerformance Measure 1: Percent of weekly surveillance reports that are received complete and timely at PHEM-CQuality datamanagementUse of informationtechnologyTOT for surveillance data managers on the88,000 88,000 88,000 88,000 88,000reporting formats and data managementEquip PHEM offices with communication300,000 300,000 300,000 300,000 300,000Avail i reporting formats at all level 500,000 500,000 500,000 500,000 500,000Integrate the weekly reporting with the newHMIS software at woreda level1,000,000 1,000,000 1,000,000 1,000,000 1,000,000Total budget1,888,000 1,888,000 1,888,000 1,888,000 1,888,000OBJECTIVE 10. IMPROVE RISK IDENTIFICATION AND PHE PREPAREDNESSPerformance Measure 1. Percent of threats/ risks mapped and communicated to the Regions and partnersRisk management Vulnerability assessment and risk mapping ofImplement h j prophylaxis bli h l h and prevention i activities145,200 145,200 277,200 277,200 277,200for the risks identified accordingly 66,000 66,000 132,000 132,000 132,000Conduct risk management trainings 168,000 168,000 168,000 168,000 168,000Total budget379,200 379,200 577,200 577,200 577,200Page 97

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Performance Measure 2. Percent of identified risks with EPRP preparedPre-planning Prepare EPRP based on the identified risks 144,000 144,000 144,000 144,000 144,000Prepare the annual national requirement /48,000 48,000 48,000 48,000 48,000i Total budget l192,000 192,000 192,000 192,000 192,000Performance Measure 3. Proportion of PHE with adequate stockpiles of drugs and medical supplies as per the guidelineStockpiling ofresourcesIdentify PHE that require stockpiles of drugsand medical supplies every year - - - - -Stock analysis and identify gaps for those list of- - - - -PHE Secure f the drugs l and medical supplies for the70,700,000 70,700,000 70,700,000 70,700,000 70,700,000idTotalifibudgetd70,700,000 70,700,000 70,700,000 70,700,000 70,700,000Performance Measure 4. Proportion of PHE specific guidelines developed and distributedAvail relevantguiding documentsIdentify priority disease that require a detailedand separate guideline and update/prepare the 420,000 420,000 420,000 420,000 420,000Ensure printing and distribution to the RHBs 960,000 960,000 960,000 960,000 960,000Total budget1,380,000 1,380,000 1,380,000 1,380,000 1,380,000Performance Measure 5. Number of health professionals trained on management of public health emergenciesHuman resourcecapacity buildingIn partnership with universities and otherpartners, coordinate the training of Masters 374,800 512,000 904,000 904,000 904,000Train regional PHEM staff on PHE including 1,148,000 1,120,000 1,040,000 1,040,000 1,040,000id liTotal budget1,522,800 1,632,000 1,944,000 1,944,000 1,944,000Page 98

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 11: Enhance Laboratory Quality System and Standardize LabortoriesPerformance Measure – 1: Number of developed and revised guidelines, manuals and format typesDevelop and reviselaboratory qualityEQA guidelines for integrated diseases(malaria, HIV, TB, …) 10000 10000 10000 10000 10000system guidelines, Laboratory quality manual 9000 9000 9000 9000 9000manual, standardsLaboratory referral linkage manualand formats9000 9000 9000SOPs, Job aids, Reporting and recording17000 20000 23000 26000 29000formats for HIV, TB, Malaria, etc… diseases(assumption: 7 packages for different diseases)Establishment of Establish accreditation body 90,000 20,000 20,000 20,000 25,000accreditation body Develop and revise accreditation standards 4000 2000 3000 2000 2000Standardizing Need assessment and prioritization of lab3000 3000 3000 4000 4000trainingstrainingsDevelop/revise training curriculum and3000 3000 3000 4000 5000Develop/revise d l training guidelines 3000 4000Total budget145000 70000 80000 79000 93000Performance Measure-2. Number of laboratories with standard data management systemEstablishing datamanagementsystemDevelop and distribute database for EQA,training and equipment maintenance to 3,000 4,000 4,000 4,000 4,000Establish Lab Information System (LIS)software for hospital laboratories 1,000,000 1,000,000 1,250,000 1,500,000 2,000,000Total budget1,003,000 1,004,000 1,254,000 1,504,000 2,004,000Performance Measure-3. Number of laboratories evaluated with External Quality Assessment SchemeIncreaselaboratoriesparticipated in EQAImporting and distributing panel samples ofdifferent tests to laboratories250,000 250,000 250,000 250,000 250,000Preparation of different test panel types30,000 35,000 35,000 40,000 40,000Supportive supervision of EQA participatinglaboratories 20,000 20,000 25,000 25,000 25,000Total budget300,000 305,000 310,000 315,000 315,000Page 99

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 12: IMPROVE THE DIAGNOSTIC CAPACITY OF LABORATORIESPerformance Measure-1. Number of enabled laboratories to provide special and referral servicesEnablinglaboratories toperform special andreferral testsProviding ART machines to Health centres 10,573,250 10,573,250 7048833 5286625 3524416Enabling central, regional and federallaboratories to perform referral tests (TB liquidculture, viral load, DNA PCR, epidemic pronedisease diagnosis…) 210,000 90,000 90,000 60,000 60,000Enabling regional laboratories to implementREQAS for the laboratories at their region 70000 30000 20000 10000 0Total budget10,853,250 10,693,250 7,158,833 5,356,625 3,584,416Performance Measure -2: Proportion of health facilities linked to referral laboratoriesStrengthening300000 375000 400000 475000 500000referral linkageStrengthen laboratories with laboratorynetworking (Logistic and IT technology: Fax,Mapping of I health facility ) laboratories forf Total l (GIS) budgetPerformance Measure -3: Number of trained personnelConductingprioritized trainingsTraining of laboratory personnel on integrateddisease diagnosisTraining of laboratory manager/supervisors onlaboratory managementTraining of laboratory personnel on qualitymanagement systemTraining of laboratory personnel on equipmentpreventive maintenanceIn-service training of biomedical engineers onthe currently available integrated laboratoryservice equipment (n=11 regions including the2 administrative cities)Training of laboratory personnel on specializedtests like viral load and DNA PCR150000 190000 200000 0 0450000 565000 600000 475000 50000025500 30000 36000 39000 4050025500 30000 36000 39000 4050030000 36000 42000 48000 6000025500 30000 36000 39000 405006000 9000 12000 12000 120006000 6900 7200 7200 7500Training on epidemic prone diseases 25500 30000 36000 39000 40500Training on gap analysis and comprehensive 25500 30000 36000 39000 40500accreditation support of laboratoriesPage 100

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Training on microbiological diagnosis (culture& sensitivity)In-service training of laboratory personnel onoccupational health and safetyTraining on laboratory sample handling andtransportationRegular coaching and supervision of in-servicetrainings at regions81,000 85,000 90,000 95,000 100,00025500 30000 36000 39000 40500183,000 183,000 183,000 183,000 183,0001800 2400 3300 3300 3300Pre-service training on ART monitoring and 2,800,000 2,800,000 2,800,000 2,800,000 2,800,000integrated disease diagnosis for 5UniversitiesTraining on TB liquid culture 68,000 70,000 70,000 70,000 70,000ToT training on ILED microscopy (for TB, 142,500 45,000 45,000 45,000 45,000malaria and others diagnosis)Total budget3260800 502300 553500 582500 608800Performance Measure -4: Proportion of laboratories getting maintenance servicesProvision ofmaintenance servicesfor laboratoriesResponse to service and maintenancerequirements of laboratoriesPreventive equipment maintenance oflaboratoriesService agreements with manufacturers/vendorsfor automated analyzers4500 3000Establish regional maintenance centres450000 180000Total budget1459500 1288500 1216050 1337655 1471421Performance Measure -5: Proportion of preventive maintenance services providedProvision of Provision of preventive maintenance (PM)maintenance services services to major lab equipments 10000 17500 30000 35000 45000Total budget10000 17500 30000 35000 45000Performance Measure-6. Number of iodized salt quality control laboratories strengthenedStrengthen publichealth laboratoriesfor iodized saltquality controlEnabling public health laboratories to controlthe quality of iodized saltTotal budget1005000 1105500 1216050 1337655 1471421212,052 248,487 50,000 50,000212,052 248,487 50,000 50,000Page 101

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE13: IMPROVE EFFICIENT MOBILIZATION AND UTILIZATION OF RESOURCESPerformance Measure -1. Proportion of mobilized resources as per planEstablish efficientresourcemobilization systemEstablish efficientprocurement systemEstablish EmergencyResponse Fund(ERF)Regulatingimplementation of allactivities of theInstituteMobilization of resources for research andtechnology transfer _ _ _ _ _Mobilization of resource for Public healthemergency management_ _ _ _ _Mobilization of resources for public healthlaboratory service _ _ _ _ _Mobilization of resources for managementand leadership _ _ _ _ _Install finance software 700,000Develop operational annual procurement plan_ _ _ _ _Establishing stock data base 100,000Prepare and revise purchasing guidelines _ _Legislate the establishment of the ERF_Preparation of utilization SOP _ 60,000 _ _ _Secure the fundTotal budgetPerformance Measure -2: Proportion of complaint performanceConduct audit and inspectionConduct anti-corruption follow upRegulate legal compliance of activities_ _ _ _ _800000 60000 0 0 0_ _ _ _ __ _ _ _ __ _ _ _ _Page 102

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 14: IMPROVE HUMAN RESOURCE MANAGMENTPerformance Measure -1. Proportion of employee developed with Long and Short term training programsDevelopingprofessionals withlong and short termtrainingNumber of Employees trained in MSc(MPH, MD+ MPH, MA) and PhD Programs2,250,000 3,415,331 4,090,331 3,265,331 1,840,331Train Employees with Short Term TrainingPrograms 4,340,000 4,340,000 5,425,000 5,425,000 5,425,000Total budgetPerformance Measure -2. Number of Employees RecruitedReview Career Structure6,590,000 7,755,331 9,515,331 8,690,331 7,265,331Filling Vacancies Recruiting Employees as per the request 40,000 40,000 40,000 40,000 40,000with EmployeesTotal budget40,000 40,000 40,000 40,000 40,000Performance measure 3: Proportion of employees retainedRetaining the skilledmanpower’s in theinstituteProduce and implement Incentive guideline _ __Expand Transport Service coverage _ _ _ _ _Continue existing canteen subsidy _ _ _ _ _Construct Sport and other healthy recreational _ _ _ _ _facilitiesTotal budget_ _ _ _ _Page 103

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 15: IMPROVE PROJECT MANAGEMENT SYSTEMPerformance Measure 1. Proportion of researches with public health relevanceEvaluating theScientific andEthical standards ofresearchesPublic healthoriented researchprojectsEstablishingpartnershipScientific and ethical proposals submittedaccording to the standards set by SERO _ _ _ _ _Follow-up of scientific and ethical progress ofresearch projects _ _ _ _ _Prioritize projects with public health researchagenda_ _ _ _ _Performance Measure 2: Number of National and international research partnership establishedEstablishing partnership/collaborative researchactivitiesTotal budgetPerformance measure 3: Number of Monitoring conductedMonitoring researchprojects, laboratoryservice and PHEMactivities400,000 400,000 400,000 400,000Conduct quarterly monitoring of projects _ _ _ _ _Conduct Suportive Supervision(SS) 90,000 90,000 100,000 100,000 100,000Conduct annual review meeting 200,000 200,000 200,000 200,000 200,000Total budgetPerformance measure 4: Number of Evaluation conductedConduct the process evaluation of the institute 5years’ SPMEvaluation ofresearch projects,laboratory serviceand PHEM activitiesConduct the summative evaluation of theinstitute 5 years’ SPM200,000400,000Total budget200,000 400,000Page 104

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007OBJECTIVE 16: Strengthen the capacity of technical facilitiesPerformance Measure 1. Number of developed technical capacity for vaccine productionVaccine productioncapacity buildingDevelop quality-control lab for vaccineproduction 630,000Develop vaccine production facilities forMeningitis 2,000,000Develop vaccine production facilities for DTP2,000,000Develop vaccine production facilities for Hiband HeB 2,000,000Total budget630,000 2,000,000 2,000,000 0 2,000,000Performance Measure 2. Number of developed National capacity for biological ProductsDevelopment ofbiological productsfor diagnosis andinterventionTransfer biological products productiontechnology 500,000 500,000 500,000 500,000Partnership with international with appropriatecompanies 200,000 200,000 200,000 200,000Total budget700,000 700,000 700,000 700,000Performance Measure 3. Number of developed national databaseDeveloping technical Establishing research databasefacilitiesEstablishing public health laboratory databaseEstablishing Public health emergencymanagement databaseTotal budget____ _ _ _ _Page 105

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Performance measure 4: Number of developed technical facilitiesEstablish emergency Equip the EOC with IT and communicationoperation centre tools needed(EOC)3,430,000 - - - 3,430,000Build technicalfacilitiesEnsure the full functionality of the EOC 100,000 100,000 100,000 100,000 100,000Strengthening institutional web-site30,000Improve library service_Building training facility_Building laboratory animal breeding facilities210,000Strengthening of herbarium , botanical gardenand conservation of medicinal plants700,000Buildingoccupational BiosafetysystemStrengthening and equipping of Insectaries500,000Building stock ware-house 500,000Strengthen laboratory safety system30,000 30,000 30,000 30,000 30,000Build safe laboratory sewerage system 500,000Develop dangerous chemical disposal system 500,000Total budgetPerformance Measure -5. Number of developed research outcomes dissemination systemDevelop research Development of a scientific journal of the500,000dissemination tools institutePublish scientific newsletter_ _ _ _ _Total budgetPage 106

InitiativesContent/activityRequired Budget (Birr)2003 2004 2005 2006 2007Objective-17. Enhance coordination and collaborationPerformance Measure 1. Proportion of PHEM stakeholders involved in at least 9 of the monthly meetings of the PHEMTTFStrong coordinationand collaborationEstablish multidisciplinary coordinating team(PHEM TTF) to handle PHE - - - - -Prepare TOR for the taskforce - - - - -Conduct monthly meetings to review activities21,600 21,600 21,600 21,600 21,600Sign memorandum of understanding with keystakeholders- - - - -Total budget21600 21600 21600 21600 21600Performance Measure 2: Number of national and international research partnership establishedEstablishingpartnershipEstablishing partnership/collaborativeresearch activities - - - - -Performance measure 3: Proportion of research partnership maintainedMaintainingpartnershipsMaintaining national and international researchpartnerships- - - - -Page 107

12. AppendicesAppendix-I. Detail SWOT and PEST analysisInternal environmentFactors Strength WeaknessMANAGEMENTOrganizational structureOrganizational structure is nowprocess based through BPR andffImplementation is slowStrategic plan Available Not implementedProcesses, systems and Procedures• Planning Exist Poor implementation• M&E Exist Poor implementation• Reporting Exist Focus on activities only and poorly organized• MIS and transparency Exist weak• Mandate Exist No clear mandate• Delegation Exist Inadequate delegation• Empowerment Exist No empowermentHUMAN RESOURCES• Skill Exist Limited• Availability of qualified Exist Limited high level professionals• Values, attitudes and Existweak• l Physical workGoodPoor waste disposal system, limited occupationalenvironmentsafety etc• Staff development Career structure, training, Inadequate training opportunity promotionalprocedures108

Factors Strength Weakness• Performance appraisal Exists Poor implementation & discriminatory• Salary and benefit Exists Salary scale: wide gap (administrationVs scientific)• Staff retention Exists Benefit: Limited (Serious brain drainand turn over)FINANCIAL RESOURCES• Financial control and budgeting Compatible with the government system Under/over estimation of budget lines• Budget utilization Fairly good Inadequate utilization• Adequacy of financial resources Exist Not adequate• Monitoring and evaluation Exist InefficientPHYSICAL FACILITY• Offices /labs Exist Inadequate• Transport and logistics Exist Inadequate• Communications Adequate Under utilizationRESEARCH ACTIVITIES AND SERVICE DELIVERY• Adequacy Limited Inadequate in scope• Users satisfaction Efficient in service delivery Users need not fully met• Efficiency and innovation for ExistsLimited calibre in researchimprovement• Complaint handling system Exists Inefficient• Collaboration Exists Limited National and International109

External environment (PEST)FACTORS OPPORTUNITIES THREATSPOLITICALGovernment policiesRegionalizationDonors policyECONOMICGDPNatural and manmadedisasterGlobalizationSOCIALBeliefs and values of thecommunityTECHNOLOGYCommunicationsLaboratory equipmentand suppliesAvailability of policies in:• National health and drug• Science and Technology• Capacity Development and Rural DevelopmentRegional Health Bureau and Decentralization willstrengthen research, epidemic containment and publichealth laboratory net workThe government encourages donors.Resource availability for capacity building in healthresearchIncrease in GDP favours investment in health andnutrition researchNoneEnhancement of knowledge and technologies for furtherquality serviceIncrease competitionStrong positive attitude towards the InstituteAvailability of modern and ever improving informationtechnologyAvailability of state of the art laboratory facility atdifferent levels• Regulations emanating frompolicies are not fully in placeInadequate capacity at regional level.Most funds are donor driven rather thandemand drivenDependencyDecline in GDP reduces investment inhealth and nutrition researchIncreased mortality and morbiditydecreased allocation resourcesStaff attritionFast spread of infectious of diseaseOver expectationCost incurred on advanced technologyEver increasing cost of equipment andsupplies110

Appendix-II. Stakeholder and collaborator analysisStake holder Stake holder expectation Likely reaction and impactif expectation is not metBoard and To achieve institutional goal Change management andseniorrestructuring to improvemanagementperformanceEHNRI staffGeneral publicCapacity building , conduciveworking environment, andmotivationQuality, expanded and affordableservices (diagnostic/analytic,consultancy, trainingPoor staff performanceStaff attrition,Low institutionalperformanceLoss of credibility of theInstituteInstitutional response-Implement in accordancewith the directive of theBoard of Directors-Assess the situation andtake appropriate correctivemeasures-Design an appropriatehuman resourcemanagement system andcapacity building of staff.-Modify/re-plan.-Put in place transparencyand accountability-Creating conduciveworking environment andattractive career structure,recognition to meritoriousindividualsSituation analysis andtaking appropriate actionReliable information on majorhealth and nutrition problemsEarly detection and timelyresponse of public healthemergenciesFMOH/Quality and expanded laboratoryservice and productsReliable information on majorhealth and nutrition problemsEarly detection and timelyresponse of public healthemergenciesQuality and expanded laboratoryservice and productsAdherence to the rules for theregulation of effective, safe andquality herbal products.-Strengthening of Regionaland Specialized Hospitalslaboratories will behampered and services willbe poor-Policy relevant evidencebased information will belimited-Increased incidence ofdiseases, disease outbreaksand malnutrition-FMOH will take correctivemeasures-Reject registration andrecognition of products ofherbal remedies-Undertake situationassessment and takecorrective measures111

Stake holderStake holderexpectationLikely reaction and impact ifexpectation is not metInstitutional responseRHBMinistry ofEducationMinistry ofAgricultureTechnical assistance andcollaborative researchResearch collaborationand teaching in higherlearning institutions-Evidence basedinformation on diseaseepidemics (malaria etc.)and nutrition-Collaboration oncommon interests likezoonotic diseases,nutrition issues andpublic health emergencymanagement-Poor performance of health andnutritional service at regional level-Inefficient public health emergencymanagement-Loss of credibility on EHNRI andappeal to appropriate body for action-Poor quality research performance andcollaboration-Poor human resource development-Loss of credibility-Inefficient public health emergencyresponse such as zoonotic diseases,malaria epidemics and nutritionalemergencies-Loss of credibility on EHNRI and appealto appropriate body for action-Improve workingrelationship andcommunication-Readjust and takeappropriate measure-Improve workingrelationship andcommunication-Promote and improvecollaboration andcommunication.MOFEDMOSTGovernmentCommunicationAgencyTraditionalmedicinepractitioners-Timely report onfinance utilization-Proper planning, financeutilization-Adherence to scientificand ethical standards inbiomedical research-Compliance to nationalintellectual propertyright rules and guidelinesEvidence basedinformation-Scientific evaluation oftraditional medicine andtherapies-Negative implication on budgetallocation-Rejection and/or pending of researchproposals (financial support)-Creativity and innovation will beaffected-Under utilization of research outcomes-The Institute will be held responsible-The public would be exposed topreventable health problems-Loss of interest and trust to collaboratewith the Institute-Loss of the indigenous knowledge-Increase in the number of quacktraditional healers, mal practice andremedies of poor quality, un safe andless or ineffective remedies may beemployed by the healers.Loss of interest on the traditionalmedicine by the public-Proper utilization ofallocated fund.-Taking correctivemeasures with regard tobudget utilization-Strengthen in-houseresearch and ethicalclearance committee-Compliance with theIPR, ethical guidelinesand standardsProvide timely andreliable information112

Appendix-III. Collaborators and area of collaborationsCollaboratorsFunding Agencies(CDC,WHO,GF,WB,UNICEF,UNDP,Etc)Currentstatus ofcollaborationExistsFields of collaboration-Build/upgrade Institutionalimplementation capacity-Joint researchRelative advantageCapacity buildingIBC Existing Joint research on medicinal plants -Get new experience on exandin-situ conservation, ----genetic diversity ofmedicinal plants, field genebankMOAD Existing Joint research on ethno-veterinarymedicine, human nutrition andpublic health emergencymanagementGet new experience,nutritional value ofimproved variety foodcrops and better emergencymanagementILRI future Joint research Information generationNVI Existing Joint research and exchange oftechnical expertise on vaccinesAHRI Existing Joint research and exchange oftechnical expertiseRed Cross Society of Ethiopia Existing Joint research, quality control andemergency responseFaith based organizations future Information on health andnutritionMinistry of water resources Existing Research collaboration , laboratoryservices, evidence basedinformationEARI, MOAD, ICB (Biodiversity),EORI (Essential oil researchinstitute) School of Pharmacy,School of Public Health, Facultyof Medicine, Faculty of Science(Chemistry and Biology depts.and National herbarium),Faculty of Veterinary Medicine,AAUNewJoint research on ethno-veterinarymedicine, human nutritionMinistry of Defence Existing Emergency management,laboratory services and trainingMinistry of Trade & Industry, Existingfood industriesResearch collaboration andlaboratory testing of industrialfood productsKnowledge and experiencesharingKnowledge and experiencesharingInformation generation,supportive serviceAwareness creationSafe water supply, Diseaseprevention and control,Timely meteorologicalInformationGet new experience,nutritional value ofimproved variety foodcropsLogistical supportAvailability of researchmaterials and relevantinformation113

CollaboratorsCivic and professionalassociationsCurrentstatus ofcollaborationFutureFields of collaborationResearch collaboration andevidence based informationRelative advantageAwareness creation andcapacity buildingPrivate health institutions Future Research collaboration andevidence based information,laboratory services, informationexchangeEPA Future Research collaboration andevidence based information,laboratory servicesHealth informationexchange and health caredeliveryEnvironmental informationexchangeTraditional practitioners Existing Research collaboration Knowledge transferNGOs Future Collaborative research, serviceand fundingInformation generation andaccess to remote areasInternational universities andresearch institutionsExistingResearch collaboration andfundingCapacity building114

Appendix IV. Participants of the strategic planning processA. Name and address of participants of Stakeholder Review Meeting that discussed on thedraft Five –Year Strategic Plan /2010-2015/ held in Dire International Hotel, Adama, Ethiopiafrom May 10 to 12, 2010No Name Organization1. Abebe Bekele EHNRI2. Abel W/tensay EHNRI3. Abel Yeshanneh EHNRI4. Abiyot Bekele EHNRI5. Abraham Ali,Dr EHNRI6. Addis Mulugeta UCSD-E7. Addis Teshome EHNRI8. Adugna Woyessa EHNRI9. Alemayehu Abate EHNRI10. Alemayehu Nigatu SCMS11. Almaz Abebe, Dr EHNRI12. Almaz Merdekrose UNIEF13. Amaha Kebede, Dr EHNRI14. Amare G/Yesus, Colonel MOD15. Arega Zeru EHNRI16. Aregash Samuel EHNRI17. Asefa Deresa, Dr EHNRI18. Aseged Woldu, Dr EHNRI19. Asmamaw Guta Mot20. Ato Wondwossen Girmay Bilogical Society of Eth.21. Ato Tadesse Nigatu EHNRI22. Berekat H/giorgis, Dr ICAP115

No Name Organization23. Berhane Beyene EHNRI24. Betru Tekle, Dr HAPCO25. Cherinet Aboye, Dr EHNRI26. Dadai Jima, Dr EHNRI27. Derege Teshome EHNRI28. Desta Kassa EHNRI29. Dilnesaw Zera EHNRI30. Dr Akram Eham WHO31. Elias Asfaw EHNRI32. Endashzw Shsro SNND RHB33. Endris Mohammed EHNRI34. Esayas Gelaye NUI35. Eshetu Lemma, Dr EHNRI36. Fikadu Mindaye MOTI37. Fikrewold Haddis EPHA38. Firdu Egi EHNRI39. Gemechu Haile EHNRI40. Getachew Addis,Dr EHNRI41. Getachew Belay EHNRI42. Gezahegn Tesfaye Malaria Consortium43. Giorgio Rosaeio FIND44. Gonfa Ayana EHNRI45. Gudeta Tibosso, Dr EHNRI46. Habtamu Fufa EHNRI47. Haftom Mamo EHNRI116

No Name Organization48. Hussein Mohammed EHNRI49. Hussien Faris EHNRI50. Isreal Tareke, Dr WHO51. Kekbessa Urga EHNRI52. Kisse Mudie EHNRI53. Mamuye Hadis, Dr EHNRI54. Markos Abebe, Dr AHRI55. Meaza Dmissie ACTPH56. Mekbebe Getahune EHNRI57. Mekdes Gebeyehu MSH-TBCAP58. Mekdes Mebea Chemical Society Eth.59. Mekonnen G/Selassie, Dr A.A Health Bureau60. Mekonnen Tesfamariam CRS Ethiopia61. Melese Abdesa AAU(FSCN)62. Melke Tadesse EHNRI63. Mengistu Kefele EHNRI64. Milka Theodros FMO,MSD65. Mulalem Agonafer EHNRI66. Negero Gemeda EHNRI67. Negussie, Dr MSH68. Ralegn Howe, Dr HHRI69. Solomon Shiferaw SPH-AAU70. Solomon shimeles EHNRI71. Solomon Zewdu, Dr THU72. Tehaynesh Messel, Dr EHNRI117

No Name Organization73. Tesfaye Hailu EHNRI74. Teshaynesh Elias EHNRI75. Teyay Abrele ICAP76. Tilahun Muchie EHNRI77. Workenesh Ayele, Dr EHNRI78. Wubshet Mamo I-TECH79. Yenew kebede CDC80. Zenebech Adella EHNRIB. Strategic Plan Development Team Members1. Dr. Eshetu Lemma /Scientific and Ethical Review Office/2. Ato Arega Zeru /Plan, Finance and Monitoring & Evaluation Directorate/3. Ato Addis Teshome/ Plan, Finance and Monitoring & Evaluation Directorate /4. Ato Elias Asfaw / Plan, Finance and Monitoring & Evaluation Directorate /5. Ato Hussien Faris /Plan, Finance and Monitoring & Evaluation Directorate/6. Dr. Belete Tegbaru /Infectious and Non-infectious Diseases Research Directorate/7. W/ro Aregash Samuel /Food and Nutrition Research Directorate/8. Dr. Getachew Hadis /Traditional Medicine and Modern Drug Research Directorate/9. Ato Getachew Belay /Laboratory Capacity Building Directorate/10. Ato Haftom Taame /Public Health Emergency Management/11. Ato Abiyot Bekele /Public Health Emergency Management/118