The Ethiopian Health Sector Transformation Plan II

Submitted by admin on Wed, 10/16/2019 - 11:13

 

downlaod

 

 

Panel discussion on success, challenges during implementation of HSTP I and way forwards for next (HSTP II)

Panels present their suggestion based based on WHO 6 Building Block

  1.  Health delivery system

              Success

  • Success stories in background on HSDP I , the health sector decided to conduct situational analysis and come up on the following major areas to address critically  
  1. Health Proportion and diseases prevention
  2. Access to health Services was the critical issues that need to address while developing HSDP I strategic plan – this was due to low service utilization and low access to health facility.
  •  As a result of that different health facilities were constructed, very good health promotion and diseases prevention activities had done at community level,
  • Taking experience from global experience and used to improve health of the community , through time accessibility improved but
  • Quality of care remained low, then established mechanisms to improve through giving focus for Health professionals, HR and infrastructure
  • Availability of water, electric supply which can say anatomy has tried to improve
  • Capacity has tried to improve through introducing different modalities (Pre-service and in-service training)
  • Revisited of  curriculums to strengthen accessibility of basic service,

 

Challenges  

      • Ambitious plan – frustrates the workforce
      • Environmental Health and sanitation at community level  very  bad compare to other countries
      • In adequate service network at each level
      • Inadequate interaction between RHBs and Federal ministry of health
      • Still gap in evidence generation and utilization

Recommendation

      • Other revolution should be done to improve service to community level
      • Contribution of nurses and MD at community level should be needed to improve/ this can help the effort of HEWs
      • Recognition of performance in terms of financial, training, etc. of HEWs should be strengthen
      • Improve service network both vertical and horizontal level
      • Interaction among RHBs and Federal should need further strengthen
      • Evidence generation and utilization should be needed to optimize
      • Focus should be given for health education/participation
      • Transform Health post to provide primary health care
      • Ensure equity of service through conducting analysis at each level of health system
      • Identification of vulnerability  at each areas

 

  1.  Health work force

   Success

  1. Improved  access to professionals
  2. Massive expansion of health professional training institutions
  3. Workforce density is increased from  time to time

Challenges

      • Low quality work forces /pre-service education  should need to improve
      • Train of professionals without  demand of health system
      • Inadequate commitment of some professionals & unemployment
      • Still inadequate number of health health workers
      • Low efficiency of  health workforce
      • Inadequate monitoring of  individual performance

Recommendation

      • Increase number of  health workforce
      • Enhance efficiency of the health workforce
      • Design better mechanism to monitor performance of  employees
      • Prioritize workforce for next training
      • Improve distribution of manpower next time and motivated competent workforce
      • Identify most important stakeholders, barriers in ensuring competent work forces
      • Carrier of health professionals should be needed  to address on next strategic plan 
      • Clinical education should be improve
      • Strengthen Regulation , standards, external enforcement, private sector accreditation

Proper addressing of  community priorities

      • Design mechanism for frequent assessment of the professional satisfaction

 

  1. Health Care financing

  Success

  • Progress monitoring of  National Health Account is very good
  • Tried to Consider financial requirement for setting targets
  • Relatively increase total health expenditure though not reached to the expected level
  • Out pocket contribution still show some improvement when compare with previous one
  • Established Community Based Health insurance

Challenges

      • Ambition plan
      • In adequate Government expenditure health expenditure
      • Insufficient to identify gain from allocated budget
      • Still high level of out of pocket expenditure
      • Inadequate involvement of  private sector

Recommendation

  • Additional financial protection strategic should be in place
  • Design a mechanism to minimize out of pocket expenditure
  • Improve financial allocation to health care
  • Contribution of government should be increased to ensure the Declaration Of Abuja
  • Social Health insurance should also be in place
  • Outsource for  certain services
  • Improve involvement of community
  • Strengthen CBHIS  and revenue utilization

 

  1. Governance

Success

  • Lots of success stories in the last 15 -20 yrs. On the Dimensions of governance by WHO, evidence and regulations,
  • Global commitments contributed for having good governance in Ethiopia
  • Capacity building on strategies development, policy formulation, integration of plan with different stakeholder
  • Very good experiences on planning approach and can be used as an experiences by  different countries
  • Various reforming has done to improve the performance to health sector
  • Good plat forma for relationship among each level of the health system
  • Have good initiation to strengthen community ownership .

Challenges

      • High staff turnovers at each level of health system
      • Inadequate Multi-sectorial contribution / poor involvement of other sectors
      • Have Double standards
      • Poor  evidence for decision making
      •  

Recommendation

      • Further strengthening community ownership using different mechanisms
      • Strengthen already established system
      • Maintain staffs at each level of health system
      • Multi- sectorial l  approach should need revitalize – authority clarification
      • Strengthen Legal framework
      • Avoided double standards should be avoided
      • Further strengthening community ownership using different mechanisms
      • Assessment of governance of health system should be conducted in the country
      • Functionality of JSC and other consultancy programmers
      • Review and revise the mandate of each level if necessary
      • Mechanism to improve participation of privates sectors
      • Critical thinking on implementation of multi-sectoral collaboration 
      • Data use at point of connection remains a challenge – need to continue the information revolution and access data to decision makers should need to check
      • Strengthen digitalization of data at all level 

 

  1. Logistic management & Technology

Success

  1. Huge improvement in logistic and human resource
  2. Improve in terms of importers but not fulfill to the demand of community
  3. Increases number of local manufacturing and professionals
  4. Improve in access to essential drugs
  5. Introduce long term contract Agremment
  6. APTS services
  7. Supply chain and regulatory mechanisms

Challenges

  • In adequate availability of supplies
  • Low Information synthesis and utilization
  • Low access to financial for pharmaceutical procurement
  • Low Workforce in r/s to this areas
  • Inadequate capacity in regulation
  • Inadequate Scale up pharmaceutical services
  • Local manufacturing
  • Responsibility -  Inadequate performance
  • Community pharmacy

Recommendation

  • Enhance quality Management
  • Strengthen leadership capacity
  • Strengthen regulatory services
  • Strengthen emergency preparedness and  response’s and minimize wastage
  • Medical equipment maintenance center