Southern Ethiopia - Gwent Health Link

Memorandum of Understanding to develop three Exemplar Health centres

The exemplar health centre project is in line with the link's philosophy of improving health care provision in rural communities and relates to the Millennium Development Goals as well as the Ethiopian Government's health sector strategic plan. Following earlier visits in November 2007 the link, along with our Ethiopian partners, identified three health centres in the SNNPR region of Ethiopia. The health centres at Wondo-Genet, Alaba and Yirgacheffee each serves a rural population of over 100,000. The link again visited these health centres in March 2008 and organized meeting at each health centre between the link members; health centre staff; woreda health office; community members including local Mayor, women’s group and religious group leaders to discuss obstacles in improving health care provision for the community. A 'memorandum of understanding' was signed by all the parties to this effect.

The link also agreed with all the groups about exemplar standards for the health centres which included improving availability of services, well resourced health centre with skilled staff, clean welcoming environment, privacy and dignity for the patients.

Monitoring and evaluation at the health centres

The key questions and ones that are difficult to answer for any link are: 'Does the work of the Link make any difference?  What is realistic?'   The problems are great and our Link is rightly confining itself to taking small measures. Outcomes are difficult to measure and it is also difficult to attribute specific outcomes/positive changes to the work of the Link in isolation to other factors. In 2008 with support from THET our link has started a formal evaluation and monitoring in the three exemplar health centres. Monitoring and evaluation are carried out in establishing the extent to which training, resources and equipment had been used thus far and with what impact; defining simple baselines and use the outcomes of the evaluation to identify ‘next steps’ for ongoing work with colleagues in the health centres, particularly in relation to exemplar standards.

A healthcare worker in each Health Centre has begun to collect evaluation data on a weekly basis and reports to a co-ordinator in Ethiopia monthly. This information is then shared with the Gwent team via e-mail or post. The link members, during their visits to the health centres, checks the records in the health centre for accuracy with the monitoring team. So far the evidence shows that the Link is using the right methods to achieve its goals and achieving them with varying degrees of success. It is early days for the Exemplar Health Centre project but the emphasis on partnership is particularly strong and valued by all parties. This is perceived to be a great strength of the Link and one that will be essential to taking the work forward and achieving the outcomes of improvement.

Reflection workshop and questionnaires

In 2008 a reflection workshop was arranged in Gwent for the link members to look back the links progress and activities over the years and learn from this. Subsequently during November visit these reflection questionnaires were also given to the link members in Ethiopia. Responses received so far have been very positive.