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I-TECH Collaborates with Africa CDC to Enhance Public Health Informatics Capacity

Post categories: DIGI Ethiopia Health Information Systems Kenya Nancy Puttkammer Uncategorized Zambia
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From left to right: Bonheur Dounebaine, Senior Technical Officer for Public Health Workforce Development at Africa CDC; Anne Njoroge; Nancy Puttkammer; and Robert Oboko. Photo credit: DIGI/UW

In partnership with PATH, the International Training and Education Center for Health (I-TECH) and Digital Initiatives Group at I-TECH (DIGI) at the University of Washington (UW), are providing technical assistance to the Africa Center for Disease Control and Prevention’s (Africa CDC) African Epidemic Service Public Health Informatics (AES-PHI) Fellowship.

The two-year fellowship will gather mid-career professionals working in computer science, information systems or public health  practice. Fifteen African fellows will be selected for the first cohort after a call for applications from Africa CDC.

“If recent epidemics of COVID-19, cholera, and mpox have taught us anything, it’s that diseases can easily cross borders and that decision makers and heath leaders in every country need information at their fingertips that allows them to take action to protect the health of their populations,” said Dr. Puttkammer.

“We need data systems that are robust, based on standards, that collect timely and accurate data and allow for the integration and visualization of these data so that it can feed into public health decision making,” she continued. “To get there, we first need the people who can lead and manage these systems.”

The AES-PHI fellowship is a part of three tracks: applied field epidemiology, public health informatics, and leadership in laboratory science. These fields are critically important to respond to both epidemics within countries and pandemics that cross borders—the fellowship will address working across these disciplines so that the best information can be brought to bear in solving public health challenges.

The PHI curriculum includes topics such as data collection methods, data systems, interoperability, data science and machine learning. The innovative training model is 80% practical and 20% instructional, delivered through virtual sessions and in-person training at Africa CDC in Addis Ababa, Ethiopia. Practical learning intervals will be hosted at designated sites, including in Democratic Republic of the Congo, Kenya, Morocco, Senegal, and Zambia. Each fellow will be placed within a national health institute or ministry of health and have opportunities to apply their learning in practice.

The fellowship structure and curriculum are built on a series of consultative planning workshops with a Technical Advisory Group (TAG) convened by Africa CDC. The AES-PHI TAG includes representatives from Africa CDC, the Pan African Health Informatics Association (HELINA), the U.S. Centers for Disease Control and Prevention (CDC), PATH, UW, Resolve to Save Lives, the African Field Epidemiology Network (AFENET), and numerous faculty members from African universities.

“Health informatics is a novel field of study in most African countries,” said Anne Njoroge, project lead for the DIGI/UW team and Africa TAG member. “As such, there is a clear gap in the number of highly skilled health informatics professionals, especially in the public sector. Accelerating the pipeline for these professionals through AES-PHI will be critical for digital transformation of public health in Africa.”

DIGI has worked with the TAG, Africa CDC workforce development team, PATH, and CDC to standardize competencies and develop and validate the AES-PHI curriculum for in-person and virtual learning. DIGI has also supported hosting of the curriculum within Africa CDC’s online learning management system, the AES-PHI application process, faculty recruitment, host site and mentor orientation, and program monitoring and evaluation.

“I have seen such great excitement among my colleagues across the African continent,” said Robert Oboko, faculty in the Department of Computing and Informatics at the University of Nairobi and Africa TAG member. “These trained professionals will lead the way toward strengthening health information systems across the African continent.”

 

Mental Health – A New Challenge for HIV Treatment in Ethiopia

Post categories: Ethiopia Health Systems Strengthening HIV Care and Treatment Mental Health
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I-TECH-supported HIV care and counseling in northern Ethiopia, in 2009. Photo courtesy of Julia Sherburne.

Although HIV patients in Ethiopia have greater access to antiretroviral therapy (ART) than they did a decade ago, ensuring that patients adhere to a full course of ART is still a major challenge. In response, in 2008, the International Training and Education Center for Health (I-TECH) launched a landmark HIV/AIDS Case Management program in several of the country’s regions where HIV prevalence was high.

This project was supported by the U.S. President’s Plan for AIDS Relief (PEPFAR), through the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA).

The goals of the project are to help control the HIV epidemic in Ethiopia, minimize transmission of HIV, and help HIV patients lead healthy lives. The project actively targets and engages patients considered to be likely non-adherents by assessing clinical, nutritional, domestic, and economic indicators. Those at risk of non-adherence are transferred to I-TECH-trained case managers located within ART clinics.

“ART taken for life is a challenge, but missing a few pills can cause a rapid decline in the health of a patient suffering from HIV. A discontinued course of ART will create a resistant strain of HIV that is much more difficult to treat,” says Misti McDowell, former Country Director for I-TECH Ethiopia.

Poor adherence can also mean high risk of transmission in the patient’s community. The Case Management program helps mitigate that risk.

A new screening tool

I-TECH quickly realized that many patients attending adherence counseling sessions were suffering from mental health issues, including depression, anxiety, and substance abuse. It was also understood that many health workers did not have the competencies or skills to adequately engage in conversation with patients about their mental and emotional welfare.

I-TECH formulated a mental-health screening tool for all ART patients to better assist patients with ART adherence and mental health issues.

“Many HIV patients in Ethiopia become overwhelmed by depression, and commit suicide. The mental health component to our work has helped to prevent these outcomes, and manage mental health issues related to HIV diagnosis,” says Dr. Manuel Kassaye, I-TECH’s Care and Treatment Programs Director.

Shared experiences can save lives

In Ethiopia, there are currently only 42 working psychiatrists catering to the needs of an estimated population of 93 million. “The country is in need of a strategy to deliver mental health services to people,” says Dr. Manuel. I-TECH-trained adherence case managers, working in partnership with hospital clinicians, have directly helped to address mental health issues related to HIV in Ethiopia.

The majority of case managers selected and trained by I-TECH have themselves been diagnosed with HIV, ensuring empathic relationships with their patients.

“To be a good adherence support worker, I believe it is necessary to have HIV,” says Mulugojam Yilikal, who was trained as a support worker by I-TECH in 2008. “The case worker will have enough experience to empathize with the patient, to help guide them through their mental and emotional issues.”

She adds that patients feel secure and comfortable talking to people who also have HIV. “By opening up and talking freely with us, it benefits their mental health, and their adherence to taking their medication.”

Mulugojam’s brother tragically committed suicide in 2007, after struggling to come to terms with his HIV diagnosis. “I know that if this support and counseling service [had been] available to my brother, he would have been saved from killing himself,” she says. “If a patient confides to a support worker that they want to take their own life, they can be prevented [from doing so] through counseling.”

Genet Behre, 30, is married and has a 5-year-old son. She discovered her HIV status during a pregnancy check-up in 2009. She immediately started taking ART and reluctantly disclosed the news to her husband—who subsequently left her. Once disclosure is made, there usually follows a period of emotional and mental distress that often leads to household dysfunction. “It was a terrible time when I first found out,” says Genet. “I was very distressed, and came into conflict with family and friends.”

After being screened for mental health, Genet was offered counseling and medical treatment for her depression and anxiety. “After six months, I had stopped fighting with my family,” she says. “My life is now stable again, my home life is peaceful, and I have an income selling injera. The counseling and medical support I receive has helped me to live like ordinary people, and not fear for the future.”

After counseling, new hope

A peer support group has been set up by I-TECH, in which patients have a platform to confide in others and speak openly without fear of being judged. Here, people are encouraged to share personal experiences and coping strategies. The group focuses on helping patients cope with the stigma associated with HIV, and overcome any barriers to ART adherence, including social and economic problems.

Zenabe Teklu, 35, silently sits with her I-TECH trained case manager at Gondar Hospital. Although she barely speaks, she is evidently happy to be in the reassuring company of her mentor. Zenabe had two children who both tragically died within six months of being born. After the departure of her husband in 2007, her mental health started to deteriorate. Then, after developing physical sores in 2007, she was tested for HIV, and promptly joined I-TECH’s case support program. However, between 2007 and 2013, she continued to suffer strong symptoms of mental disturbance and suicidal tendencies.

In 2013, I-TECH introduced the mental health screening service at Gondar Hospital. Up to this point, Zenabe was mistakenly told that her depression and suicidal thoughts were symptoms of ART medication. Zenabe started receiving the correct medication and counseling shortly after hospital staff members had completed I-TECH training in mental health screening.

Zenabe, who currently works as a cotton weaver, is happy to have turned a huge corner in her life with the support of I-TECH: “My life is stable compared to how I was before. I no longer feel full of anger and depression. I have experienced a lot of trauma, but the support I get from my case managers helps me to live a normal life”.

Stories of Success from Ethiopia: Mother’s Support Groups for PMTCT

Post categories: Ethiopia HIV Care and Treatment
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In Mothers’ Support Groups, trained mentors counsel HIV-positive pregnant women and mothers on optimal child-rearing practices and encourage them to adhere to PMTCT programs. Photo courtesy of Julia Sherburne.

The following is the second in a three-part series of I-TECH success stories from Ethiopia.

In Ethiopia, only 24 percent of HIV-positive pregnant women receive antiretroviral therapy (ART) to prevent transmission of the virus to their children (UNICEF, 2012). The importance of counseling for these pregnant women is critical to increase treatment rates and ensure more children are born HIV-free.

In 2009, the International Training & Education Center for Health (I-TECH), with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), began managing support groups for HIV-positive pregnant women and mothers in three regions of Ethiopia: Axum, Gondar, and Dubti.

This case management program, which came to a close at the end of 2014, was the first of its kind in the country, training a group of 63 mentors to counsel pregnant HIV-positive mothers on optimal child-rearing practices and offering psychosocial support to help them adhere to prevention of mother-to-child transmission (PMTCT) programs.

Yirgalem Taye is one of the trained mentors from the Mother’s Support Group based at St. Mary’s Hospital in Axum, Northern Ethiopia.

In addition to urging mothers to follow treatment regimens, “we encourage mothers to give birth in a hospital to reduce the risk of transmission during delivery,” says Yirgalem. “We teach mothers breastfeeding practices, family planning, as well as the importance of disclosure to a partner and the need to get all partners to come and test with us.”

Offering consolation, solidarity, and friendship

Alem Tsehaye sits by a bowl of smoldering frankincense while playing with her 7-month-old baby girl, Heyab.

In 2009, Alem tested HIV-positive, forcing her to change her plan to move abroad and work as a domestic servant. In 2013, she became pregnant, which caused anxiety about the well-being of her child.  She enrolled herself in the Mother’s Support Group at St. Mary’s Hospital and started to receive counseling.

“I learned that it’s possible to be HIV-positive and have a HIV-negative child,” says Alem, “which might not have been possible had I not joined the group.”

Alem notes the consolation and solidarity she derived from spending time with other young mothers in the support group. “If one of us came to the group feeling low, we would build each other up again,” she says. “I have made new friends. Between us we continue sharing the support within the community.”

One of the biggest challenges facing a woman diagnosed with HIV is disclosure to her husband. If a person with HIV status fails to make a disclosure to his or her partner, the uninformed partner becomes a risk to home and community health. One role of a Mother’s Support Group mentor is to mitigate this risk by encouraging group members to inform their partners so that they can be tested without delay.

Real results for child and mother

From 2009 to 2014, nine hundred mothers were enrolled in the mentorship program at Gondar University Hospital. Out of those 900 births, only 72 infants – or 8 percent – tested HIV-positive. The World Health Organization estimates that, in the absence of any intervention, transmission rates can range from 15-45 percent.

Outside the Mother’s Support Group ward at Gondar University Hospital is a courtyard where a group of young mothers sit doting over their babies. Many of these mothers do not have an appointment but have come to see their mentors.

“The mothers love the support and security of this small community group,” says Rachel Birhanu, a mentor. “The mentors attend their children’s birthdays and ceremonies. We have become close. They confide in us and know we are the few people who will listen and not judge them.”

The I-TECH program may have come to an end, but the Mother’s Support Groups are acknowledged for their comprehensive service delivery and for their successful efforts to reduce the number of HIV-positive babies born in Ethiopia – and to increase the productivity and well-being of HIV-positive mothers.

Helen Alebachew has two children. In 2007 she discovered her HIV-positive status after undergoing a test while suffering from tuberculosis. She says she benefited from learning about HIV-friendly family planning practices and coping strategies within the group.

“The solidarity I experienced in the mother’s group saved me from losing my mind,” Helen says while roasting coffee beans in a pan over a small fire.  “After starting ART treatment, I made a fast recovery and was soon living a normal life again.”

Stories of Success from Ethiopia: The Tsadkane Holy Water Well

Post categories: Ethiopia Health Systems Strengthening HIV Care and Treatment
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Samuel Tadessa at the Tsadkane monastery.

Samuel Tadesse found consolation at the Tsadkane monastery, but he saw that more needed to be done.

The following is the first in a three-part series of I-TECH success stories from Ethiopia.

Samuel Tadesse discovered he was infected with HIV in 2004, after undergoing a routine test as part of a U.S. visa application. He spent the next four years feeling utterly hopeless.

Although not a church-going man, Samuel visited one of the country’s largest holy water springs as a last resort: The Tsadkane monastery, located within the Amhara region of Western Ethiopia.

The holy water site is visited daily by up to 5,000 pilgrims, all in search of a cure to their ailments by way of prayer, holy water consumption, and bathing. The majority of these pilgrims are extremely ill, and a large group have been diagnosed with advanced HIV/AIDS.

Samuel immediately experienced consolation and decided to live at the site of the well. However, he soon realized that many of the people living by the well, waiting for a miracle, were dying. He also understood that the strict diet of holy water and a single daily portion of dried barleycorn flour was inadequate nutrition for those who were sick. He resolved to try to improve the welfare of the stricken community.

Samuel’s fundraising efforts, launched at local bus stations, quickly gained momentum, and soon he was able to buy and distribute bread and blankets to the dying pilgrims at Tsadkane. In just a few months, the number of people benefiting from the new funds had grown from 115 to 1,200.

But Samuel knew that blankets, bread, and water were only a short-term solution.

“I realized that many of these people were dying,” says Samuel. “It was frightening because there was no medical care, and I knew many more would die if we did not create a link between the well and a nearby health center.”

So he approached the local Church.

Historically, the relationship between medical science and the Ethiopian Orthodox Christian community — the country’s largest religious group — has been contentious. When the AIDS epidemic began to spread rapidly in Ethiopia, any discussion in favor of antiretroviral treatment (ART) was discouraged. According to the Church, there was only one treatment for HIV patients: faith, prayer, and holy water.

The Church donated a small thatched hut to shelter HIV victims, but despite Samuel’s commitment, he didn’t have the capacity to accommodate the ever-growing numbers.

A Successful I-TECH Partnership

The facilities at Tsadkane

The facilities at Tsadkane provide HIV testing, counseling, treatment, and care.

It wasn’t long before the International Training and Education Center for Health (I-TECH) learned about the growing HIV community living at the Tsadkane holy water site and the urgent need to scale up Samuel’s operation. In response, I-TECH formed a partnership with the Ministry of Health in 2008, based on a commitment to promoting access and adherence to ART as well as providing care and support services for HIV-positive people seeking a holy water cure.

Between 2009 and 2013, with funds made available through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), I-TECH provided more than US$200,000 in support to the shelter. During this period, 1,370 HIV patients were successfully rehabilitated after being brought to the shelter in a critical health state.

“I-TECH was a lifeline for me,” says Samuel. “I was feeling very overwhelmed and frightened at how many people were going to die as a result of limited support to people with HIV. Up to five people a day were dying in my arms.”

With I-TECH support, Samuel was now able to offer and deliver extensive counseling on HIV testing and ART services to the community of people that had gathered in search of his help.  “It was a huge relief” to have I-TECH’s support, says Samuel.

Within a year, the project had sourced a hub of buildings as a base for the rehabilitative shelter 5 kilometers from the holy water site and was accommodating a steady influx of HIV patients. HIV testing, counseling, ART treatment, and care had been made available to the holy well community.

Fighting Stigma and Discrimination

The shelter community is widely recognized for having succeeded in empowering a large HIV community to overcome fear and stigma and reach out for ART.

With the support of I-TECH management and training, the shelter has been one of the few places in Ethiopia to offer rehabilitation and care to those who have been excluded from their family and community because of their HIV status, says Misti McDowell, Country Director for I-TECH Ethiopia.

“Tsadekane has provided support and acceptance to people living with HIV when so many others have rejected them,” she says. “The shelter offers them a safe place to receive health services as well as working with their home communities to reduce stigma and discrimination.”

Strengthening the Community

The bakery at Tsadkane provides nutritious food.

The bakery at Tsadkane supplies both nutritious food and income for patients.

To help patients rehabilitate, I-TECH funded the installation of a bakery, a dairy, a restaurant, and a seed-oil extraction mill to offer income-generating activities. The aim of these activities was to provide economic empowerment and livelihood training for patients so that they could have an active role in their home community.

The Tsadkane shelter also prioritizes the security and welfare of children born to HIV-infected mothers by providing a dormitory, a playground, schooling, and immediate HIV testing of all children entering the shelter.

According to Dr. Manuel Kassaye,I-TECH’s Care and Treatment Programs Director, “I-TECH played a key role in transforming an informal community group into a community-based organization dedicated to increasing access to HIV care services including mental and spiritual health, as well as increasing the number of ART users.”

To help the shelter improve its service delivery, I-TECH conducted an organizational capacity assessment in 2012.

Another Story of Hope

In early 2014, Tsige Birhanu, 38, arrived at the shelter center on a stretcher. She was weak and emaciated; many feared she would not survive another week. She had been sleeping on a plastic sheet by the well for nine months. Like many pilgrims, she had been subsisting on a diet of holy water and small amounts of barleycorn flour. After suffering frequent bouts of vomiting and diarrhea,she was carried to a nearby hospital where she was diagnosed with TB and HIV.

With a fast deployment of care, nutrition, and ART at the shelter, Tsige’s health improved dramatically in just two months. “The shelter saved me,” she says. “Because of the treatment and care I received, I can now look forward to living a normal, healthy life. …Living, working, and serving here has given me a renewed sense of purpose and confidence.”

I-TECH and DGH Leadership Visit I-TECH Ethiopia, Speak at Outpatient Clinic Launch

Post categories: Ethiopia Health Systems Strengthening HIV and STI Prevention HIV Care and Treatment
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Dancers prepare to perform at the University of Gondar's Diamond Jubilee.

Dancers prepare to perform at the University of Gondar’s Diamond Jubilee.

Earlier this month, a distinguished group from the University of Washington’s International Training and Education Center for Health (I-TECH) and Department of Global Health (DGH) visited Addis Ababa and Gondar, Ethiopia, for several days of discussion, workshops, events, and celebration — including the University of Gondar’s 60th anniversary Diamond Jubilee and the inauguration of the University of Gondar Comprehensive Outpatient Center.

Workshops and discussion at the I-TECH Ethiopia offices

I-TECH has had a presence in Ethiopia since 2003, and in that time, has become a guiding force in antiretroviral therapy service delivery and human resources for health, building the capacity of the Regional Health Bureaus (RHBs), universities, and health facilities; introducing innovative initiatives such as task sharing; activating effective monitoring and evaluation interventions; advocating for and implementing TB prevention programs, including MDR-TB; and building the capacity of health facilities and regional labs. The team acts in close partnership with the RHB offices of the Ministry of Health in Afar, Amhara, and Tigray and will be transitioning most of its programs to the RHBs in September 2014.

In advance of this transition, Dr. King Holmes, Chair of the DGH, and Dr. Ann Downer, I-TECH Executive Director, met with staff in Addis Ababa during a July 4 coffee ceremony. The meeting was an opportunity to say farewell to some incredibly valuable members of the I-TECH Ethiopia team who are leaving as projects are transitioned to the RHBs and discuss highlights of more than a decade of outstanding work in Ethiopia.

Bryan Verity, I-TECH HQ Director of Human Resources, was earlier on hand to facilitate a four-day career transition series with materials adopted from the UW career center. The series was co-facilitated by Tigist Dagne, Human Resources Manager at I-TECH Ethiopia.

“We had a great level of involvement by the staff, especially during the ‘assessing personal strengths’ workshop,” said Verity. During this exercise, a staff member shared experiences, while “listeners” tracked skills/strengths that the speaker employed during the experience.

The series also covered writing curriculum vitae (CV), conducting a job search, and strengthening interview skills. In addition, Verity presented a 60-minute training on personal financial management.

“It’s been a tremendous honor to work with such a dedicated and talented group of people,” said Dr. Downer. “I am so pleased that King and I had the opportunity to express our gratitude in person for the fine work this team has done to combat HIV/AIDS in Ethiopia. Everywhere we went in Ethiopia we heard about the positive reputation and valued contributions of our I-TECH Ethiopia team.”

Much to celebrate at the University of Gondar

Ethiopian Prime Minister Hailemariam Desalegn

Ethiopian Prime Minister Hailemariam Desalegn

Speaking alongside Ethiopian Prime Minister Hailemariam Desalegn and U.S. Ambassador to Ethiopia Patricia Haslach, Dr. Holmes delivered a keynote address at the inauguration of the Gondar Comprehensive Outpatient Center on July 6. The launch was bookended by the university’s graduation ceremony and its 60th anniversary Diamond Jubilee conference.

The center was a collaborative effort of I-TECH, UW, the University of Gondar, and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) representatives in Ethiopia: the U.S. Centers for Disease Control and Prevention (CDC) and the Health Resource and Services Administration (HRSA).

The construction of this center was critical to address the significant burden and impact of disease in Ethiopia to comply with the Ethiopian Ministry of Health’s (MOH) mandate to increase the number of health care workers and to support the goal of PEPFAR to improve delivery of acute and preventive services related to HIV, TB, and malaria.

To meet these goals, the building can provide care to approximately 350,000 patients per year and serve as a training center for clinical outpatient care in TB, infectious disease, adult medicine, surgery, pediatrics, and emergency care. It houses a state-of-the-art TB facility.

Dr. Holmes visits his namesake CPD center.

Dr. Holmes visits his namesake CPD center.

I-TECH and the UW, through funding from PEPFAR, were instrumental in the conception and execution of the center, serving as consultants for both facility design and curriculum development. In this work, I-TECH helped to ensure that the facility allows for the integration of clinical care, teaching, and training. Dr. Scott Barnhart, an I-TECH principal investigator and a UW professor of medicine and global health, brought in Christine Kiefer, a Harborview Medical Center architect, to consult on the project.

In the days following the inauguration, Dr. Holmes and Dr. Downer led conference sessions on Innovations in Global Health and Effective Teaching, respectively.

Dr. Holmes also had the opportunity to visit a namesake training hall at the University of Gondar: the King Holmes Continuous Professional Development Center. “What a wonderful and humbling experience,” Dr. Holmes said of the visit. “And what a great way to end the trip.”

Five Questions For Misti McDowell, I-TECH Ethiopia Country Director

Post categories: Ethiopia Health Systems Strengthening
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Editor’s Note: This is a first in an occasional series featuring I-TECH staff.

Misti McDowell joined I-TECH Ethiopia in February, assuming leadership of I-TECH’s largest country program. In Ethiopia, I-TECH’s work is primarily in the Amhara, Afar, and Tigray regions, which account for nearly 50% of the national HIV burden. I-TECH is focused on strengthening the country’s public health systems, including hospitals and health centers, laboratories, public universities and medical schools. Prior to joining I-TECH,  McDowell worked for five years in Dhaka, Bangladesh, for FHI360 where she oversaw projects on HIV/AIDS, nutrition, family planning, TB, hospital accreditation, and neglected tropical diseases.

Misti McDowellYou just became the Country Director for I-TECH Ethiopia. What has been the biggest surprise in your first few weeks at I-TECH?
I wouldn’t say that it is a surprise, but I was very impressed with the quality of work that I-TECH has accomplished over the years in Ethiopia, especially around all the infrastructural upgrades to hospitals and universities, the capacity building and training to providers delivering quality HIV care, treatment to patients, and strengthening universities to deliver comprehensive pre-service and in-service training.

What will your primary focus be over the next 18 months? 
My primary focus will be to diversify funds, build a stronger team, and improve morale. I think with a stronger team we can accomplish more than we already have and continue to make a greater impact in the health care system of Ethiopia.

Tell us about a leader who inspires you. 
Dalai Lama: “If you think you are too small to make a different, try sleeping with a mosquito.”

You have brought your family to Ethiopia, including your husband and two young girls. What do your girls like best about their new life in Addis? 
I think what my girls love best about Addis is the mountains and that they can go hiking and rock climbing.

What’s the most interesting challenge you think I-TECH’s programs are tackling in Ethiopia? 
The transition of programs to the government with a quick timeline.  I think the government of Ethiopia really wants to have everything transitioned; however with the planned timeline, it will be difficult to transition everything and maintain quality.  There are many systems in the government that need to be streamlined to ensure sustainability and quality of the programs that are now being supported by NGOs and to change those systems will take a long time.

New Tuberculosis Facility in Ethiopia Unveiled

Post categories: Ethiopia
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Report by Yonathan Alemu

EthiopiaA state-of-the-art tuberculosis (TB) facility in Ethiopia is a new weapon in the country’s battle against the disease.

Located at the Mekelle Hospital in the Tigray region, the facility features a TB isolation ward with a multiple-drug resistant TB unit. The ward was constructed by International Training and Education Center for Health (I-TECH) Ethiopia with funding from the United States government. It is one of three such facilities in the country.

Resource-limited countries like Ethiopia struggle to address the growing demand for health care services. TB and MDR-TB are major public health problems with the highest mortality rate of any disease in the country. Ethiopia ranks seventh out of the 22 highest TB-burden countries. MDR-TB is a particularly threatening infection—it is difficult to diagnose without the proper technology. It is also difficult to treat, often requiring patients to stay on medication for two years.

The facility is in response to the urgency of implementing standardized TB prevention and the Federal Ministry of Health’s prioritized scale-up program.

The new TB facility enables the hospital—which had to refer such cases to the capital Addis Ababa—to separately treat TB and MDR-TB patients from other patients and thereby significantly reduce the risk of cross-infection. With a maximum capacity of 35 beds, the facility is able to provide scores of services, including first-rate TB case management, TB treatment, and support and community follow-up systems. It will also serve as a training center to help prevent and control the spread of TB in the region.

EthiopiaThe facility was inaugurated on April 4, 2013. In a ribbon-cutting ceremony, I-TECH Ethiopia officially handed over the well-equipped and furnished facility. Dr. Kesete-Berhan Adamssu, Minister of Ministry of Health, acknowledged the support and strong commitment of CDC and I-TECH Ethiopia in their contribution to the country’s health system development endeavor. He emphasized that the facility will improve and expand TB diagnostic services and screening in rural areas and among HIV positive residents.

During the ceremony, a female patient sat quietly in a doorway at the far end of the ward, intently watching the program. Haimanot, (whose name is changed for this report) is in a segregated section of the ward, designed for patients with MDR-TB. She is a 22-year-old single mother of two admitted three weeks ago. She is in a very frail state as she has been living with the MDR-TB for a long time. “Besides, what is more worrying is the status of her two teens as they were living with her in a very small flat which allows them the cross-contamination,” said the TB nurse treating her.

The nurse said that Haimanot’s story is common, particularly in the rural areas of the region. Follow-up in communities with these cases is critical to preventing this deadly and quick-spreading infection.

For a hospital serving more than four million where TB infection is rampant, this facility will play a substantial role in the fight against tuberculosis. It could save countless lives through the scale up of MDR-TB diagnosis, management, and follow-up of patients.

Present at the transfer were several dignitaries and high-level officials, including H.E Dr. Keseteberhan Admassu, Minister of the Ministry of Health; H.E. Hagos Godefy, Tigray Region health bureau head; Dr. Thomas Kenyon, CDC Ethiopia Country Director; and Misti Mc.Dowell, I-TECH Ethiopia Country Director. Also present were representatives from the Mekelle University and regional health bureaus.

Learn more about I-TECH Ethiopia.

Ethiopia: New Regional Lab in Afar Launched

Post categories: Ethiopia Health Systems Strengthening Laboratory Systems
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Report by Yonathan Alemu, I-TECH Ethiopia

A new regional referral health and research laboratory in Afar regional state, in Semera was inaugurated on February 9, 2013. The regional laboratory was renovated and established by I-TECH through partnership with the Ethiopian Health and Nutrition Research Institute (EHNRI) and collaboration with the Afar Regional Health Bureau and funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Centers for Disease Control and Prevention (CDC).

lab
The new regional laboratory

The new regional health facility, which is well equipped with advanced laboratory diagnostic technologies, was handed over to the Regional State with eventful program that brought together high level officials from the Federal Ministry of Health, the Afar regional state, the EHNRI, Afar regional health bureau and I-TECH Ethiopia leadership team.

The Afar regional Health Bureau Head, and the EHNRI regional laboratory capacity building directorate, Director addressed the impacts of partnership/collaboration to the improvement of the health system in the country in general and in the Afar region in particular and also applauded the I-TECH-Ethiopia’s significant contribution in strengthening the laboratory system in the Afar region.

The health facilities in the Afar region were small in number and were not well developed to provide standard and quality laboratory diagnosis services for the highly prevalent and deadliest diseases, but this is now changing following the intensified national health system strengthening programs in the country.

Dr. Nega G/yesus, the acting country Director of I-TECH Ethiopia acknowledged the long years of collaboration and partnership efforts put up by partners and the regional health bureau for all the successes achieved and appreciated the unwavering support of the United States Government in the health sector development in Ethiopia.

This new regional referral health laboratory will be a center to systematically build capacities of laboratories in the region to improve, assure and maintain quality laboratory diagnostic services. Moreover, it strengthens the regional referral system that would significantly improve the diagnostic capacities of laboratories for such as, HIV/AIDS, Malaria, TB, STIs and other opportunistic and tropical diseases, playing an integral role in Ethiopia’s public health emergency response system.

Lab SignDr. Wubshet Mamo, I-TECH Ethiopia’s Laboratory Program Director said, “The goal of the PEPFAR laboratory program is to support countries implement laboratory services in a sustainable manner to provide quality diagnostic tests, strengthen integrated laboratory systems and support and/or establish country or regional laboratory institutions. Establishing this modern laboratory, which is the 1st in the Afar regional state and the 9th regional referral health laboratory in the country will play a substantial role in changing the region’s laboratory diagnostic service quality, ensuring accurate and reliable laboratory test results that every patient deserves to get.”

He further explained that the role of this regional laboratory primarily will be assuring the quality of laboratory services through conducting external quality assessment, providing referral testing services and strengthening the referral system, supporting in skill building of laboratory professionals, conducting disease surveillance and taking appropriate measures in case of emerging infections in the region. This laboratory will also be a hub for evidence-based interventions (operational health research). More importantly, supporting laboratories in the region to improve their laboratory quality system towards the WHO-AFRO step-wise laboratory accreditation will be another key role of this regional laboratory facility, said Dr Mamo.

The establishment of this Regional Referral Health Laboratory will have significant impact in building the capacities of the hospitals and health centers in the Afar region to provide standardized and quality laboratory services to the people in the region.

If there is one reason that shines the glowing happiness of the local leaders over the scorching sun during the event; it is the anticipated reduction in referrals to distant cities for a better laboratory diagnosis.

Learn more about I-TECH Ethiopia.