Standardizing In-Service Training in L+M+G to Improve Health Systems in Ethiopia

Jemal Mohammed

LMG/Ethiopia Project Director

LMG Ethiopia staff training on health systems delivery.

In-service training with LMG Ethiopia staff work on the L+M+G results model. Photo: Jemal Mohammed/MSH Staff

Leadership and governance are one of the six building blocks of health systems (WHO). In Ethiopia, health sector leaders within the Federal Ministry of Health (FMOH) have made a concerted effort to increase the capacity of their staff through leadership training. The curriculum developed by various partners and agencies for training government health workers has not been uniform in terms of scope, content, and methodology, and often uses leadership training designed for developed countries that hasn’t been adapted to the Ethiopian health context. This has made it difficult for the FMOH to assess the quality and effectiveness of training in leadership and management, and determine the best methods and approaches to improve health sector performance. Furthermore, training in governance practices is relatively new in Ethiopia.

The FMOH has therefore sought to develop a standardized curriculum and modules that are adapted to the Ethiopian context, and that can be used at different levels of the health system. Since 2012, the USAID-funded Leadership, Management & Governance (LMG) Project has provided technical support to the FMOH to support these efforts.

The first step has been to bring different actors together in a Technical Working Group (TWG). The TWG, made up of technical experts from the FMOH, training institutions, universities and various partner organizations and agencies, developed a standard curriculum for senior, mid-level and facility level health leaders. The curriculum uses a team-based approach and an experiential learning methodology, participant manuals, facilitators guide and reference handouts that are appropriately designed for each level of the Ethiopian health system. The FMOH took further ownership of this agenda by offering certification upon completion of the training.

The FMOH held a national consultative meeting of all key stakeholders to validate and enrich the draft training materials. After pre-testing for more than three months at the field, inputs were incorporated, and based upon the new national in-service guidelines, the modules were approved for use this month by the FMOH.

The FMOH and the LMG Project have now certified 36 master trainers from several universities and health science colleges. The modules are currently being rolled out in collaboration with local training institutions through workshops for 340 participants drawn from 14 directorates within the Ministry, and two regional health bureaus. During the six-month training, health teams are working to address real-life workplace challenges. The federal directorates are working on priority health challenges such as maternal health (skilled attendance at delivery); Human Resource teams are working to have automated personnel records for more than 60,000 health staff; and the Audit Directorate teams are working on improving follow up of audit findings to improve accountability within the health sector. In addition, a team from the Law and Legal Affairs Directorate is working to identify contractors who handed over substandard buildings to the FMOH in order to make them legally liable based on their contractual obligations. Local training institutions and universities are providing capacity building in leadership, management and governance through on-site coaching and mentorship.

I am happy to answer any questions that health leaders have about integration of the LM&G curricula by the FMOH in Ethiopia. We will also provide you with further updates after the rollout of this important leadership program—stay tuned!