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 I. Projects underway

Project Title: ESOG-ACOG Collaborative Project: Enhancing Medical Education and Residency Training in Obstetrics and Gynecology in Ethiopia

 

1.      Executive Summary

Women’s health continues to be a particularly urgent health issue in Ethiopia where the maternal mortality ratio is 420 for every 100,000 births, among the highest in the world. A large proportion of women have poor access to the high-quality care. Increased access to state of the art Continuing Medical Education (CME) will support health professionals with the resources and expertise to provide best care to the women and serve community.

 

Ethiopian Society of Obstetricians and Gynecologists (ESOG) strives to promote and provide relevant, need-based assessment and educational activities to OBGYN specialists, residents, students and other health professionals to maintain and produce changes in knowledge, skills, attitudes and behaviors that will enable optimal provision of patient care and serve community. This project fits well with ESOG’s leadership in Reproductive Health in Ethiopia.

ESOG has wide experience in managing projects and programs. Members work all over the country giving the Society opportunities for smooth implementation of projects in the area of maternal and reproductive health by providing technical support at all stages of the project implementation. The Executive Board of ESOG is composed of members experienced in designing, monitoring and evaluation of projects. Accordingly, quarterly plans and reports of projects are presented to the Executive Board and seen in terms of implementation status, challenges and ways forward. In addition, project appraisal meeting is conducted biannually where the Executive Board meets with the project coordinators and assesses projects thoroughly. The financial flow of the projects is also assessed quarterly. In addition, standards and tools for project monitoring and evaluation are developed, supportive supervision to the project sites are periodically conducted and project review meetings are conducted jointly with government bodies and other stakeholders to evaluate the progress of projects. ESOG records best practices and success-stories to be used as foundation for upcoming projects and share the experiences to key partners.

 

ESOG, with financial support from numerous international donors, has realized a number of notable achievements in the reproductive health field. ESOG has also demonstrated leadership and commitment to address maternal-newborn health issues in Ethiopia. It has conducted and is currently engaged in several interventions in nationwide efforts to reduce maternal and newborn morbidity and mortality. Among the efforts, Save the Mothers Project and Sexual and reproductive health rights projects in collaboration with FIGO, the “PPH Prevention Initiative” in collaboration with Intra Health International, “Mainstreaming Emergency Contraception in the public sector” in collaboration with EC Afrique and Population Council, capacity building in the management of complications of FGM in Afar region in collaboration with Care-Ethiopia, FIGO/Gates MNH Initiative, Introduction of Magnesium Sulphate for the management of preeclampsia and eclampsia related mortality in collaboration with UNICEF, Medical Care for survivors of Sexual Assault in Ethiopia in collaboration with UNFPA, PMTCT service expansion in the private

health facilities in collaboration with CDC in Ethiopia are testimonies.  ESOG is an active member of several national task forces and technical working groups related to safe motherhood, family planning, and HIV/AIDS where its members provide technical advice and exert influence on policy issues.

 

There is also firm international and national collaboration with several institutions including Federal Ministry of Health, Regional Health Bureaus, FIGO, WHO, UNICEF, UNFPA, Ipas-Ethiopia, David and Lucile Packard Foundation, Pathfinder International, Engender Health, CDC Ethiopia and health professional associations etc.

 

2.      Objective and project aim

3.1 Project goal (general objectives)

 

Ensure residency programs in Ethiopia are implemented in a standardized and harmonized manner through a binding accreditation process.

 

3.2 Project specific objectives and key activities

 

Objective One:

 

Ob-Gyn RESIDENCY PROGRAMS –ESOG will develop syllabus for the implementation of harmonized curriculum

Objective

Year One Activities

Develop consensus and a formal agreement with Ministries of Health and Education on the development of syllabus for the implementation of standardized curriculum for ob-gyn residency programs

Work on the development of syllabus with the universities

 

Develop syllabus for the implementation of standardized curriculum for ob-gyn residency programs

Establish a Residency Program Committee

Committee

Develop capacity of obgyns in the universities on the syllabus

Provide training on the syllabus to implement the standardized curriculum

Develop monitoring mechanisms to follow implementation of the ob-gyn educational objectives and residency program requirements and implementation of the standardized curriculum for ob-gyn residency program

Establish an exam committee to begin planning for in-service exams for ob-gyn residency programs

 

Facilitate ob-gyn residency program participation in the development and implementation of monitoring tools

Objective TWO:

 

Continuing Medical Education - ESOG will develop high quality, up-to-date continuing medical education for ESOG members.

Objective

Year One Activities

Optimize the integration of CME into all ob-gyn educational programs (including Residency, Fellowship and Undergraduate medical education)

Establish a CME Committee

 

Continue to train additional ESOG members and faculty in CME

Position ESOG as a preferred source of CME information and expertise in reproductive health In Ethiopia

Review and select CME content

Develop intra-professional and inter-professional collaboration

Establish an ob-gyn lecture series at hospitals

Develop a sustainable infrastructure and funding mechanisms for CME

Explore options for an online platform for CME

Establish a Conflict of Interest policy

Design IT infrastructure for association management, accounting for CME credits, and interactive delivery of CME content

Decide on the appropriate system

Develop IT staff depending on specific skills needed

Create pre and post tests for CME for Journal (see Research and Journal objectives)

 

Objective three:

 

Ethiopian Journal of Reproductive Health --ACOG and ESOG will collaborate to develop the Ethiopian Journal of Reproductive Health into one of the premier ob-gyn journals in the region and enhance the research capacity of faculty and residents in all ob-gyn residency programs.

Objective

Year One Activities

Enhance the quality of research presented and position it as the premiere ob-gyn journal for research in the region.

Form a Journal committee including ESOG staff, several ESOG and ACOG consultants

Establish plans for enhancement of the Journal, including development of a pipeline of contributors

Develop a long-term plan for sustainable funding and short term plans to cover initial costs

Develop ESOG commentaries on content material such as the Clinical Expert Series

Increase their capacity of the Journal Editorial Board, reviewers and staff and to critically review research

Re-establish the Journal Editorial Board and define incentives for participation including CME

Train Residents and Junior Faculty on research methods to enhance their capacity to develop peer-review ready research for inclusion in the Journal and for CME credit

Conduct additional training for research and scientific writing

Work with ob-gyn residency programs to enhance, re-establish or establish Resident Research Days

 

Project Title: Overcoming demand side barriers Improving utilization of RMNH services through engaging pastoral community and promoting compassionate and responsible care at health institutions at zone two of Afar Regional State

        I.            Executive Summary

The Ethiopian Society of Obstetricians and Gynecologists, as a prime organization, is applying in partnership with the Ethiopian Medical Association (EMA) under the title of “Improving utilization of RMNH services through engaging pastoral community and upholding compassionate and responsible care at health institutions”

The Ethiopian Society of Obstetricians and Gynecologists (ESOG), as one of the partners who has been supporting the scaling up of maternal and child health services in the country, with financial support from numerous international donors, has realized a number of notable achievements in the reproductive health field towards ensuring availability and access to RMNH services. Thus ESOG in partnership with EMA, after critically examining the needs to be addressed, has formulated this project addressing mainly the demand-side factors affecting RMNH service utilization in 8woredas of zone two Afar regional state with a total population of  491 209 ,  of 29 % of the total Afar regional state population.

The project is designed to tackle the demand side barriers by mainly overcoming the socio-cultural barriers and improve community attitudes towards RMNCH. The expected outcomes of the project areincreased demand for RMNH services and modern contraceptive methods, and increased demand for new born care and post-natal care. These are achieved for the interventions will improve the community attitude towards RMNCH needs of women and youth, and iincrease uptake of culturally acceptable and appropriate RMNH services for women. The other expected outcome will be enhanced accountability and responsiveness of service providers to communities particularly to youth and women.

The key interventions which will be used are the establishment of mobile clinics, construct culturally acceptable maternity waiting homes, increase awareness on CBHI, involves TBAs in RMNH services provision specially in referral, conduct training for health care providers & HEW, using IEC/BCC materials to increase demand side, strengthen HDA, women empowerment, promote compassionate respectful maternal care, and strengthen health facilities management boards.

The key strategies that will be employed in the project are community empowerment, collaboration and networking, and capacity building at all levels.   

The project will maximize partnership with government sectors, especially health sector at Woreda and PHCU level to implement its program in a cost effective way and to lay down program sustainability portfolios in the project sites. A total of 11 full time project staffs will participate in the project.

Program monitoring and reporting will be overseen by community coordinator. Each quarterly activity report from the field/woredas will be compiled and sent to community coordinator. She/he will compile community officers’ report and sent to the project directors. The project director and one assistant director will evaluate the progress of the project. Annual review meeting will be held by engaging multiple stakeholders: zonal health department, woreda health offices, and key community opinion leaders. External financial audits will be done and reports will be submitted to Charities and Societies Agency. The audit report will be submitted to the general assembly of ESOG and EMA and be endorsed.

1.1  Goal:

The overall goal of the proposed project is to contribute todecrease maternal and neonatal mortality rate in Zone two of Afar Regional state

1.2   The specific objectives

  • To increase the proportion of SBA in 8 pastoralist woredas of zone two in Afar Regional State from the current rate23% to 45 %by the end of 2017
  • To increase the proportion of family planning acceptance of women in 8 pastoralist  woredas of zone two in Afar regional state from 6.6 % to 26 %.

 

 

 Phased Out Projects:

 1. Expanding PMTCT services in private health institutions in Ethiopia project

The private sector initiative for the prevention of mother to child transmission of HIV (PMTCT) was started in 2007/8 as a collaborative effort between the Addis Ababa Regional Health Bureau (RHB), the Ethiopian Public Health Association (EPHA) and Ethiopian Society of Obstetricians and Gynecologists (ESOG), Johns Hopkins University (JHU/TSEHAI) and private health facilities. The project is implemented with funding from the U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS), Centers for Disease Control and Prevention (CDC) Under the President’s Emergency Plan for AIDS Relief (PEPFAR) in accordance with the ESOG-CDC Cooperative Agreement. Starting under COP2010, ESOG became a direct CDC grantee and now is in the fifth year of implementation. 

Objective:  To contribute to the reduction of HIV transmission with extensive training and promoting wide application of the recommended PMTCT intervention strategies in the private health sector which increasingly are becoming important allies in the fight against HIV/AIDS.

  The project is implemented in collaboration with Federal Ministry of Health (F-MoH), Regional Health Bureaus (RHBs), HAPCO, PFSA, partner governmental & non-governmental organizations in the country and private health institutions. 

Currently the number of target facilities supported by the project and providing the standard PMTCT services based on the Option B+ approach has grown to 68 in seven regions of the country. These regions are Addis Ababa, Amhara, Oromia, SNNPR, Dire-dawa, Harare and Somali regions.

 

 The major activities accomplished:- 

 The project site support teams conduct regular mentoring of all target facilities visiting each facility once in 1-1 ½ months to support onsite implementation of the PMTCT services according to the national standards. 

  • Joint (ESOG and RHBs) supportive supervisions and catchment area review meetings conducted in all target regions biannually.
  • Basic PMTCT Training, DBS training and update training on option B+ of health care providers conducted as planned to address the dynamics of trained professional in the private facilities
  • ESOG conducted TOT training on PMTCT in collaboration with FMOH and WHO country office to facilitate the scale up PMTCT and to rollout the revised PMTCT guideline for 23 participants from all project sites regions.
  • TOT on mother baby pair cohort follow up and continuous quality improvement (CQI) approach was provided for 56 staff health providers from project supported facilities in collaboration with the Federal Ministry of Health. The trainings were given to strengthen option B+ PMTCT service data management system and to improve quality of PMTCT service. Mother baby pair cohort follow up registers were distributed to all supported facilities, cascaded to all target regions and their implementation was followed up.
  • Provides technical support to FMOH and RHBs in expanding/strengthening and improving quality of PMTCT/MNCH/FP services in the country.

 

2.Performance Assessment of Emergency   Surgical Officers (ESOs) deployed at 97 primary hospitals in Ethiopia (Strengthening CEmONC at the facility level Supporting Integrated Emergency Surgery   MSC Program)

General objectives:

To provide an in-depth performance assessment of CEmONC services provided by Emergency Surgical Officers deployed at the Primary/District hospitals of the country and inform the national IESO program, for quality improvements of CEmONC service.

Specific:

1. Conduct facility level ESOs performance assessment of 97 selected health facilities providing CEmONC and Emergency Surgical Services by ESOs in all target regions of the country.

2. To assess the current working environment and facility preparedness for CEmONC and Emergency Surgical Services of target health facilities where ESOs are deployed.

3. To assess ESOs clinical skill in the provision of CEmONC and Emergency Surgical Care services and procedures.

4. To identify gaps and challenges in the provision of CEmONC and Emergency Surgical Services by ESOs in the target facilities

5.To compare and describe the status of CEmONC & Emergency Surgical services in the target facilities, one year before and one year after deployment of ESOs.

6. To measure successes in the provision of CEmONC and Emergency Surgical Services by ESOs in the target facilities.

7. To provide facility specific on site feedback on the assessment findings to the ESO and CEmONC team through debriefing sessions by the assessment team.

8. Inform local and international stake holders of the IESO program of assessment findings and come up with appropriate recommendations for the program improvement. 

9. Disseminate identified best practices nationally to expand the program approach.

Project sites:

 The project sites are 97 facilities located in all regions of the country except Addis Ababa & Dire Dawa Administration. The regional distribution of facilities is shown in the following table.

 

SN

Region

Number of facilities

1

Oromiya

31

2

Tigray

24

3

SNNP

18

4

Amhara

17

5

Somali

3

6

Benishangul  Gumuz

2

7

Gambella

1

8

Harari

1

 

Total

97

 To facilitate the data collection process the  sites in these regions are organized and grouped in to four centers, based on geographic proximity and simplicity for data collection and supervision.

 

 

Centers

No of facilities

Regions

1

Addis Ababa

38

Oromiya, part of SNNPRS,Gambella, Harari, Somali, and Part of BG and Gumz

2

Mekelle

24

Tigray

3

Bahir Dar

18

Amhara and part of BG and Gumz

4

Hawassa

17

SNNPRS

Major activities accomplished:

 1. Preparatory activities for assessment

  • Questionnaire (prepared by FMoH) revised                                                                                                                                                            
  • Protocol for the assessment developed
  • TOR and Work plan are developed
  • Discussions and consultations were made both on the revised questionnaire and protocol with the FMoH
  • Both the questionnaire and the protocol were forwarded to CDC for comments and approval.
  • Comments were given by CDC, and the comments were incorporated and resubmitted for CDC
  • The task (assessment) considered as research determination and required an ethical clearance for approval. Obtained from DC. Accordingly the document is submitted to EPHI and then to CDC for ethical clearance.
  • Ethical clearance is obtained both from EPHI and CDC.
  • Adequate number of assessment tools (112 copies) including printing of format and protocol prepared.
  • Adequate number of  bags (112 bags)  , and  stationary procured

2. Mobilization and communication recruitment work

  • Appropriate Communication , consultations and mobilization activities with FMoH, RHBs, Partners and ESOG Chapter Offices
  • Data Collectors and supervisor were recruited from FMoH, RHBs of Tigray and Amhara, RHBs and via Mekelle, Bahir Dar Jimma, Harari Hawassa and Gondar ESOG chapter offices. More over Supervisors from CDC and WHO staffs seconded to FMoH have participated.
  • A one day orientation for Data collectors and supervisors was given in four centers.
  • 37 vehicles were made available for data collection and supervision.

3. Conduct and oversee the Assessment

 

 

Centre

Date

No of sites

Man power at field

 

 

 

 

Data collectors

Supervisors

Field coordinators

1

Mekelle

July 27 – Aug 19/2015

24

14

2

2

2

Bahir Dar

Aug 3 – 23/2015

18

10

2

2

3

Hawassa

Nov 2 – 19/2015

16

10

2

2

4

Addis Ababa

Nov 16 – Dec 10/2015

39

24

5

2

Total

 

96

58

11

2

As shown in the table the assessment was carried out from July 27 up to December 10/2015 in two rounds. The assessment was carried out in all sites except one site found where there was no assigned ESO at all. 29 clinicians (21 Obstetricians and 8 surgeons) and 29 PHS were involved in the data collection.

 3.Consultancy for Research

Prevention of unsafe abortion initiative (Situational Analysis):

It is anticipated that situation analysis will result in significant awareness and advocacy in regard to the interrelated problems surrounding unsafe abortion including the development of evidence-based national action plan. It was a three years project started from 2007. Ipas funded the project and FIGO is a collaborator with the Society. ESOG is happy to have been involved in the activity but concerned that it has not yet received the results of data analysis as they are of importance to the activities of the society and safe motherhood activities in the country.

Health Professionals Survey on Health system cost of unsafe abortion:


Its objective is to increase awareness and provide evidence on health system cost of unsafe abortion for advocacy and evidence based policy action. The site of project sampled public and private health facilities and it is funded by Ipas Ethiopia. FMoH and Ethiopian Public Health Association are the partners of the society. It started in November 2007 and completed.

Female Genital Mutilation (FGM):

The society in collaboration with Care Ethiopia conducted an institutional capacity assessment to provide care for complications of FGM and development of training material for management of these complications.

Developing Training Manual for Comprehensive Abortion Care: 

It’s objective is to standardize and increase quality of training on comprehensive abortion care. The project was undertaken by FMoH, Ipas Ethiopia and Engender Health Ethiopia.

 

Save the Mothers Initiative (SMI):
The first Project of ESOG. A five years pilot project carried out from 1998 to 2004 in collaboration with FIGO and Swedish Society of Obstetrics and Gynecology. The major aim of the project is availing Emergency Obstetric Care services to rural women. Project site is Ambo town in West Shoa zone, 125 KM west of Addis Ababa.

Active Management of the Third Stage of Labor (AMTSL):

A one year project from February 2003 - June 2004 launched in collaboration with Federal Ministry of Health Ethiopia and IntrahHealth-International. The project focused on reduction of maternal mortality and morbidity through preventing the occurrence of Post Partum Hemorrhage by the universal application of active management of third stage of labor.

Sexual and Reproductive Health Rights Project 

A two year project from 2004- 2006. It is aimed at raising awareness of stakeholders and members alike, develop a national code of ethics on sexual and reproductive health and subsequently introduce same into medical curricula of post graduate studies in Obstetrics and Gynecology and undergraduate studies in Obstetrics and Gynecology and undergraduate medical students. In addition, it increased public awareness on the problem of unsafe abortion and make sure that unsafe abortion remains in the public agenda by involving the media. the project was implemented with Federal Minisitry of Health and FIGO.

Main streaming emergency contraception in to public sector:

 Its objective is familiarization of Emergency Contraception in the country by using the dedicated products (progestin only preparation). It has been implemented in the project sites of 5 regions of the country, in 37 health institutions. It is funded by African forum on Emergency Contraception (EC Afrique). Federal Ministry of Health & Regional Health Bureau are the collaborators of the project. It is completed at the beginning of 2008.

4. Safe Motherhood and RH Project 

The project was a three year project implemented from 2004-2007. It was aimed at improving access to life saving procedures and ensure skilled care at delivery, demonstrate ways and means of increasing use of injectible contraceptives by involving junior health personnel at health post level in two regions, make use of the results of the study to influence policy makers and managers on ways of expanding FP utilization with special emphasis on injectibles, to build support to influence policy on sexual and reproductive rights including abortion services and orient women on family law including the revised law on abortion.

 Prevention of Post Partum Hemorrhage Initiative (POPPHI):  

This is a regional survey on the management of the third stage of labor which is conducted in collaboration with Family Health Department, Ministry of Health. It was carried out from 2006-2007. The aim of the study is to provide the descriptive information necessary to assess current practices regarding Active Management of Third Stage of Labor and to identify major barriers to its use. A complementary component of the study includes a qualitative assessment of perceptions and practices with regard to serious post partum bleeding in home births. A secondary aim is to provide public domain tools for future monitoring activities. The projects sites are 10 health professional training institutions and 6 health facilities located in Tigray, Diredawa and Harar regions.

 Saving Mothers and Newborns Initiative:

It aims to improve basic emergency obstetric and newborn care. It was started in 2007 and completed in Dec 2008. The project is funded by ACCESS-USAID. Project site Partners were Ambo hospital and its referring 10 health centers. 

ESOG-Venture Strategies Post Partum Hemorrhage Prevention Initiative:

It aims to expand Misoprostol knowledge and provision by developing national guideline on active management of third stage of labor (AMTSL) with Misoprostol and by inclusion of Misoprostol use during Active Management of Third Stage of Labor for prevention and treatment of Post Partum Hemorrhage in mid-level health training schools curricula. Ministry of Health and Venture Strategies for Health and Development are the major collaborators. It is funded by Venture strategies for Health Development.

 Strengthening and expansion of service provision at the model clinic and nationalization of ESOG’s guidelines on comprehensive management for survivors of sexual assault:

The objective of the project is to improve sexual gender based violence related health, legal and social services in Ethiopia. Family Health Department of Federal Ministry of Health worked in collaboration with the society. It was financed by Population Council. It was started in November 2007 and completed in March 2009. Project successfully completed and achieved the major activity of providing the country with a national guideline for management of survivors of sexual assault.

Ensuring sustainability of the model clinic of victims of sexual violence and strengthening collaboration against sexual violence:

It aims to improve sexual violence related health, legal and social services in Addis Ababa. It started at the end of 2007 and ended in August 2010. UNFPA financed the project Gandhi Memorial Hospital and Addis Ababa legal system are project site partners.

Save the Mothers and RH Project

The major objective is to improve the availability, accessibility, quality and use of basic obstetric care and family planning services. The project is in Hadiya Zone of SNNPR and funded by the David and Lucile Packard Foundation. The partners are Ethiopian Midwives Association and Zonal Health Bureau & Woreda Health Bureaus. The project started in April 2008 and is ongoing until September 2011.

Major activities accomplished include; Training on family planning & Emergency Obstetric and Newborn care are conducted. Community mobilization activities are undertaken & support by supplying appropriate medical equipment and supplies to the Project sites undertaken.

Saving Mothers and Newborns at two regions of Ethiopia (Amhara and Oromia)-Fiche Hospital, Debre Markos Hospital, Ejere Health Center and Bichena Health Center

The objective of the project is expandingand strengtheningmaternal and newborn care. The project is funded by FIDE, Germany and the partners are Regional Health Bureaus and Zonal Health Bureaus. The project sites are from Amhara region-East Gojam Zone-Debremarkos Hospital and Bichena Health Center and from Oromiya Region North Shewa Zone-Fiche Hospital and Ejerie Health Center. The project started in January 2009 and ended in June 2012.  

The major activities accomplished include: Technical update and skill standardization training, training of providers at zonal hospital and referral health centers to conduct near miss audit. Blood bank is established in Debremarkos and Fiche Hospitals. Community mobilization activities are undertaken, supportive supervision activities are performed. End line survey is conducted.

Magnesium Sulphate use for prevention of Preeclampsia and Eclampsia related mortality in Ethiopia

The objective of the project is to contribute towards the reduction of maternal mortality by introducing Mgso4 in all public hospitals in Ethiopia. The project was funded by UNICEF. The partners are UNICEF, Federal Ministry of Health, Pharmaceutical Fund Supply Agency and Emory University. The project started in April 2009 and ended in July 2011. The activities accomplished include training of Obstetricians and Gynecologists, an advocacy on magnesium sulphate at the ESOG 2010 annual conference through a program on “MgSO4 Day” was undertaken, training to General Practitioners, Health Officers & midwifes given at the local chapters of ESOG and Addis Ababa, data collection in 24 hospitals selected for audit and distribution of Mgso4 drug.

 Sexual Violence Against Women Project

The objective is to improve the delivery of integrated and quality of care for survivors of sexual violence. It is funded by UNFPA. The project was started in April 2009 and ended in May 2012. Activities accomplished include: Two model clinics are providing services to survivors of sexual assault at Adama & Hawassa Hospitals, health care providers are trained on care for survivors of sexual assault, nationalization of training manual developed by ESOG on care for survivors of sexual assault, inclusion of GBV in the medical school curricula is successful, monitoring and evaluation conducted and purchase of medical equipments and supplies to the model clinics undertaken.

FIGO LOGIC Initiative in MNH Project

The goal of FIGO-LOGIC Initiative in MNH Project is to improve policy and practice by strengthening Ethiopian Society of Obstetricians and Gynecologists and using its position and knowledge to facilitate and contribute to these improvements, leading to better MNH for under-served populations in Ethiopia. The project is funded by Bill and Melinda Gates Foundation through International Federation of Gynaecology and Obstetrics (FIGO) during the period of November 2009 to October 2013.

Major Performances of the project during the project period were establishing working groups of health professionals and other partners working on MNCH in Ethiopia. The group meet every six months, and twelve organizations represented and conducted 11 regular meetings and discussed on the current MNH affairs and each organization presented its best practices. By the help of the Society of Obstetricians and Gynaecologists of Canada an organizational capacity building framework and plan were developed and implemented.

Under the project, a weekly FM radio broadcast and articles in private newspaper were posted. Birth and death registration in eight public hospitals were conducted. Regarding maternal death and near miss case, reviewing standard and structured questionnaire were developed and used to collect data. Hospitals started completing the tools since May 2011, preliminary (six months) and final paper (18 months) produced and findings communicated at different events. Maternal Death Review Ethiopian Initial Experiences Sharing Workshop was conducted in Addis Ababa and people from five African Countries which also implement the FIGO-LOGIC project participated in the workshop. In addition, regional health bureaus and other partners attended the experience sharing workshop.

 In addition, provision of technical update training for health professionals was conducted for 2 consecutive years. Changes and improvements were observed as a result of maternal death review processes like formal deaths and near miss review is in place, relatively complete information kept in client or patient card, improved patient card retrieval system and good documentation of MDR process was developed and implemented. Services are available 24/7 in all facilities. In the health facilities oral referrals are minimized. Recently these hospitals have improved linkage and give supervision to health centers. Moreover, feedbacks are given to referring health centers, and there are decreased unnecessary referrals. Project mid-term review was conducted by external independent consultants on all physical and financial project status.

Challenges faced in conducting maternal death review were vital. Moreover MNH statistics registration is incomplete and there is difficulty of requiring information near or at the time of maternal death. There is also inaccurate measurement of medical causes of death and near misses, and fear of being judged. The other challenges are demanding workload and women were afraid to tell their stories.

 Women And Their Children’s Health (WATCH) Project

WATCH project was funded through the Canadian Department of Foreign Affairs, Trade and Development (DFATD) and managed by Plan International Canada working through partnering with Plan International Ethiopia, Society of Obstetricians & Gynecologists of Canada (SOGC) and Ethiopian Society of Obstetricians and Gynecologists (ESOG). WATCH project used a community-based approach to improve the quality of community outreach and MNCH services, while encouraging health-seeking behaviors and improved health care management to reduce the three delays for patients to seek care and to save the lives of more mothers and their children.

WATCH project was implemented in 8 rural districts in three regions namely: Amhara Region: Lasta, Bugena and Meket districts; Oromia Region; TiroAfeta&Kersa districts and SNNPR Region: Shebedino, Gorche and Bona Zuria districts. The project was implemented from November 2011 to April 2015.

 The major activities accomplished during the implementation of the project were:

 Two ESOG board members travel to Canada for WATCH Project Orientation meeting.

  • ToT training on ALARM International Program for ESOG members.
  • BEmONC needs assessment at 48 health centers.
  • A three day BEmONC sensitization workshop for health administrators conducted to create an enabling environment for BEmONC service at the ground level.
  • Follow up meeting on BEmONC with health administrators.
  • CEmONC focal persons were also recruited for each of the three regions. The CEmONC focal persons are ESOG members who oversee that referrals are occurring in a timely and efficient manner between BEmONC and CEmONC facilities.
  • Training of 167 mid-level health care providers on BEmONC.
  • Five rounds of quarterly supportive supervision were carried out.
  • Meeting with CEmONC focal persons.
  • Five types of BEmONC related posters were developed and distributed to health centers.

After all these efforts, health care providers are managing complications that were previously referred.Project monitoring trends indicated increases in usage of MNCH services (i.e. four antenatal visits and/or delivery with a skilled birth attendant). 

Sexual Assault Clinical Outreach Project 

The objective is to improve the delivery of integrated and quality of care for survivors of sexual violence. The project is funded by UNFPA and was carried out from January 2013-December 2015. Major activities accomplished:-

In 2013:- 

  • Three rounds of training on care for survivors of sexual violence were conducted.
  • GBV is incorporated into the medical school curriculum.
  • Adama and Hawassa Model Clinics which were established to provide care for survivors of sexual assault in Ethiopia were handed over to the hospital administration.
  • Standard operating procedure on response and prevention of sexual violence is developed. 
  • An outreach campaign was undertaken at Benishangul Gumuz Region, Assosa Hospital and operation on uterine prolapse and cervical cancer screening were performed.

 In 2014:- 

  • Established model clinics at Mekelle, Gondar and Jimma which provide care for survivors of sexual assault.
  • Conducted two rounds of trainings on care for survivors of sexual violence.
  • Conducted an outreach campaign at Assosa Hospital and performed 61 uterine prolapse operations and 169 cervical cancer screening.

 In 2015:- 

  • Three model clinics at Mekelle, Gondar and Jimma provided services to 734 survivors.
  • Conducted two round training on care for survivors of sexual violence.
  •  Conducted outreach campaign at Assosa Hospital and performed 31 uterine prolapse operations and 80 cervical cancer screening and at Chiro Hospital and performed 45 uterine prolapse operations and 147 cervical cancer screening.
  • Three model clinics were headed over to the hospitals.
  • Standard Operating Procedure for the response and prevention of sexual violence is printed in 4500 copies.

 ESOG and CHAI BEmONC trainings 

Objectives: to build the capacity of mid – level health care provider through BEmONC training

Project sites: Eight regions of Ethiopia namely Amhara, Oromia, Afar, Benishangul-Gumus, SNNP, Gambela, Tigray and Ethiopian Somali Regions

Project period: February to June, 2015

Funded by:Clinton Health Access Initiative

Partners:Regional health bureau, Federal Ministry of Health, and Woreda health office

Major activities accomplished:

  • A three day BEmONC refresher training on February 2015.
  • Five BEmONC training carried out in the first round between March and April, 2015
  • Eight BEmONC training were conducted in second round between April and May, 2015
  • Total of 240 midwifes and nurses trained on BEmONC

Improving Maternal and Newborn Health through Capacity Building and Community Based Activities, at Two Zonal Public Hospitals

 Project duration: 2 years (February 1st, 2014 - July 31st, 2016) 

 General objective: The overall objectives of the project is to improve maternal and newborn health by increasing quality and accessibility to essential services 

 Activities accomplished:- 

1. Site Selection: Butajira and Bishoftu 

2. Setting Permissible Project Ground 

3. Establishing Project Site Coordination Team (PSCT) 

4. Project Introduction and Site Level Debriefing  

5. IEC/BCC Materials production and distribution on Key danger signs during pregnancy, labour/delivery and post natal (mother and child). 

6. Medical equipment and supplies procurement and distribution. 

7. Integrated refresher training for health extension workers 

8. Community mobilization on FANC and its Danger signs, BPCR, PNC and its Danger signs and Breast feeding

    More than 55 thousand people mobilized in five weeks period. Out of the total mobilized people, more than 48 thousands were from Butajira project area. In the mobilization campaign, 4 health centers and 13 catchment health           posts  were involved that is three health posts from Bishoftu and 10 from Butajira project areas.

9. Project end evaluation was conducted

 

 

 

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Vision

To see that our community understands the elements and properly utilizes the services of sexual and reproductive health (SRH); and that the profession secures the proper professional environment to realize its mission.

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