joint-aus-us-gov-review-hamlin-fistula-ethiopia-final-report.doc

Aid and usaid review of support to hamlin fistula

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AID and USAID Review of Support to Hamlin Fistula Ethiopia (Ethiopia) 31/05/2018 Services Order 230 Draft report 2.3. Organisational Effectiveness 2.3.1. Monitoring, evaluation and research HFE can demonstrate, from its data, that it is delivering services that contribute both to Ethiopia’s and Australia’s strategic goals. Different data are collected: hospital data, data from the government health centres using government systems and other data related to HFE-specific programs. Data are not disaggregated for gender or disability (all patients are women and all patients have impairments). Some women are disabled from drop-foot, while others are not cured of incontinence and HFE collects data on such cases i.e. impairment which affects mobility. Alignment of M&E Framework FMOH HMIS indicators Systems for M&E have only been developed during the past 1 ½ years – a very short time in the history of the organisation following repeated recommendations for improvements from AusAID assessors. The M&E department is keen to do a good job and is making best efforts to improve quality, use and feedback of data. While some technical assistance was provided by an HFA consultant, there is a lack of evidence to suggest that capacity was built to the desired level where robust, reliable and consistent data are generated and used for planning, training and advocacy among others. There is no indicator for Obstetric Fistula in the government HMIS so there can be no alignment until this is included. This is an issue deserving of advocacy with FMOH. Historically hospital records have been kept but not analysed and used by management. Annex 4a shows that HFE service statistics have been used for research and dissemination purposes by previous Medical Directors. There is otherwise lack of evidence of historic and on-going systematic M&E to link with strategic performance targets. This has arguably not been part of the HFE organisational culture until more recent efforts to formalise M&E. The HFE M&E department was not aware of feedback on M&E from AusAID provided to the past CEO of HFE. With improved information technology (IT) systems and staffing additions, including a statistician, routine data collection is now more systematic and the team was informed that HFE provides regular feedback to the regions on their reports. Hospital data generated are used by HFE but not shared with FMOH. HFE has asked FMOH to include OF as one of the HSDP-IV indicators. The Regional Health Bureau (RHB) in Tigray expressed interest in having routine hospital reports and plans to include OF among its indicators. This needs to be followed up both at regional and central levels to ensure consistency between regions and to ensure that HFE hospital data are properly reflected in national reports, which is currently not the case.
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