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

The first batch of midwives is now completing three

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generalise without more information. The first batch of midwives is now completing three years’ service and questions now arise as to whether the strategy of separate accommodation and a six year commitment is realistic and sustainable. HFE is cognisant that six years is a long time to stay in situ and expects some attrition. With this in mind, discussion on career path options and continuing professional development will need to be included in strategic planning discussions as well as viability of construction of new accommodation: Should HFE continue to expand the outreach model of midwives in health centres to the planned 25 or is it appropriate to review the current strategy of deployment, construction and support? Some midwives have voiced a preference for living within the community in rented accommodation. Should midwives work in rotation, to gain experience in different parts of the country? Should there be a career structure for HCM midwives? Will they stay 6 years in situ? If not, how can they be deployed? As tutors? Can HFE sustain the top-up payments? Should HFE explore career development for midwives through the FMOH model of ‘task shifting’ – to enable them to perform Caesarian sections and anaesthetics (in addition to MVA)? 34 Who will take responsibility to ensure infrastructure is maintained and repaired? How are the ambulances used? Are there systems for regulating this and do the midwives have easy access to the ambulances when referrals need to be made? 35 How long can HFE sustain the cost of the ambulances? 33 Personal communication Director Mekelle. 34 This model has had varied success in Mozambique. http://www.human-resources- health.com/content/7/1/49 35 FMOH plans to provide ambulances to all Woredas. Experience thus far – from the HSDP-IV MTR shows that there is significant abuse and damage of the ambulances AusAID Health Resource Facility 13 Managed by HLSP in association with IDSS
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AID and USAID Review of Support to Hamlin Fistula Ethiopia (Ethiopia) 31/05/2018 Services Order 230 Draft report HFE needs to explore options which will keep midwives in the system but at the same time address the issues highlighted above. HFE had plans to upgrade some facilities to be able to provide Comprehensive Emergency Obstetric Care (CEmONC). This level of care can only be provided at hospital level and while this can and is being done in the HFE centres, it is not an appropriate aim for HFE to achieve in government facilities. HFE midwives: program delivery against HFE and national targets HFE’s midwives (quite rightly), use the government Health Information Management System (HMIS) 36 and send a copy of their service data to HFE. Interpretation of the data is somewhat difficult as reports provide data both for the calendar year as well as for the Ethiopian Fiscal year 8 July - 7 July. The plans and reports use different measurements with contraceptive acceptance rate 37 used for the plan (see below), contraceptive prevalence rate (CPR) used for the 2011-2012 report and actual numbers of services
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