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

Hfes best efforts towards of prevention are in

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HFE’s best efforts towards OF prevention are in improving skilled delivery and AusAID Health Resource Facility 34 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 Criteria Conclusions increasing family planning uptake. Efficiency: 4 Serious concerns have been expressed in AusAID reports regarding efficiency. Reporting has been delayed and is of poor quality, offers for technical assistance have not been taken up. Only 63 per cent of the 2011 tranche of funds were acquitted. AusAID funding for HFE has been used both for capital development and running costs. The hospitals are well built, functional and appear to be in excellent condition. The Hamlin College of Midwives and Desta Mender have been built to exceptionally high standards. A comment was made to the team that the Western design of houses of Desta Mender was not ideally suited to the women’s needs and houses in local style (e.g. Tukul) could have been made at less cost. This said, the land for all HFE’s infrastructure has been donated, thanks to the efforts of Drs Hamlin and could arguably be used to generate revenue. The residents of Desta Mender grow food which is consumed on site with some going to AAFH. The women also run the small centre with café that is rented out for meetings to generate revenue. HFE acknowledges that cost cutting is needed for cost efficiencies. Current infrastructure plans include expansion of the residential buildings in the College of Midwives and accommodation for midwives in the HCs. The former could have greater potential for cost recovery by increasing the number of students while the latter has significant cost implications and alternative arrangements (such as renting accommodation) might be more cost effective. Sustainability: Rating: 5 HFE has been highly successful in raising money through its partners in eight countries and AusAID contributions over the years amount to less than a quarter of HFE’s total income. There are indications that recent fundraising both by HFIF and HFE(A) have been successful suggesting that fundraising through HFE’s eight country partners can raise substantial revenue. Increasing revenue from training of surgeons is possible provided there are adequate trained trainers on staff and marketing of training for the Africa region. HFE can explore other ways in which revenue can be sustainably increased such as charging fees for operations (from FMOH budget), hiring out facilities, and applying for grants from other sources in Ethiopia and globally. Partnership with GoE could increase access to national resources and GoE ownership of the fistula program. A realistic vision for the future functioning of both HCM and the fistula centres is also critical and FMOH needs to share this vision.
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