PSP-Ethiopia - Lessons Learned: Engaging Regional Health Bureaus for Program Sustainability

The Abt Associates-led Private Sector Program in Ethiopia (PSP-E), is a program focused on increasing the capacity of private sector organizations to deliver HIV/AIDS and tuberculosis (TB) diagnosis and treatment services by working in close collaboration with the Ministry of Health. PSP-E currently supports TB/Directly Observed Therapy Short-Course (TB/DOTS) services in 90 private sector clinics in Addis Ababa, Amhara and Oromia regions.

Although the Public-Private Mix TB (PPM-TB) initiative was launched by the Federal Ministry of Health, the project’s driving partners in program implementation are the Regional Health Bureaus (RHBs) of Addis Ababa, Amhara and Oromia. The RHBs are involved in all steps of the program planning, implementation and monitoring process. This spectrum begins with the assessment of clinics, site selection, signing of memoranda of understanding with private clinics, training, data monitoring, through to external lab quality control and supportive supervision. Sister Genet Yusef, TB Expert from the Addis Ababa RHB, said "We have good partnership from national to RHB and from RHB to PSP. We had a good partnership during scale-up – assessment, joint planning and joint supervision." The RHBs also recognize the need for them to integrate the private sector into their routine activities. Dr. Zelalem from the Oromia RHB stressed "We need to own it. When we train public providers, we need to include the private providers. When we do supportive supervision, we need to supervise the private providers."

The RHBs are fully engaged and committed to ensuring the success and sustainability of the program. There is a strong sense of ownership from the RHBs participating in the program and an expressed desire to transition the program to the RHB in the future. Tadesse Almair, TB/Leprosy Team Leader, Amhara Regional Health Bureau said, "We know programs started by partners are not sustainable so RHB needs to make it sustainable. We know the program is to 2009 and we have a plan to handover. This year we are planning to expand to 20 more facilities on our own or with PSP. We are on our way with this sustainability issue."