Ethiopia HIV/AIDS Activities

Typically in Ethiopia, government and donor support for HIV/AIDS related services has prioritized a public sector response. While these efforts have achieved tangible gains and greatly increased access to quality HIV/AIDS/TB services, there are limits to the absorptive capacity and reach of the public sector. The public sector is not always the best channel to reach high risk groups that may be reluctant to attend public sector clinics (for limited operational hours, fear of long lines, concerns about quality, stigma and anonymity). For these reasons, USAID Ethiopia funded the PSP-One project to engage private partners to expand the reach of counseling and testing, TB DOTS and ART. Given this lack of information about the private sector and its motives, PSP-One has carried out the following activities:

Assessed the Private Sector’s Potential as a Partner in Service Delivery: PSP-One conducted a groundbreaking private provider assessment to develop an understanding of Ethiopia’s private sector strengths and challenges. Few studies examining the private sector have been conducted in Africa, so its results will be valuable to Ethiopia and the region. The quantitative study was conducted among the practitioners and facility managers in private clinics (lower, medium, and higher levels), pharmacies, and hospitals. It examined topics including facility management procedures, access to and potential uses for credit, availability of HIV/AIDS/TB medical supplies and drugs, training and education, services available, counseling and testing procedures, referral protocols, and standards of care. A final report detailing the findings of the study is expected to be produced in late 2008, with dissemination events (to further dialogue and peer exchange) scheduled to commence in early 2009.

Provides Technical Support to the Government and Private Associations: Throughout its duration, PSP-One has worked closely with the newly establish Public Private Partnerships Unit of the Ministry of Health. PSP-One guides the Unit in their mission to engage the private sector in public health initiatives, specifically those related to HIV/AIDS/TB. PSP-One also provides technical assistance to the Medical Association of Physicians in Private Practice-Ethiopia (MAPPP-E) – the country’s only private sector professional association. Through PSP-One’s support, MAPPP-E is addressing public-private barriers by developing a private sector facilities directory, to inform the public of the presence and availability of the private sector in medical, laboratory and pharmacy services. The directory will be supplemented by an information booklet for MAPPP-E members. The booklet will inform them of opportunities (training and resource sharing) and obligations (taxes and reporting) as private sector health professionals in the country.

Demonstrates the Nuts and Bolts of Public Private Partnerships: To support the rollout of public-private delivery of HIV/AIDS and TB services, PSP-One has delivered technical assistance through online and interpersonal forums between 2007-2008. It has used expert mentoring and peer exchange to enable governments to build trust of the private sector, while learning pragmatic steps for engaging it. PSP-One has ensured that key government officials in Ethiopia have been introduced to the concepts of contracting, performance-based pay, and other financial vehicles that link funding to quality improvement in service delivery; an issue of great concern for both the public and private sectors. PSP-One has provided comparative country analysis of East Africa’s regulatory statutes that govern the private sector in health.

Offers Technical Assistance while fostering Peer Exchange: Dialogue fostered by PSP-One’s “Network for Africa Program” brought African leaders from Ministries of Health throughout Anglophone Africa to Addis Ababa in May 2008. The forum provided key technical assistance to build public-private linkages through health financing, and legal and regulatory. In September 2008, PSP-One built on this forum by partnering with MSH to launch the Virtual Leadership Development Program. The VLDP reaches 82 key African leaders and policy makers from Ethiopia, Swaziland, Ghana, Kenya and Nigeria in a 13-week program. The Program enables PSP-One to provide further technical assistance in private sector collaboration for HIV/AIDS service delivery.