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International Aid to HRH development in Ethiopia: Assessment of Irish Aid investment in the development of human resources for health in Southern Nations, Nationalities and Peoples Region (SNNPR)
Abstract
Background: Human resources for health (HRH) are considered the linchpin in health development but, until recently, donors were reluctant to support HRH development considered as higher education and not a priority for support. There have been changes in this attitude in the last few years. The evolution in Ethiopia is explored using the experience of Irish Aid (IA) as a case study.
Methods: The evolution of HRH in SNNP is explored through study of IA and Regional documents and interviews of key informants, focus group discussions and field visits in the region.
Results: Major national initiatives with short and long term impact on HRH are briefly documented including the ‘flooding strategy’, the Accelerated Health Officers Training and the rapid deployment of health extension workers (HEW). Major constraints/uncertainties in improved IA support are noted including absence of specific HRH policy and an outdated health policy; delays in the development of an HRH strategy; impacts of over-drawn BPR process… IA impacts on HRH in the region, including middle level HRH training; training of HEW, in-service training in general…, are commendable. The assessment also documents current weaknesses/gaps in IA support including lack of training needs assessment, weak supportive supervision, lack/delay in upgrading training - for HEW in particular, lag in training to clear the backlog of junior categories and inadequate increase of HRH for Emergency Obstetric Care. Adequate measures have not been taken to improve quality of pre-service training; improve motivation, efficiency and retention of the health workforce (HWF) and strengthen HRH management.
Conclusions and Recommendations: Overall, IA had discernable impact on HRH development in the region. Areas for future policy level dialogue and improved impact are recommended.
Methods: The evolution of HRH in SNNP is explored through study of IA and Regional documents and interviews of key informants, focus group discussions and field visits in the region.
Results: Major national initiatives with short and long term impact on HRH are briefly documented including the ‘flooding strategy’, the Accelerated Health Officers Training and the rapid deployment of health extension workers (HEW). Major constraints/uncertainties in improved IA support are noted including absence of specific HRH policy and an outdated health policy; delays in the development of an HRH strategy; impacts of over-drawn BPR process… IA impacts on HRH in the region, including middle level HRH training; training of HEW, in-service training in general…, are commendable. The assessment also documents current weaknesses/gaps in IA support including lack of training needs assessment, weak supportive supervision, lack/delay in upgrading training - for HEW in particular, lag in training to clear the backlog of junior categories and inadequate increase of HRH for Emergency Obstetric Care. Adequate measures have not been taken to improve quality of pre-service training; improve motivation, efficiency and retention of the health workforce (HWF) and strengthen HRH management.
Conclusions and Recommendations: Overall, IA had discernable impact on HRH development in the region. Areas for future policy level dialogue and improved impact are recommended.
