Leadership Management and Governance, Ethiopia (LMG ET

Leadership Management and Governance, Ethiopia (LMG ET) Project

Annual Report PY3: October 1, 2014 – September 30, 2015

Author: Management Sciences for Health (MSH)

Date of Publication: October 2015

Development Objective:

The LMG Project’s objective is to support health systems strengthening by addressing the gap in leadership, management, and governance capacity of policymakers, health care providers and program managers to implement quality health services at all levels of the health system. Governance functions – distinct from leadership and management functions – are an important focus of LMG because they provide the ultimate commitment to improving service delivery, and foster sustainability through accountability, engagement, transparency, and stewardship.

Any Suggested Keywords: Leadership, Management, Governance, Health Systems Strengthening, Annual Report, PY3, Ethiopia, Africa

Leadership, Management, and Governance - Ethiopia Management Sciences for Health 200 Rivers Edge Drive Medford, MA 02155 Telephone: (617) 250-9500 http://www.msh.org

This report was made possible through support provided by the US Agency for International Development and the USAID Addis Ababa Office, under the terms of Cooperative Agreement Number AID-OAA-11-00015 and Petros Faltamo. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the US Agency for International Development.

http://www.msh.org/

USAID/PEPFAR Ethiopia In-Country Reporting System (IRS)

Reporting Template

Management Sciences for Health

LMG/Ethiopia

ANNUAL

PROGRESS REPORT

FOR

FISCAL YEAR 2015

(OCTOBER 1, 2014 TO SEPTEMBER 30, 2015)

CONTACT INFO FOR THIS REPORT:

JEMAL MOHAMMED

COUNTRY PROJECT DIRECTOR

TEMESGEN WORKAYEHU

M&E ADVISOR

Management Sciences for Health

PO Box 1157 Code 1250

Addis Ababa,Ethiopia

Mobile: +251 911754483

Email: [email protected]

mailto:[email protected]

LMG/Ethiopia: September 2015 Annual Progress Report Page 2

LIST OF ACRONYMS

AAU Addis Ababa University ALERT All African Leprosy and TB Rehabilitation and Training

ANOPA+ Addis Ababa Network of PLHIV Association ART Anti-Retroviral Therapy CCM Country Coordinating Mechanism CDC Center for Disease Control CHS College of Health Sciences CLM Center for Leadership and Management CPD Capacity Development CSO Civil Society Organizations DATIM PEPFAR’s Data for Accountability, Transparency and Impact DMR Desired Measurable Result

EHRIG Ethiopian Hospital Reform Implementation Guideline EPHOA Ethiopian Public Health Officers Association FHAPCO Federal HIV AIDS Prevention Control Office FMOE Federal Ministry of Education FMOH Federal Ministry of Health GAC Grants Approval Committee GF Global Fund GFATM The Global Fund to Fight Aids, Tuberculosis and Malaria HAPCO HIV AIDS Prevention Control Office HIV Human Immunodeficiency Virus HSM Health Service Management HTC HIV Testing and Counseling ICU Intensive Care Unit IPD Inpatient Department IST In-Service Training L+M+G Leadership, Management, and Governance MTR Mid Term Review NEP+ Network of Positives NOP Network of Oromia Positive NNPWE National Network of Positive Women in Ethiopia OALFA Observe, Ask, Listen, give Feedback, and Agree OPD Outpatient Department OR Operation Room OVC Orphans and Vulnerable Children PLHIV People Living With HIV PLWHA People Living With HIV AIDS PST Pre-service Training PFSA Pharmaceuticals Fund and Supply Agency PMTCT Preventing Mother to Child Transmission PSM Project Support Management RHB Regional Health Bureau


RCC Rolling Continuation Channel SLP Senior Leadership Program SNNPR Southern Nations and Nationalities Peoples Region SR Sub-Recipients TOT Training of Trainers TTP Team Training Program TRP Technical Review Panel VCT Voluntary Counseling and Testing

TABLE OF CONTENTS

1. Reporting Period ............................................................................................................. 4

2. Publications/Reports ....................................................................................................... 4

3. Technical Assistance ....................................................................................................... 4

4. Travel and Visits ............................................................................................................. 5

5. Activity ........................................................................................................................... 5

6. Accomplishments and successes during the reporting period ........................................ 6

7. Challenges,Constraints,and Plans to Overcome Them during the Reporting Period ... 27

8. Data Quality Issues during the Reporting Period ......................................................... 27

9. Major Activities Planned in the Next Reporting Period ............................................... 28

10. Environmental compliance ......................................................................................... 29

11. Financial accomplishment .......................................................................................... 29

12. Issues requiring the attention of USAID Management ............................................... 29

13. Data Sharing with Host Government: ......................................................................... 29

14. Appendices ................................................................................................................. 30


1. Reporting Period

From

October 1,2014

To

September 30,2015

2. Publications/Reports Did your organization support the production of publications, reports, guidelines or assessments during

the reporting period?

No/Not Applicable

Yes If yes, please list below:

Publications/Reports/Assessments/Curriculums

Title Author Date

If Yes, Please attach an electronic copy of each document as part of your submission.

3. Technical Assistance Did your organization utilize short-term technical assistance during the reporting period?

No/Not Applicable

Yes Please list below:

Consultants/TDYs

Name Arrival Departure Organization Type of Technical assistance

provided

Simon, Rebecca April 12,2015 May 3,2015 LMG/Global Communication strategic plan

development

Alain Joyal July 25, 2015 July 31st,

2015

LMG/Global Project management support

Jackie Lemlin 01/08/2015 01/26/2015 LMG/Global Program management support

Barbara Tobin 01/12/2014 12/12/2014 LMG/Global Strategic Planning support

Belkis Giorgis 11/01/2014 Feb 5,2015 LMG/Global Technical support on Gender in

the context of public health

Lourdes de la Peza 24/11/2014 28/11/2014 LMG/Global Governance training for public


Name Arrival Departure Organization Type of Technical assistance

provided

universities

If Yes, Please attach an electronic copy of the TA report as part of your submission.

4. Travel and Visits

Did your organization support international travel during the reporting period? No/Not Applicable

Yes Please list below:

International Travel (All international travel to conference, workshops, trainings, HQ or meetings).

Name Destination Departure

from

Ethiopia

Arrival Host Organization Purpose of the travel

Have any Monitoring Visits/supervision been made to your program in during the reporting period? Description of Monitoring team

Start date End date Sites visited Written recommendations provided

An Internal mid Term Review conducted

March 2nd 13th 2015 Addis, Dire Dawa and Harari

5. Activity Program Area

(Tick all which apply)

Activity ID

Activity Title ( Please write the title of the activity)

01-PMTCT

02-HVAB

03-HVOP

04-HMBL

05-HMIN

07-CIRC

08-HBHC

09-HTXS

10-HVTB

11-HKID

12-HVCT

13-PDTX

14-PDCS


15-HTXD

16-HLAB

17-HVSI

18-OHSS

6. Accomplishments and successes during the reporting period

Program area 18-OHSS

Intermediate Result 1: Management System in Place for Harmonized and Standardized L+M+G Pre- and In-service Training Modules:

Key activities under this IR

1) Review and updating of the L+M+G IST manuals

2) Support provided to eight public universities to develop new syllabus for pre-service L+M+G courses

- Governance Training provided for 20 HSM course instructors from the eight universities that have integrated leadership, management, and governance (L+M+G) into their HSM courses (Indicator 13).

- L+M+G Core Competency Development and Content Integration Workshops held for Medicine and Pharmacy categories (Indicator 13)

- L+M+G core competency facilitation training provided to 35 TTP instructors and coordinators from the same eight partner universities

- L+M+G capacity building orientation provided to Team Training Program (TTP) support, 88 university staff and 500 graduating students from Jimma and Gondar universities received L+M+G capacity building orientation in order to incorporate the challenge model into TTP. (Indicator 13).

1) Updating of the L+M+G In-service Training (IST) materials initiated and in progress:

The three L+M+G training manuals for the Senior, Woreda/district and Facility level managers were revised and updated. This also included completion of the participants’ manuals and supplementary notes/handouts. The review process involved obtaining inputs through interviews of a number of users of the training modules (facilitators, trainers, and trainees) and other key informants. The updating exercises mainly focused on 1) improving the experiential learning aspect with a focus on the holistic approach of the learning process and the multilinear model of adult development, both of which are consistent with what we know about how people learn and grow 2) ensuring that the manuals reflect recent


developments in the health sector, most notably the new Five Year Health Transformation Plan, the outcomes of the 20 year Visioning Exercise and the updated National Health Policy; and 3) better aligning the participants’ manual with the facilitators’ guide.

2) LMG provided Technical Support to Eight Public Universities

The L+M+G capacity building support was provided to training institutes throughout the reporting period. In January 2015, the project carried out a five day competency development workshop with eight1 public universities. The participants developed competency areas as part of revising the Health Services Management (HSM) undergraduate course syllabus for medicine and pharmacy students. The participants developed core and sub-competencies, instructional objectives and reviewed contents to address the instructional objectives. The workshop was attended by 12 (12 M and 0 F) participants from the public universities as well as from professional associations of medical doctors and pharmacists.

During the reporting period, there was a request from the universities to have more support in their skills development to facilitate subject matters related with governance for health. This request was made after the pilot testing of the newly revised curricula for under graduate students of midwifery, nursing and health officers. As part of responding to their request a four days complementary course was organized for 20 HSM instructors drawn from the eight public universities.

Most public health schools in Ethiopia have now adopted a 2-3 months L+M+G practicum at facility and community level for undergraduate students in their last year of formation as part of their HSM course and of their graduation requirements. This practicum, commonly called the Team Training Program (TTP), is a community based learning activity that follows a problem solving approach. The students coming from various health and medical sciences areas are organized in multidisciplinary teams and cover tasks such as mapping and site selection, developing investigation tools, gathering data, processing and analyzing information, listing and prioritizing problems, drawing a plan of action, carrying out interventions and conducting follow-up and evaluation work involving all stakeholders. During the reporting period, the LMG project closely partnered with the universities providing TTP to support them in developing and integrating the L+M+G content to the practicum based on the Challenge Model. As part of the integration process the LMG project trained 35 (34 Male + 1 female) TTP instructors and coordinators from the eight partner universities. During the reporting period, the LMG team with trained

1 The eight universities include Addis Ababa, Wollo, Mekele, Jimma, Haramaya, Gondar, Bahir Dar and Hawassa


instructors managed to provide orientation sessions for 88 other staff in Jimma and Gondar and 500 medical students (189 from Jimma University and 311 from Gondar University students) taking part in the TTP.

It is imperative to mention here that we were asked by the Mission to remove the pre-services program in March 2015 from the reporting period work plan, and consequently only follow up of TTP students as per the PEPFAR’s DATIM requirement was carried out.

Intermediate Result 2: L+M+G Capacity of Selected FHAPCO, FMOH Directorates, Core Processes and Relevant Agencies, as well as selected Regional Health Bureaus, Zonal/District Health Offices and Facilities Developed

Key activities under this Intermediate Result include the following:

• L+M+G Trainings:

• 57 federal and regional HAPCO senior staff attended two days of L+M+G training.

• 168 health managers and workers in 69 teams from the HIV/AIDS Prevention Control Office (HAPCO), people living with HIV/AIDS (PLWHA) associations and facility-level HIV units attended their 1st and 2nd round L+M+G trainings. (28 teams completed the 1st round and 39 teams completed the 2nd round ) (Indicator 6)

• A total of 135 health mangers in 31 teams from South West Shoa, East Shoa and West Arsi Zone, West Shoa Zone and Amhara RHB completed their action plan and held result presentation workshop.

• From Ayder, Gondar, Hawassa, Jimma and Hiwoth Fana teaching hospitals 287 staff in 57 teams received their 1st, 2nd and 3rd round L+M+G training sessions (Indicator 6)

• 177 senior health managers and workers in 50 teams from Emerging Regions regional health bureaus took part in the first and second round L+M+G training session

• 126 health managers and workers from Emerging Regions district /Woreda health office staff took part in L+M+G training session completed their action plan and held result presentation workshop; 8 teams in Gambella and 31 teams in Somale).

• 61 participants of Benishangul Gumuz districts /Woredas and 44 participants of Afar region districts/Woredas took their 2nd and 3rd round L+M+G workshop


respectively. 2) Coaching Support: Coaching support provided for Amhara and Oromia RHB teams

1) L+M+G Trainings:

Senior Alignment Meeting with Officials of Federal and Regional HIV/AIDS Prevention and Control Offices

As part of aligning LMG’s support to the country’s HIV/AIDS strategic plans and priorities, LMG organized a senior course for participants drawn from federal and regional HAPCOs, and RHBs. The senior course focused on key areas of leadership, management and governance, and how improved L+M+G skills can bring changes in HIV/AIDS prevention, care, support and treatment programming. During the training critical gaps in leadership and management were identified. These gaps include limited capacity to decentralize the health/HIV sector in terms of devolving authority to districts and facilities, and non-use at the lower levels of several national guidelines and protocols. Several challenges were also identified in the area of grant and financial management indicating a need for better skills in leadership, management and governance. The challenges include poor budget planning and alignment with program planning, lack of follow-up by the leadership on audit recommendations, and lack of skills for improving fund liquidation and reporting at facility and district level. During the sessions, it was agreed that roll-out of the L+M+G IST courses to regional, district and facility levels would contribute greatly to improving the performance of staff of HAPCO and HIV/AIDS departments/units within RHBs, district health offices and facilities. The training was held from March 8-9, 2015 and attended by 57 (49 M and 8 F) senior officials from FHAPCO, RHAPCOs, and RHBs.

HAPCO and PLWA associations (see Table 1 below, section 1).

• Addis Ababa based National PLHIV associations (Mekdim and NEP+):

As part of the rollout plans agreed with senior FHAPCO officials the first and the second L+M+G workshops for two national PLWHA associations (Mekdim Ethiopia National Association of PLWHA and the Network of Networks of HIV Positives in Ethiopia) were conducted from May 23-25, 2015 and August 4-6, 2015 in Addis Ababa. During the first workshop, 7 teams with 19 participants (15 males and 4 females) attended the workshop while 6 teams with 12 participants (7 males + 5 female) attended the second one. One team did not the second workshop attend due to conflicting priorities. They will be subject to a make-up session the next quarter so that they can continue the program along with the other teams. The teams have refined their respective draft L+M+G project in a discussion held with their workplace teams after the first workshop. Increasing ART adherence, targeted HIV testing and resource mobilization are among the measurable results the team selected and continued to work on during the program. Large and small group discussions, group and take-home exercises, and mini lectures were among the methodologies applied. Both


workshops were facilitated by a team of facilitators from the LMG/Ethiopia project.

Region Teams Male Female Total

1 HAPCO and PLWHA associations

1.1 Addis Abab PLWHA 2nd ( One team declined) 6 7 5 12

1.2 Amhara HAPCO ( during 1st there were 33 participants -24M+9M) 22 35 29 64

1.3 North and South Wollo Zone HHAPCO (1st ) 10 23 12 35

1.4 North and South Gondar Zone HHAPCO(2nd)i 11 24 12 36

1.5 East and West Gojam Zone HAPCO 18 27 25 52

Sub Total 67 116 83 199

2 Regional Health Bureau 0

2.1 Oromia regional health Bureau (3rd) 10 24 6 30

Sub Total 10 24 6 30

3 Result presentation 0

3.1 Amhara RHB ( 10 of the 13 teams presented their result) 10 33 20 53

3.2 West Shoa Zone Health Department 5 19 5 24

3.3 South West Shoa Zone Health Department 5 18 3 21

3.4 West Arsi and East Shoa Zone health department 11 33 4 37

Sub Total 31 103 32 135

4 Teaching Hospitals 0

4.1 Jimma teaching hospital 20 45 19 64

4.2 Hiwot Fana Teaching Hospital ( 2nd round)( During the first workshop there were 48 participants ( 28 M+20F)

10 26 18 44

4.3 Ayder Teaching Hospital 3rd round) 9 35 21 56

4.4 Gondar Teaching Hospital( 2nd round) 9 41 16 57

4.5 Hawassa Teaching Hospital ( 1st round)( first workshop ( 62 participants ( 48M+14 F)

9 44 22 66

Sub Total 57 191 96 287

5 Emerging regions ( districts )

5.1 Somale districts/Woreda result presentation 31 102 5 107

5.2 Gambella district teams result presentation 8 19 0 19

5.3 Benishangul Gumuz District /Woreda 2nd ii 24 58 3 61

5.4 Afar region district/Woreda 16 41 3 44

Sub Total 79 220 11 231

6 Emerging regions ( Seniors )

6.1 Gambella region senior ( 2nd) 16 42 8 50

6.2 Afar region Senior 1st 10 29 7 36

6.3 Benishangu Gumuz region senior 1st 15 48 11 59

6.4 Somali region senior 1st 9 30 2 32

Sub Total 50 149 28 177

Grand Total 294 803 256 1059


Table 1. Number of teams and health workers trained with the approved L+M+G modules between October 2014 and September 2015 (disaggregated by Gender, location and type of site)

• Amhara regional HAPCO and its partners:

The second L+M+G workshop for Amhara HAPCO and its partners including PLHIV associations, facility level HIV/AIDS units as well as local HIV/AIDS-NGOs was conducted from September 19th -21st in Dangila town. This workshop was attended by 64 participants (35M, 29F) organized in 22 teams. As a result of a request from the RHAPCO’s human resources department, the number of teams and participants increased during the second workshops with additional teams coming from two health centers and a hospital where ART and PMTCT services are delivered. During the workshop root cause analysis for their selected challenges, stakeholder mapping and resource mobilization were covered. Participants were also trained in prioritization, coaching and monitoring and evaluation. Decreasing dropout rate of ART, follow up of HIV positive women in income generating, computerization of patient cards, and increasing the scope of VCT services are a few examples of the measurable results the teams selected and continued working on throughout the training cycle.

This second workshop is a follow up of the first workshop held on May 16-18, 2015th in Bahird Dar town where 33 participants (24 M, 9F) were in attendance. Both workshops were delivered by facilitators from LMG, Amhara Regional Health Bureau and Bahirdar Health Science College.

• North & South Wollo HAPCO and PLWHA associations: The first L+M+G workshop for North and South Wollo HAPCO office and its partners' leadership teams was delivered from June 20-22, 2015 in Woldiya town. Ten teams consisting of 35 participants (23 males and 12 females) attended the workshop. Seven participants are from PLWHA associations (Addis Hiwot Rehabilitation and Reintegration, and Tesfa Birhan), nine are from other local NGOs, 11 are from health facilities, and the remaining 8 participants are from two of the zonal HAPCO offices. The teams crafted their respective draft Challenge Model, which are to be refined in consultation with their workplace colleagues once they are back at their units. Increasing ART adherence, targeted HIV testing and resource mobilization are among the draft measurable results the teams selected and will continue to work on during the 6-9 months-long training cycle. The workshop was conducted by a team of facilitators coming from Wollo University and LMG/Ethiopia project. The second workshop is scheduled to be held in the first week of October 2015.


• North and South Gondar HAPCO, PLWHA associations and facility level HIV units:

During the reporting period, the first and the second L+M+G workshops for North and South Gondar Zonal HAPCO offices, PLWHA associations and facility level HIV units was conducted from June 19-21, 2015 and August 28-30,2015 at Gondar and Debre Tabor University, respectively . A total of 39 participants (25 males and 14 females) attended the first workshop and 11 L+M+G teams were established. During the second workshop, all the 11 teams were in attendance though the number of participants decreased to 36 (24 Male + 12 Female) due to conflicting commitments. Before coming to the second workshop, the teams held meetings with their work colleagues to better refine their Challenge Model. Partner HIV testing and counselling, PMTCT services, multi-sectoral mainstreaming of HIV/AIDS, resource mobilization and peer education are among the measurable result areas the teams selected and will be addressing throughout the training cycle. The workshop was facilitated by a team of facilitators from Gondar University, and Bahirdar Health Science College.

• LMG Training for East and West Gojam HAPCO, PLWHA associations and facility level HIV units: The first L+M+G workshop for East and West Gojam HAPCO office, PLWHA associations and facility level HIV unit staff was conducted from August 1-3, 2015 at Debrmarkos. A total of 52 participants (27 males and 25 females) attended the workshop and 18 L+M+G teams were established. Out of these, 6 participants in two teams came from PLWHA associations (Addis Hiwot and Beza PLWHA Associations ), 5 participants in two teams came from other two local NGOs, ( PROPRIDE and NEP+) and 34 participants in 12 teams came from health facilities and the remaining 7 in two teams were from the Zonal HAPCO. All the teams crafted their respective draft Challenge Model, which are to be refined in consultation with their workplace colleagues once they are back to their units. Partner HIV testing and counseling,, PMTCT services, multi-sectoral responses to HIV/AIDS, resource mobilization and peer education are among areas of the measurable results the teams selected and will be addressing throughout the training cycle. The workshop was conducted by a team of facilitators coming from Bahir Dar Health Science College and LMG Ethiopia.

Oromia Regional Health Bureau (see section 2 of Table 1 above)

• Oromia RHB: During the reporting period, the second and third round L+M+G workshops were conducted for participants from Oromia Regional Health Bureau. A total of 39 participants (33 males and 6 females) and 30 participants (24 males and 6 females) attended the second and third workshops respectively. During the third workshop the number of participants decreased to 30 as the training was held close


to the time of national and regional elections. Though the number of participants was lower; it was noted that all the 10 teams were represented in the two rounds of the workshops. During the workshops teams presented their progress in implementing activities that are built up on their action plans and received feedback from facilitators and other participants. The measurable results of the teams mainly focused on providing supportive supervision for HIV/AIDS activities at the Woreda level, increasing the TB detection rate, improving health service delivery, and improving the internal audit system. The training was facilitated by a team of facilitators from Ambo University and LMG project.

Result Presentations (see section 3 of Table 1 above)

• Final results presentation workshop by Amhara RHB: During the reporting period, a results presentation workshop was held at Bahir Dar Health Bureau meeting hall from August 28-31, 2015. During the workshop 10 out of 13 teams that were trained, totaling 53 participants (33 Male +20 Female), presented their results. The remaining three teams were not able to take part in the session due to various factors. For example, the janitor team members being relocated outside the RHB could not attend while the regional lab team dropped out due to it being restructured. Follow up and coaching supports will be provided to the Public Health Emergency (PHE) team by the LMG in collaboration with the Amhara Regional Health Bureau Human Resource Department. During the result presentation workshop it was noted that 7 of the teams achieved above 80% of the target set for their measurable result. The workshop was facilitated by trainers from by Bahir Dar Health Science College and LMG/Ethiopia.

• West Shoa Zone Training: During the reporting period, the second, third and final result presentation L+M+G workshops of West Shoa Zone Health Department were conducted in Ambo town. During the results presentation workshop which was held from August 29th-30th, 2015, 24 participants (19 M and 5 F), organized in five teams, were in attendance. All the participating teams except one have managed to attend all the workshops and receive coaching support from facilitators and achieved results that they built up in their challenge models. As a result of their participation in the LMG courses, the teams managed to make extensive improvements in HIV testing and counseling, TB detection rates, improving data quality, customer satisfaction, and computerization of human resource management. It was noted that all the five LMG teams achieved more than 80% of their targets set as their measurable results. Due to other competing priorities, one team under the family health department dropped out of the training cycle after the second workshop. Follow up is being arranged with Ambo University to support the team in completing the course. All the four workshops were facilitated by trainers from Ambo University and LMG Ethiopia.


• South West Shoa Zone Training: Similarly, the third round and result presentation L+M+G workshops for participants from South West Shoa Zone Health Department were conducted from May 2-3, 2015 and August 22-23, 2015, respectively at Wolliso. During the final results presentation workshop 21 participants (18 Male +3 female) were in attendance. All the five teams presented their results and discussions were held about their achievements. As noted from the result presentation workshop 5 of the teams achieved above 80% of targets set as part of their measurable results. For instance, a team from the Communicable Diseases Control (CDC) HIV/AIDS Program sub-process has planned to apply the leading, managing and governing practices to increase the number of health centers providing Provider Initiated Testing and Counseling (PITC) services in the Zone from 65% to 89%. During the results presentation workshop, it was remarked that by applying L+M+G skills learned during the workshops, the teams improved their work climate and management systems, enhanced team work, improved communication among all levels of HIV experts in the Zone, and strengthened supportive supervision and engagement of stakeholders working in the zone. As per their action plan, the team trained 14 health care providers on PITC, increasing the number providing PITC in the Zone to 112. They also, mobilized 1252 HIV Kits which enabled 47 of the 54 health centers in the zone to provide PITC services. This has tremendously increased the number of clients receiving PITC service by 300 % (from 18,701 in 2014 to 56,709 in 2015). In between the four workshops, the teams received regular coaching support by trainers from Ambo University. It was also indicated that all the five teams achieved above 80% of their desired measurable result.

• West Arsi and East Shoa Zone Training: During this FY, the second, third and result presentation L+M+G workshops for West Arsi and East Showa Zonal Health Departments were carried out. The final results presentation workshop that was held from August 14th to 15th 2015 attended by 37 (33 M and 4 F) participants. During the result presentation workshop, a total of eleven teams presented their results and discussions were held on their achievements, challenges and lessons learned throughout the LMG course. As stated in the previous reports, the team’s projects focused on improving TB detection, improving institutional delivery, improving human resource management systems, and improving quality of health services. Four of the 11 teams achieved more than 80 % of their targets. . For those teams who achieved below 80% of their MR target, follow up support was planned and discussed with the zonal health departments, Ambo University and the Regional Health Bureau.

In their presentation, teams highlighted that the LMG course has helped them in improving their work climate and management system. For instance, in East Shoa Zone, the Communicable Disease Control (CDC) core process team planned to


increase the TB case detection rate from 51% to 85% by applying L+M+G skills . In their result presentation, the team pointed out that the training helped them in improving their work climate by improved team work, coordinated supportive supervision, TB case follow-up, creating awareness through community mobilization, and effective engagement of stakeholders. The team also organized capacity building training for 60 lab professionals, 30 health professionals (on Multi Drug Resistance (MDR) TB and provided comprehensive TB training for 173 clinicians from the Out-Patient Department (OPD) and TB focal persons from all health facilities in the Zone. This resulted in the number of health facilities providing TB diagnostic services to increase from 28 to 58, a TB smear positive case detection rate increase from 51% to 60.4%. Accordingly 887 TB smear positive and 204 TB cases positives for HIV detected and provided with appropriate care, support and treatment services.

Similarly the West Arsi Zone Health Department Family Health core process set their desired measureable result: to Increase long acting family planning utilization coverage in the zone from 3% to 30%. The team was able to plan and distribute 17,830 Implanon, and 4,396 IUCD throughout the Zone. The devices had been incorrectly stored and had created a false shortage. The Family Health core process team conducted a review meeting with heads of primary health care units, woreda coordinators, and service providers to assess the status of store management, identify key gaps in managing family planning commodities and developed action plans for improvement. As part of the L+M+G practices, the Zonal Family Health core process also designed a motivation mechanism that recognizes the performances of the health extension workers and their facilities. All these efforts significantly contributed to increased LAFP method utilization within the Zone. It was remarked that the team increased utilization of LAFP methods even beyond the planned target of 3% to 32%.

L+M+G Training for Teams from Teaching Hospitals (see section 4 of Table 1 above)

The LMG Project in collaboration with the Medical Services Directorate of FMOH provided five university teaching hospitals with L+M+G capacity building courses; Jimma, Mekelle, Gondar, Hawassa, and Haramaya universities. Fifty seven (57) teams consisting of staff from senior management and all departments participated.

• LMG training at Jimma Teaching Hospital: As one of the five teaching hospitals under our PY4 work plan, the first L+M+G workshop for Jimma Teaching Hospital staff was conducted from September 4-6, 2015. A total of 64 participants (45 males and 19females) attended the workshop. Twenty L+M+G teams were established, with five teams working exclusively on HIV/AIDS interventions. The teams crafted their draft Challenge Model, to be further validated and refined with their respective


units. Health systems reforms, health policy, concepts and practices of leadership, management, and governance were among the subject matters covered during the workshop. The number of LMG teams at Jimma Teaching Hospital is a bit higher compared to other teaching hospitals under this program. This is due to the high level of interest by the hospital leadership to engage more teams with specific roles and responsibilities from different departments and sub units.

Teams were diversified consisting of staff from all levels and disciplines within the hospital. Team members were also fully engaged in the process with 100% attendance and no interruptions or delays. Even senior clinicians who are often pulled away to address all sorts of issues, fully attended the sessions. The hospital CEO remarked that the litmus test for the success and appreciation of this training is the full attendance by our senior clinicians. He pointed to a senior gynecologist and said that he has never seen his colleague patiently y sitting in training for more than 5 minutes. The training was facilitated by trainers from Jimma University and LMG.

• The first and second L+M+G Workshop at Hiwot Fana Teaching Hospital of Haramaya University: The L+M+G workshops for Hiwot Fana Teaching Hospital were conducted with a total of 48 and 44 participants attending the first and second workshops respectively. Participants were formed into 10 teams. The teams are from the Outpatient Department (OPD), Inpatient Department (IPD), Department of Pharmacy, Department of Nursing, Department of Laboratory, Emergency Unit, Anesthesia OR, ICU Unit, and the hospital senior management committee. During the second workshop teams reported that following the first workshop, they held team meetings with their respective departments in order to s share what they had learnt, and prioritize and agree on workplace challenges. The workshops were facilitated by trainers from Haramaya University and LMG Ethiopia.

• L+M+G workshops at Ayder Teaching Hospital of Mekelle University: During this FY, the LMG project managed to rollout the third round of the LMG workshops at Ayder Teaching Hospital. A total of 56 participants (35 males and 21 females) formed into nine L+M+G teams attended the third workshop held from June 27-28, 2015. All teams presented their progress in implementing their work plan and towards achieving their measurable results. As described in the previous quarter’s progress report, the focus for the majority of the teams was on achieving improvements in the Ethiopian Hospital Reform Implementation Guide (EHIRG) indicators where HIV/AIDS, infection prevention and standard PMTCT and HCT are priorities. The training was primarily facilitated by the LMG/Ethiopia Project, in collaboration with certified trainers from Mekelle University. In between the workshops trainers from the university and champion participants from the hospitals provided coaching supports to participants.


• LMG training at Gondar Teaching Hospital: The first and the second round of the L+M+G workshop were carried out for staff of Gondar Teaching Hospital at Gondar University from November 28-30, 2014 and January 23-25, 2015, respectively. A total of 62 (48 males and 14 females) and 57 participants (41 males and 16 females) attended both trainings in 9 teams, respectively. Each L+M+G team applied the Challenge Model to identify and address critical problems. During the second workshop, teams presented their progress and noted that all teams have clarified and completed their Challenge Model, and developed action plans to be implemented in the following period. The Ethiopian Hospital Reform Implementation Guide (EHRIG) indicators were chosen by all of the teams for measuring results. The trainings were facilitated by certified trainers from the University of Gondar and LMG project.

• The first round LMG workshop at Hawassa Teaching Hospital: The first L+M+G workshop for the Hawassa Teaching Hospital staff was conducted from February 27-March 1, 2015 at the hospital. A total of 66 participants (44 males and 22 females) attended the workshop. Ten L+M+G teams were established from the: Pharmacy; Outpatient (OPD); Finance; Procurement and Commodity; Nursing Services; Laboratory; Emergency Treatment; Facility Management; Inpatient Service; ICU & NICU; and OR departments. The teams crafted their Challenge Model, which will be further refined in consultation with the workplace teams at a later date. The training was facilitated by Hawassa University and LMG/Ethiopia project staff. The delay to hold the consecutive workshops was due to the national and regional elections and recurrent restructuring happening within the hospital. During a recent meeting with the FMOH, it was indicated that the hospital senior management body is now ready to take up the remaining workshops without any further delay.

Collaboration with the FMOH’s Special Support for Health Systems Strengthening Directorate initiative in the Emerging Regions (see sections 5 and 6 of Table 1 above)

The L+M+G training program is being rolled out into the Emerging Regions of Ethiopia by the FMOH’s Special Support for Health System Strengthening Directorate. Our project support to the Directorate is limited to the provision of training material and technical assistances. All aspects of the program’s organization, logistics, training delivery and facilitation are handled directly by the Directorate and local authorities. We see this positive development as a clear indication of the high degree of ownership Ethiopia has for this program and the commitment the health authorities have for deploying it across the country, including in least developed areas.

• LMG training for Somali Regional Health Bureau senior leadership and Results presentation workshop by District Teams: The first senior level L+M+G workshop


for Somali regional health bureau senior managers and leaders was conducted from August 1-3, 2015 and attended by 32 (30 Male, 2 Female) participants organized in nine teams . During the workshop the teams identified their critical challenges and drafted measurable results for the identified challenges. The workshop instigated discussions among participants in areas like health policy, health care reforms as well as opportunities, challenges and risks that the leadership should be aware of as part of the next five year health transformation plans of the Regional Health Bureau. This is seen as a good example of senior leadership applying leading, managing and governing practices in operationalizing the health transformation plans. Before the second workshop that is scheduled to be held in the first quarter of FY 2016, the teams will further discuss their draft challenge model with their staff within the bureau. The training was facilitated by trainers from FMOH and LMG project.

The LMG project in collaboration with FMOH conducted the district level LMG workshop for 32 districts in Somali region. During the last quarter of this FY, the results presentation workshop was held from July 3-5, 2015 in Jigjiga town. All the 31 teams attended the workshop with 107 (102 M, 5 F) participants. During the sessions participants made presentations about their achievements. It was noted that most teams have managed to apply the leading, managing and governing practices to improve their work climate resulting in better team work, open and transparent communications, and use of evidence for decision making. Overall, 29 of the district teams from Somali Region have achieved greater than 80% of the target set for their measurable results. The remaining three teams including the team that did not attend the final workshop will be followed up by the FMOH and the Regional Health Bureau.

• LMG training for Gambella Regional Health Bureau senior leaders and final results presentation workshop for districts: The first and the second L+M+G workshops for Gambella Regional Health Bureau senior staff was conducted from July 10-12, 2015 and August 31-Sept 2, 2015, respectively. During the first workshop, there were 45 (37 male and 8 female) trainees in 16 teams. Those who were not able to attend the first workshop were included in the second workshop and this has increased the number of participants to 50 (42 male and 8 female). During the second workshop all the 16 teams have presented their draft Challenge Model and feedback was provided from participants and facilitators. After having a discussion with the workplace teams, all teams have completed their Challenge Model and developed action plans. With follow up and coaching supports by trainers, the teams are expected to start with implementing their action plans after they return back to their workplace.

Meanwhile, the district LMG teams within Gambella Regional Health Bureau conducted their result presentation workshop in Gambella at the Finance and


Economic Development Bureau Hall on the 25th and 26th of June 2015. Nineteen participants (all males) from 9 out of the 14 teams took part in the results presentation session and eight of them presented their Challenge Model results. Five teams could not attend the results presentations workshop due to factors such as distance and difficulty of transportation and movement during the raining season. The Special Directorate and local health authorities are reaching out to these teams to follow up on their results. Following up on the “lost” teams and teams achieved less than 80% of their MR will be conducted in collaboration with the Regional Health Bureau and FMOH to help the teams accomplish their action plans.

• LMG Workshop for Benshangul Gumuz Regional State: During the reporting period the first senior level L+M+G workshop for Benshangul Gumuz Regional Health Bureau senior staff was conducted. A total of 59 participants (48 Males, 11 Females) in 15 teams took part in the workshop. Like the other teams in the emerging regions, the Benshangul Gumuz teams also identified their critical challenges and drafted measurable results. Before coming to attend the second workshop during the first quarter of FY 2016, the teams will continue to carry out team meetings and further refine their measurable results. The training was facilitated by trainers from FMOH and LMG project.

Compared to other emerging regions, the LMG rollout started late for district management and leadership teams in Benshangul Gumuz Regional State. This was partly because the region was carrying out internal restructuring and reforms. During the reporting period the first and the second round L+M+G workshops for district teams under the Benshangul Gumuz Regional State Health Bureau was conducted. During the first workshop there were 46 (45 Male and 1 female) participants and organized in 22 teams. When the 2nd round workshop was held the number of participants increased to 61 (58 males and 3 females) and organized in 24 teams. This is because two zonal teams made a request to join the teams from two zonal health departments. The teams have finalized their Challenge Model after several discussions with their work mates. The training sessions were facilitated by trainers from the FMOH, Pawe Health Science College, the Regional Health Bureau, and LMG/Ethiopia project.

• LMG Training sessions held at Afar Regional Health Bureau and districts: The first senior level L+M+G workshop for Afar Regional Health Bureau senior staff was conducted from July 22-24, 2015 in Awash town. A total of 36 participants (29 male and 7 female) in 10 teams attended the workshop. During the workshop health systems strengthening, health systems reform, health policy and basics of leadership, management and governance were among key topics covered. All teams have identified their critical challenges and drafted measurable results for the identified challenges. The teams will further discuss their draft challenge model with their


workplace teams. The training was facilitated by trainers from FMOH and LMG project.

During the reporting period, sixteen LMG teams from districts’ health offices in Afar regional state held their third round workshop from May 15-17, 2015 in Semera town. A total of 44 participants (41 male and 3 Female) organized in 16 teams participated in the training. During the workshop all the 16 teams presented progress made on the development of their Challenge Model. Several discussions were held after each presentation and feedback from the facilitators was given to the teams. The training was conducted by a team of facilitators from Wollo University, Dessie Health Science College and LMG project. Facilitators from the Dessie Health Science College provided coaching support for all teams.

Yale-led Senior Leadership Program (SLP): During the reporting period, the LMG/Ethiopia Project hosted the fourth result presentation sessions of the Senior Leadership Program (SLP) in collaboration with the FMOH. The program aimed to strengthen the FOMH’s leadership to develop highly effective and efficient senior teams. The program was designed collaboratively with Yale University, the FMOH, and MSH. The 20 (17 Male and 3 Female) participants included the Minister of Health, state ministers, senior advisors, and directors who graduated with certificates from Yale University.

2) Coaching Supports:

Coaching is a key element in assisting teams to fully integrate the L+M+G practices and move forward towards achieving their desired measurable results. OALFA2 coaching techniques are applied to help teams reflect on their behavior and realize their own potential in implementing their action plans. During the reporting period trainers from Bahir Dar University and LMG staff provided coaching supports to 11 teams from Amhara regional health bureau. Similarly, the Oromiya regional health Bureau teams have also received coaching supports by LMG staff. Trainers from FMOH, and Somali regional health bureau provided coaching sessions to the 32 LMG teams from the districts

Similarly LMG staff managed to provide coaching to five of the seven teams from PLHA associations based in Addis Ababa.. These five teams were from Mekdim Ethiopia National Association of PLWHA (one from the Care & Support Unit, and one from HIV Prevention Unit), Addis Ababa Network of PLHIV Association (ANOPA+), Network of Oromia Positive (NOP) and National Network of Positive Women in Ethiopia (NNPWE).

During the coaching visit, teams were supported to:

2 Observe, Ask good question, Listen attentively, provide Feedback and Come to agreement


1) Scan their environment and identify their priority challenges, refine their team’s vision and measureable results using SMART3 criteria;

2) Reflect on their commitment towards fulfilling their DMR;

3) Work on the intermediate outcomes; creating conducive work climate, establishing a viable management system, and respond to client needs and demands through empowering their staff and stakeholders;

4) Exercise the identified L+M+G practices in their workplace so as to realize the aforementioned outcomes;

5) Take ownership in the process, document their successes and share them with others internally and outside their organizations;

6) Realize their teams’ potentials and utilize rationally the limited resources at their disposal; and

7) Revise the content of workshop sessions to help them link it with the actual work environment

The coaches noted that the LMG teams from civil society organizations whose major focus is HIV/AIDS continued to share what they learnt to their work mates and apply the skills learnt in their routine work. It was noted during result presentations that most teams believed in that LMG brought about the significance of coaching within an organization to improve performances of staff. It is believed that these exercises can continue to bring proper mind set among staff for improved leadership, management and governance practices within the health sector. LMG project is currently discussing with the concerned decision makers within HIV/AIDS and health sectors as well as the academia on how best the project can support and sustain coaching supports. As the project is in its final year of implementation; we will invest more to build the capacity of trainers and supervisors to better coach staff at all level in the health sector.

Skills in Leadership and Assertiveness Developed in the FMOH Women and Youth Affairs Directorate

• 109 women from all 9 regions and two city administration health bureaus attended the TOT training on gender mainstreaming in the health sector (Indicator 5)

• 196 administrative and supporting staff of the FMOH and its agencies trained on

3 Specific Measurable, Attainable, Realistic and Time Bound


assertiveness

• 85 women leaders drawn from regional health bureaus, federal agencies and hospitals attended leadership training

During the previous FY, the Gender Training Manual, consisting of a facilitator guide, participant notes and participant manual, was completed and approved by the FMOH for use in the rollout of gender training throughout the country. The manual has competency-based sessions about gender in the context of HIV/AIDS, including gender issues in terms of prevention, treatment, and provision of appropriate care and support, as well as psychosocial support for those who are infected and affected by HIV/AIDS. During this reporting period, a TOT on gender mainstreaming in the health sector was conducted for 109 women from nine regions and two city administration. Assertiveness training was also delivered for 196 administrative and support staff of the FMOH including several of its agencies. In another instance, leadership training was organized 85 women leaders jointly by FMOH in collaboration with LMG Ethiopia. It is important, however to indicate here that this activity was removed from our work plan of FY 2015 as per the guidance received from USAID.



Intermediate Result 3: Institutional Capacity of Ethiopian Training Institutions and Professional Health Associations Strengthened

Key results under this Intermediate Result include the following:

• L+M+G trainers e-learning forum established

• L+M+G trainers mapping document prepared

• Thirty nine AAU staff conducted their L+M+G result presentation workshop

L+M+G trainers e-learning forum established

A new L+M+G knowledge exchange/e-learning forum using google platform has been launched to create a forum for knowledge and experiences exchange as well as mutual learning. The main goal of the forum is to build the capacity of L+M+G trainers through sharing information and experiences among themselves. It is also aimed to empower health managers at all levels to lead, manage, and govern for results and be able to identify proven local interventions that can be scaled up to the larger health system in the country. This learning forum will be used to share resources and updated publications about L+M+G, and initiate and manage discussion on important L+M+G related topics and best practices.

For the time being, L+M+G certified trainers are included in the google group created for this purpose; eventually being expanded to all health leaders and managers at all levels.

L+M+G trainers mapping in Ethiopia:

LMG/Ethiopia trained more than 119 trainers certified by FMOH. During the reporting period, a mapping of trainers was carried out providing information on the current status of certified L+M+G trainers in terms of availability and active involvement in facilitating L+M+G workshops. The resulting document will also help to strengthen the pool of L+M+G trainers by guiding selection of candidates for refresher and TOT trainings. The document contains three sections with data disaggregated by region, institution, current status, and those who are actively engaged in delivering training. The data on the trainers was collected through one on one meetings, email and telephone. The document indicated that 89 certified trainers are available to continue cascading of L+M+G training sessions in their respective regions. From this exercise, it was noted that about 40 trainers have moved on from their institutes, universities, regions and some have even left the country for further studies.

Addis Ababa University (Black Lion Teaching Hospital ) L+M+G teams

During the reporting period, all 10 Black Lion Teaching Hospital L+M+G teams received rigorous coaching sessions by the L+M+G staff and held their results presentation workshop


in Addis Ababa University’s College of Health Sciences (CHS) Hall on June 13-16, 2015. The 10 teams (39 participants – 20 male and 19 female) presented their result to the larger group during the internal session and received feedback on their achievements. Selected teams presented their results to university and health sector officials during the final certification sessions. All the trainees received the program completion certificate from Dr. Ahmed Reja, Chief executive Director of College of Health Sciences. Eight of the ten teams achieved 100 % of their targets of measurable results while only two teams had still some work to do to fully achieve their target measurable result. Teams have also selected their next challenge to face and will continue hone their newly acquired management and leadership practices working together towards new accomplishments moving forward.

The Ethiopian Public Health Officers Association In March 2015, the project received guidance from USAID to remove our support to Ethiopian Public Health Officers Association from our work plan. Before revising our work plan, LMG provided supports to the Association in developing its Five Years Strategic Plan, and provided support for its Annual Professional Conference in January 2015. As part of its strategic plan, it was noted that the Association managed to raise funds from different partners and opened its chapters in more than six regional states and registered more than 1000 new members.

Support to Ethiopia’s GFMAT Grants Management through a Senior Professional Secondment to the FHAPCO

The secondment to the Federal HIV/AIDS Prevention Control Office (FHAPCO) of a senior professional to serve as the Government’s GFATM Grant and Project Management Coordinator continued over the reporting period. His formal secondment under the project came to an end on May 21st and MSH closed the position and his employment. The Ethiopian health authorities submitted a request to USAID for further extension. .USAID granted an additional six month extension, (May 21- to November 20, 2015,) with the understanding that the position be taken over by the FHAPCO. Here follows salient reporting points on this assistance during the reporting period.

• No-cost Extension of Six Months HIV RCC Grant approved: Because there were undispersed and unutilized funds held by the Global Fund Secretariat, a no cost extension requested for HIV RCC Phase II grant and 36.8 Million USD was approved by GF. Accordingly, support provided to PFSA to reconcile and complete the unfinished jobs. Accordingly OI drugs distributed to all PMTCT and HTC sites, reconciliation of the procurement and financial data was done, unsettled balance in PFSA reduced from US$ 109 Million in January to US$ 76 Million in March 2015. About US$ 20 Million reallocated to the procurement of products of low stock such as ARV drugs, Early Infant Diagnosis (EID) supplies and test kits. Consultation session and in house capacity building on the closure out with all regions and sub


recipients was done.

• Prepared reprogramming request, submission and getting approval: A request for reallocating 8.3 Million USD fund for the no cost extension period (January- June 2015) was submitted for Country Coordinating Mechanism (CCM) to be used for the procurement of rapid test kits to cover the 2015 need and approved.

• HIV resource mapping conducted: Based on the 2015-2020 HIV Investment case, mapping of HIV resources was conducted in five regional states, 25 Federal government sectors, bilateral, multilateral, private sectors and 10 CSOs. Following this HIV costed concept note was prepared along with experts from CDC and USAID and shared with CCM, partners and GF country team. To support this, two in house capacity building sessions to enable the staff effectively and efficiently guide the implementation and inform the main strategies and approaches included in the HIV Investment were conducted. Following this the dissemination of the HIV Investment Case was officially adopted by the HAPCO. The document was printed out and distributed to all regions and implementing partners.

• Support provided for PFSA to implement RCC year six programs: The supervision to SRs (nine regions and six CSOs) and SSRs was facilitated and regions provided support to speed up the implementation and ensure completion of the interventions and account for the fund disbursed through submitting programmatic performance and financial expenditure report.

• Developed documents for the grant making process and finalization of grant making: With the purpose of facilitating the grant making process, different documents were produced by the team. For instance self-capacity assessment was conducted using the GF Capacity Assessment tool (CAT) and the report was submitted to the Local Fund Agent. Implementation map along with description of the interventions, approach with clearly demonstrating programmatic, fund flow and proportion of fund to IP and report flow and linkage was prepared and submitted to the Global Fund and the LFA. In line with this consolidated grant of US$ 271 Million for the two and half years was prepared and submitted to the Global Fund

During the reporting period, a number of regular Global Fund (GF) grants management related activities were supported. Negotiations were also supported as part of the overall support to the Global Fund grant making process. The objects of the negotiations were the approval of the revised work plan and budget, the interventions to be carried forward and the inclusion of new indicators in the performance framework.

The contract for this position has been expired on May 21st 2015, however; after a new guidance received from USAID, it is noted that the position is extended for


additional six months before it is taken over by FHAPCO.

Management Activities

Internal Mid-Term Review (MTR) for LMG/Ethiopia Conducted

As part of its quality assurance policy and process, MSH conducts mid-term reviews (MTR) of its field projects as a source of key inputs to project staff, donor, and local counterparts to inform future directions and recommendations for change. Accordingly, a team of three experts (Sarah Johnson, Senior Director for Project Quality Assurance and Coordination, Center for Health Services, Ummuro Adano, Global Technical Lead for Human Resources for Health, and Anupa Deshpande, Monitoring and Evaluation Senior Advisor, Center for Leadership and Management) conducted the review from March 2-14, 2015.

The primary purpose of the mid-term review (MTR) is to inform program operations with regard to implementation of the program’s technical strategy to produce planned outputs and outcomes. The mid-term review also sought to identify successful strategies, bottlenecks, lessons learned, and ways for improvements to a range of invested stakeholders.

The MTR took a comprehensive approach to reviewing activity planning and implementation processes. Relevant information was gathered from key written documents and key informant interviews with selected representatives from the Ethiopian government, the USAID Mission, and other stakeholders involved with the LMG/Ethiopia Project’s activities. The MTR also collected inputs from the project team through interview and direct observation in the field as resources and permissions allow.

The team first presented its preliminary findings to the USAID Ethiopia Mission and LMG project staff. The final report of the review is now completed and shared with LMG/Ethiopia.

Strategic Technical Communications Capacity Building

During the reporting period, LMG/Ethiopia staff received technical support from LMG/Global in the area of technical communication. The support had three purposes: a strategic communications plan and editorial calendar development for the project, training delivery for LMG/Ethiopia staff in key communications concepts, and the development of at least one exemplary success story to submit to USAID. As part of the assistance received during the period, the entire LMG/Ethiopia staff took part in a four-day training facilitated by the visiting expert, key communication pieces to be developed were identified in light of the audiences’ needs and priorities, and the strategic communications plan for LMG/Ethiopia was developed. Based on the plan, technical briefs and stories started to be captured buy the team.


7. Challenges, Constraints, and Plans to Overcome Them during the Reporting Period

8. Data Quality Issues during the Reporting Period

Quarterly challenges and Constraints for each program area


• During this FY most of our activities experienced delays due to the National Election held on May 24th 2015.

• The LMG Project, in collaboration with FMOH’s Medical Services Directorate, is supporting L+M+G capacity development at 10 teaching hospitals. These being under the authority of the Federal Ministry of Education (FMOE), reaching out to them to carry out activities under a FMOH supported program has presented some obstacles.

Plans to overcome challenges and constraints in each of your program areas

• After the election we accelerated the pace of implementation whenever and wherever possible while maintaining quality assurance enabling the project to get back on track. This was also achieved through continued mobilization of key partners in training sessions.

• The FMOH and FMOE are working together to develop a directive as to how the teaching hospitals are being managed. When the directive is approved by the Council of Ministers, this should ease continuing LMG’s interventions as a FMOH’s partner project.

Specific concerns you have with the quality of the data for program areas reported in this report

1. No concerns.

What you are doing on a routine basis to ensure that your data is high quality for each program area

1. Using Excel, we routinely capture data on the profile of LMG project trainees. Immediately after each training, data is entered into the system. Checking for the completeness of the data before it is entered into the database is another way we ensure data quality.

How you planned to address those concerns / improve the quality of your data for each program area

N/A


9. Major Activities Planned in the Next Reporting Period

Upcoming activities should highlight planned activities and solutions to identified constraints (write for each program area)

IR 1: Management systems in place to harmonize and standardize LMG in-service and pre-service train

• Follow up of the HSM course delivery and challenge model application in Team Training Program (TTP) In-service Training (IST) materials revision

• Work sessions with FMOH on updating the L+M+G IST manuals.

IR 2: L+M+G capacity of FMOH Directorates and agencies as well as select Regional Health Bureaus/Zonal/District Health Offices and facilities developed.

• LMG rollout training for PLWHA associations at federal level (NEP+ and Mekdim), • LMG roll out for Amhara Regional HAPCO and Zonal HAPCOs in ex-LMS zones in

Amhara • Continued LMG rollout training and coaching for Gondar, Ayder, Hawassa, Hiwot Fana

and Jimma teaching hospitals along with an additional 3 new hospitals i.e. Wolita, Dilla and Assela.

• Collaborate with FMOH to conduct coaching and result presentation workshop for Afar Region.

• Collaborate with FMOH – for LMG workshops roll out and coaching to Somali and Benishangul Gumuz Regions,

• LMG rollout workshops for HIV/AIDS Core Processes and facilities in Oromia, Tigray, and SNNPRS RHBs. Conduct need based M&E and grant management short courses for HIV/AIDS offices , PLHIV Associations and other health sector units

IR 3: Institutional capacity of Ethiopian training institutions and professional health associations strengthened

Organized meetings with the health sector and local training institutes to develop joint plans for LMG training roll out

Monitoring and evaluation • Develop ToR for post training assessment and have meetings with RHBs • Work on costing exercises


10. Environmental compliance

11. Financial accomplishment

(In USD) Life of Project

budget

(a)

Obligated

to date

(b)

Expenditure (Accrual and

actual disbursement)

to date

(c)

Remaining

balance

(d) = (b) – (c)

Remarks

5,775,621 6,326,108 5,028,840

1,2972,68 Expenses for August

& Sept 2015 are

estimates

12. Issues requiring the attention of USAID Management

13. Data Sharing with Host Government: Have you shared this report with the host government?

Yes

No

If yes, to which governmental office/s?

If No, why not?

Describe any issues related to environmental compliance (if there are any)

The project does not have any environmental compliance issues.

Identify and state issues that USAID needs to look at and address for each program area


Have you made data reconciliation with respective regional sectoral office/s?

Yes

No

If yes, to which regional sectoral office/s? Were there any issues that came out from the reconciliation? How

these issues were handled/ will be handled?

If no reconciliation was made, what are the reasons for it?

14. Appendices

(Include any relevant documents, data etc. as appendices)

i (The number here is taken from the first round assuming that the 3 persons are absent because of other competing priorities) Previously they were 39 ( 25 M+14 F) ii (During the first workshop the participants were 46 (45 M+1F))

We will share as we get further guidance from USAID.

Documents

Leadership Management and Governance, Ethiopia (LMG ET