The Yale Global Health Leadership Institute (GHLI) has been awarded $7.5 million from the Bill & Melinda Gates Foundation to revolutionize the management and leadership of primary health care in Ethiopia.
GHLI in Ethiopia
Yale Global Enterprises
Since 2006, GHLI has worked closely with the Ethiopian Ministry of Health to support their ambitious vision for improved management, leadership, and organizational performance at all levels of the health sector, including hospital and primary health care settings, as well as district, zonal, and regional health offices. Our partnerships leverage academic guidance to ensure scientifically rigorous and locally relevant research, while at the same time developing capacity for management and evaluation among Ethiopian practitioners, clinicians, and scholars. GHLI’s country office, registered as Yale Global Enterprises, serves as the hub for a dynamic portfolio of work in Ethiopia and across the region.
Primary Health Care Transformation Initiative (PTI)
The Primary Health Care Transformation Initiative (PTI), funded by the Bill & Melinda Gates Foundation, is designed to develop performance management systems to enhance the quality and equity of primary care throughout the country, advancing Ethiopia’s goal to achieve health outcomes comparable to those of a middle-income country by 2030. PTI combines certificate-level management education, intensive mentorship, and applied health systems research to build capacity and inform effective health systems reform across 4 regions in Ethiopia. From 2016-2019, PTI will strengthen management systems at the district, zonal, and regional levels, transforming primary care for over 47 million people.
Developed through a novel collaboration between GHLI, Pediatrics, and Biomedical Engineering, PremieBreathe is a low-cost infant respiratory therapy device designed to provide lifesaving treatment for neonates in LMIC settings. PremieBreathe is a humidified high-flow nasal cannula devise that delivers warmed, humidified, and oxygenated air. The project has been the recipient of a number of innovation awards and, is currently supported through a USAID Grand Challenges award, which will allow for testing and refinement in collaboration with Ethiopian medical and engineering groups.
Global Health Equity Scholars Program
The Global Health Equity Scholars Program supports research training of post- and pre-doctoral fellows at 12 partnering institutions, bringing forth the next generation of global health researchers, educators, and professionals to address new challenges in global health. GHLI faculty support research and training at the Ethiopia training site, with a focus on health systems research and implementation science.
Ethiopian Hospital Management Initiative
For 10 years (2006-2016), the Ethiopian Hospital Management Initiative (EHMI) transformed the management and quality of Ethiopia’s government hospitals. Building on the foundation of sustained in-person management mentorship by a team of Yale-Clinton Fellows, EHMI achievements include (1) The creation of management systems and associated standards (The Blueprint for Hospital Management, later endorsed nationally as the Ethiopian Hospital Reform Implementation Guidelines); (2) The design and implementation of the first Master’s of Hospital Administration (M.H.A.) degree program in Africa, launched in 2008 at Jimma University and expanded to 5 universities to graduate more than 120 health care professionals over 6 years; (3) Launch of the Ethiopian Hospital Alliance for Quality (EHAQ), the continent’s first national quality improvement collaborative, and (4) the development of a national system for monitoring the performance of Ethiopia’s hospitals.
Ethiopian Millennium Rural Initiative (EMRI)
GHLI served as the external evaluator to the Ethiopian Millennium Rural Initiative (EMRI), which provided support to 30 rural Primary Health Care Units (PHCUs) over a period of three years. Each PHCU was comprised of one health center and five satellite health posts to serve 25,000 people. EMRI provided a systems-based package of financial support, clinical mentorship, and managerial support to the PHCUs to enhance accessibility, utilization, and quality of health services. GHLI measured the overall impact of the project and identified factors critical to the program’s success.
Health Extension Program Capacity (HEPCAPS)
The cornerstone of Ethiopia’s primary care system is the Health Extension Program (HEP). Under the Health Extension Program Capacity (HEPCAPS) project, GHLI worked with the Ethiopian Ministry of Health, Harvard School of Public Health, JSI, and The Bill and Melinda Gates Foundation to study the structure and function of the HEP, and facilitate the development of a long-term strategic plan for primary care in Ethiopia. This evidence-based strategic planning at the national level laid the foundation for the Ministry’s latest Health Sector Transformation Plan (HSTP) and corresponding Woreda (District) Transformation Plan.
Senior Leadership Program
Through the Senior Leadership Program, a component of USAID’s Leadership, Management and Governance Project led by Management Science for Health, GHLI offered a pair of flagship executive education programs in healthcare management and leadership – one to Ministry of Health officials, including the Ministry of Health, State Ministers, and Directorate Heads, and a second to members of the Regional Health Bureaus core process teams responsible for quality of healthcare services.
- Evaluation of the Ethiopian Millennium Rural Initiative: impact on mortality and cost-effectiveness. L. A. Curry, P. Byam, E. Linnander, K. M. Andersson, Y. Abebe, A. Zerihun, J. W. Thompson and E. H. Bradley; PLoS One 2013; 8:e79847.
- The Ethiopian Health Extension Program and Variation in Health Systems Performance: What Matters? N. Fetene, E. Linnander, B. Fekadu, H. Alemu, H. Omer, M. Canavan, J. Smith, P. Berman and E. Bradley; PLoS One 2016; 11:e0156438.
- Educating leaders in hospital management: a pre-post study in Ethiopian hospitals. S. Kebede, J. Mantopoulos, S. Ramanadhan, E. Cherlin, M. Gebeyehu, R. Lawson and E. H. Bradley; Glob Public Health 2012; 7:164-74.
- Use of a national collaborative to improve hospital quality in a low-income setting. E. Linnander, Z. McNatt, H. Sipsma, D. Tatek, Y. Abebe, A. Endeshaw and E. H. Bradley; Int Health 2016; 8:148-53.
- A national system for monitoring the performance of hospitals in Ethiopia. Z. McNatt, E. Linnander, A. Endeshaw, D. Tatek, D. Conteh and E. H. Bradley; Bull World Health Organ 2015; 93:719-726.
- Implementation of hospital governing boards: views from the field. Z. McNatt, J. W. Thompson, A. Mengistu, D. Tatek, E. Linnander, L. Ageze, R. Lawson, N. Berhanu and E. H. Bradley; BMC Health Serv Res 2014; 14:178.