Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Ethiopia

Yibeltal Mekonnen; Charlotte Hanlon; Solomon Emyu; Ruth Vania Cornick; Lara Fairall; Daniel Gebremichael; Telahun Teka; Solomon Shiferaw; Wubaye Walelgne; Yoseph Mamo; Temesgen Ayehu; Meseret Wale; Tracy Eastman; Ajibola Awotiwon; Camilla Wattrus; Sandy Claire Picken; Christy-Joy Ras; Lauren Anderson; Tanya Doherty; Martin James Prince; Desalegn Tegabu

doi:10.1136/bmjgh-2018-001108

Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Ethiopia

BMJ Glob Health. 2018 Nov 16;3(Suppl 5):e001108. doi: 10.1136/bmjgh-2018-001108. eCollection 2018.

Authors

Yibeltal Mekonnen¹, Charlotte Hanlon^{2

3

4}, Solomon Emyu⁵, Ruth Vania Cornick^{6

7}, Lara Fairall^{6

7}, Daniel Gebremichael¹, Telahun Teka¹, Solomon Shiferaw⁸, Wubaye Walelgne¹, Yoseph Mamo^{9

10}, Temesgen Ayehu¹, Meseret Wale¹, Tracy Eastman^{6

11}, Ajibola Awotiwon⁶, Camilla Wattrus⁶, Sandy Claire Picken⁶, Christy-Joy Ras⁶, Lauren Anderson⁶, Tanya Doherty¹², Martin James Prince^{2

13}, Desalegn Tegabu¹

Affiliations

¹ Federal Ministry of Health of Ethiopia, Addis Ababa, Ethiopia.
² Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, King's College London, London, UK.
³ Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁴ Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁵ Technical Assistant to the Clinical Services Directorate, Federal Ministry of Health of Ethiopia, Addis Ababa, Ethiopia.
⁶ Knowledge Translation Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
⁷ Department of Medicine, University of Cape Town, Cape Town, South Africa.
⁸ Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
⁹ Institute of Palliative Care, Kozhikode, Kerala, India.
¹⁰ Tropical Health Education Trust and Jimma University Chronic Disease Project, Jimma, Ethiopia.
¹¹ BMJ Knowledge Centre Department, BMA House, London, UK.
¹² Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
¹³ King's Global Health Research Institute, King's College London, London, UK.

Abstract

The Federal Ministry of Health, Ethiopia, recognised the potential of the Practical Approach to Care Kit (PACK) programme to promote integrated, comprehensive and evidence-informed primary care as a means to achieving universal health coverage. Localisation of the PACK guide to become the 'Ethiopian Primary Health Care Clinical Guidelines' (PHCG) was spearheaded by a core team of Ethiopian policy and technical experts, mentored by the Knowledge Translation Unit, University of Cape Town. A research collaboration, ASSET (heAlth Systems StrEngThening in sub-Saharan Africa), has brought together policy-makers from the Ministry of Health and health systems researchers from Ethiopia (Addis Ababa University) and overseas partners for the PACK localisation process, and will develop, implement and evaluate health systems strengthening interventions needed for a successful scale-up of the Ethiopian PHCG. Localisation of PACK for Ethiopia included expanding the guide to include a wider range of infectious diseases and an expanded age range (from 5 to 15 years). Early feedback from front-line primary healthcare (PHC) workers is positive: the guide gives them greater confidence and is easy to understand and use. A training cascade has been initiated, with a view to implementing in 400 PHC facilities in phase 1, followed by scale-up to all 3724 health centres in Ethiopia during 2019. Monitoring and evaluation of the Ministry of Health implementation at scale will be complemented by indepth evaluation by ASSET in demonstration districts. Anticipated challenges include availability of essential medications and laboratory investigations and the need for additional training and supervisory support to deliver care for non-communicable diseases and mental health. The strong leadership from the Ministry of Health of Ethiopia combined with a productive collaboration with health systems research partners can help to ensure that Ethiopian PHCG achieves standardisation of clinical practice at the primary care level and quality healthcare for all.

Keywords: health policy; health systems; public health.

Publication types

Review