Performance of Ethiopia's Health System in Delivering Integrated Community-Based Case Management

Background. Analyzing complex health programs by their components and subcomponents serves design; documentation; evaluation; research; and gap identification and prioritization. In 2012; we developed a rapid methodology to characterize integrated community case management (iCCM) programs by assessing benchmarks for eight health system components in three program phases. Objective. To assess iCCM benchmarks in Ethiopia three years after scale-up commenced; and to compare the benchmarks across the geographical region. Methods. Six national iCCM experts scored each of 70 benchmarks (no; partial; or yes) and then were facilitated to reach consensus. Results. Overall; iCCM benchmark achievement in Ethiopia was high (87.3); highest for pre-introduction (93.0); followed by introduction (87.9) and scale-up (78.1) phases. Achievement bysystem component was highest for coordination and policy (94.2) and lowest for costing and finance (70.3). Six regional countries' benchmark assessments; including two from Ethiopia 14 months apart; were highly correlated with program duration at scale (correlation coefficient: +0.88). Conclusion. Ethiopia has a mature; broad-based iCCM program. Despite limitations; the method described here rapidly; systematically; and validly characterized a complex program and highlighted areas for attention through government or partners

Research Ethics Review Practices: Experiences of The Armauer Hansen Research Institute/ All Africa Leprosy and Tuberculosis Rehabilitation and Training Center Ethics Review Committee; Ethiopia

The need for ethics review committees (ERCs) is imperative in the conduct of research to ensure the protection of the rights; safety and well-being of research participants. However; the capacities of most ERCs in Africa are limited in terms of trained experts; competence; resources as well as standard operating procedures. The aim of this report is to share experiences of one of the local institutional ERCs; the Armauer Hansen Research Institute (AHRI)/All Africa Leprosy and Tuberculosis Rehabilitation and Training Center (ALERT) Ethics Review Committee (AAERC); to other ERCs found in academic and research institutions inthe Country. In this report; we used an empirical approach to reviewarchived documents of the AAERC Secretariat to assess the Committee's strengths and weaknessesThe experiences of the AAERC in terms of its composition; routine work activities; learning practices and pitfalls that require general attention are summarized. In spite of this summary; the Committee strongly acknowledges the functions and roles of other ERCs in the Country. In addition; an independent assessment of the Committee's activity in general is warranted to evaluate its performance and further assess the level of awareness or oversights among researchers about the roles of ERCs