Quality Assurance for the Scale-Up in the Availability of Health Professionals Towards Improved Maternal and Newborn Health in Ethiopia

Presentation at the Global Maternal Newborn Health Conference, October 20, 2015

In Ethiopia there are 0.3 doctors, nurses and midwives per 1000 population, far below the WHO recommended 2.3 per 1000 population. The greatest shortage is for physicians, midwives and anesthetists, critical for maternal and newborn health care. Since 2012, with USAID funding, Jhpiego supported the FMOH to accelerate the increased production of critical cadres, particularly midwives, anesthetists and health extension workers. Between 2008 and 2014, public midwifery schools increased from 25 to 49, and midwives from 1275 to 7944; public medical schools increased from 7 to 28, and the annual graduation of physicians from 161 to 1253; and public anesthesia schools and anesthesia professionals increased from 3 to 26 and 375 to 1340 respectively. This rapid scale-up has posed challenges for assuring the quality of education. Jhpiego is now helping to ensure quality of educational programs through faculty development, competency-based curriculum development, infrastructure strengthening, and application of quality improvement and assurance (QI/QA) to educational programs. The educational QI/QA strategy includes strengthening the Ethiopian Higher Education Relevance and Quality Agency (HERQA) to be able to implement institutional and program quality audits and accreditation of programs. After partnerships were established, including the Federal Ministry of Health, Higher Education Institutions, and HERQA, a Technical Working Group was created, and standards were developed for teaching, governance and leadership, academic support, educational resources, and others. The HERQA’s qualified QA assessors’ pool was expanded and an interactive website has been established. Visits to 24 programs at 10 private colleges and an advocacy workshop with policy makers for legislative support were conducted. The national QI/QA implemented through a partnership led by HERQA and the FMOH in Ethiopia offers a nation-wide model for quality improvement and assurance of health education and should help to ensure that the massive expansion of pre-service education in the country produces competent providers.