Ethiopia has strong government structures and is significantly more decentralized compared to its neighbors. However, the country also has a staggering number of funding agencies, technical assistance agencies and others involved in the delivery of health care services, especially in the area of HIV/AIDS. This makes coordinating HIV/AIDS activities particularly challenging. In spite of the significant funding available to support Ethiopia in its battle against the HIV/AIDS pandemic, a variety of logistical constraints makes for a severely limited absorptive capacity. The emphasis on speed, orderly and timely accounting, and demonstrable results at all levels calls for strong management and leadership skills at all levels, not just at the top. The overall goal of the LMS project in Ethiopia is to contribute to the reduction of HIV/AIDS burden in Ethiopia by ensuring effective coordination of HIV/AIDS activities, and to ensure that funds provided through the GFATM and PEPFAR flow unencumbered through the health system to produce intended results.

RESULTS

LMS is working with the country's HIV/AIDS Prevention and Control Offices (HAPCOs) and Health Departments (HDs) to provide management systems development support, and to increase efficiency, effectiveness and collaboration between the HAPCOs/HDs, civil society organizations (CSOs), and PEPFAR partners.

• In March 2010, 12 teams from HAPCOs and Health Departments completed the Leadership Development Program. Nearly all teams chose to focus on the challenge of increasing the number of people counseled and tested for HIV/AIDS in their respective zones, and most achieved significant increases from July 2009 to March 2010.
• In December 2009, Leadership Development Programs were launched with teams from 37  civil society organizations involved in the implementation of HIV/AIDS activities. As of March 2010, the teams had assessed their current situations and begun developing measurable results and action plans to address challenges facing their organizations.
• Support in developing stronger management systems has been provided to HAPCOs, HDs and CSOs. As of April 2010 this includes:
  
  1. MOST workshops with 15 HAPCOs and 12 CSOs;
  
  2. HRM Rapid Assessment workshops with 7 HAPCOs/HDs;
  
  3. M&E training with approximately 50 participants.
• As of April 2010, the project has coordinated Joint Review and Planning Meetings in 12 zones, bringing together government, private sector and NGO partners to discuss the planning and implementation of HIV/AIDS activities.

EXPERIENCE IN COUNTRY

HAPCO and CSO Capacity Building

Strengthened Coordination of PEPFAR Partners

HAPCO and CSO Capacity Building

One major bottleneck for strengthening the HIV/AIDS response in Ethiopia is low personnel levels and management challenges at the country’s HIV/AIDS Prevention and Control Offices (HAPCOs), at both national and regional levels. LMS is conducting Leadership Development Programs (LDPs) for teams from 12 zonal and regional HAPCOs as well as approximately 30 civil society organizations (CSOs) in Oromia and Amhara regions in order to build their leadership and management skills for the improved coordination of HIV/AIDS activities. LMS is also helping the HAPCOs, Health Departments, and CSOs to assess their organizational systems and providing technical assistance to address strengthen key management systems such as monitoring and evaluation, financial management, and human resources. An LMS Health Management Specialist has been placed with each of the 12 HAPCOs and Health Departments in order facilitate work directly with them and their partner CSOs.

Strengthened Coordination of PEPFAR and Global Fund Partners

USAID requested LMS support in coordination among PEPFAR and Global Fund partners at the national and regional level. LMS is developing a PEPFAR Implementing Partner Activity Database to enable partners to see where others are working and identify gaps and overlaps in coverage. The project is also supporting the Federal HAPCO (the main GF Principal Recipient for HIV/AIDS) in strategic planning and management systems strengthening.