With support from USAID, MSH and the Ministry of Health made quality TB services accessible to 55 million people—reaching more than half the country’s population. Our HIV work in Ethiopia has focused largely on women and children at the community level and on programs that integrated HIV services into antenatal care and labor and delivery clinics through provider training, supportive supervision, quality improvement, and mentorship. By building the capacity of health centers to care for children with HIV and to trace those previously missed by the system, our programs more than doubled the number of HIV-positive children receiving treatment. MSH supported the introduction of clinical pharmacy services in Ethiopia, which have become an integral part of hospital services; developed a national strategy to prevent and contain antimicrobial resistance; and introduced guidelines, regulations, manuals, and supervisor checklists to support patient-centered pharmacy services. 

Under the USAID-funded Eliminate Tuberculosis from Ethiopia (ETBE) project, MSH, together with the KNCV Tuberculosis Foundation and local partners, are building the capacity of public and private sector providers to deliver quality, sustainable TB services. As a sub-awardee to the Jhpiego-led, USAID-funded Ethiopia Health Workforce Improvement Program (HWIP), MSH is working with the Ministry of Health, Ministry of Science and Higher Education, and other local institutions to improve the leadership, management, and governance capacity of Ethiopia’s health workforce at every level of the health system.

Highlights

• Assisted the National TB Program (NTP) in diagnosing and treating over 490,000 TB patients with a treatment success rate of 92%. Over 2,600 multi-drug resistant TB patients were also diagnosed and treated.

• Built the capacity of TB program officers and clinicians through virtual and face-to-face training, implemented TB contact investigation at multiple levels of the health system, and strengthened national TB diagnostics platforms such as GeneXpert. 

• Introduced new pediatric TB drug formulations, reached key affected populations such as prison inmates, mine workers and people with comorbidities, and expanded ambulatory care to treat drug-resistant TB.

• Improved the quality of TB care and prevention services. Over five years, treatment success rates rose above 90%, with 75% of those suffering from multidrug-resistant TB able to beat the disease after completing their treatment regimens. 

• Through contact screening, increased the number of eligible children under five put on isoniazid preventive therapy (IPT) for TB from 1,390 in 2015 to 6,856 in 2018.

• Implemented Option B+ to prevent the transmission of HIV to children during pregnancy and supported almost 300 health centers serving more than 87,000 HIV patients—two-thirds of whom were women and 5.4 percent of whom were under the age of 15.

• 97 percent of women receiving antenatal care were tested for HIV and received their results and 87 percent of HIV-infected pregnant mothers seen at program-supported health centers received antiretroviral therapy by 2014 (up from 45 percent in 2011).

• 72 percent of HIV-exposed infants enrolled at program-supported health centers were tested by two months of age, compared to 2 percent nationally.

• Among TB patients, 94 percent were tested for HIV and 90 percent of those co-infected started antiretroviral therapy.

• Addressed challenges related to quality diagnostic capacity, TB/HIV activities, pediatric TB, TB in prisons, contact investigations, and active case finding.

• Supported more than 2,000 laboratories in TB diagnosis.

• TB medicine stock-outs dropped to 2 percent, and 2,186 drug kits were made available.

• With support from MSH-led programs, every region mandated and adopted a package of interventions to help hospital pharmacies operate more efficiently and with greater accountability. In most hospitals, availability of key medicines increased from 65 to more than 95 percent.

• To promote rational medicine use and help prevent the spread of antimicrobial resistance, projects helped establish and support more than 500 Drug and Therapeutic Committees.

• Trained nearly 8,000 pharmacy workers, medical doctors, hospital CEOs, and finance professionals over five years.

• A new in-service training program deployed 200 pharmacists from 65 hospitals, 98.5 percent of whom now provide clinical pharmacy services.

• To manage antimalarial medicines, MSH’s program work helped 44 PMI sites implement a monitoring system to track the availability, storage, and use of antimalarial medicines and data on patient treatment.