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Task shifting and regulatory frame work, Ethiopia Yibeltal Assefa National HIV/AIDS prevention and control office

Task shifting and regulatory frame work, Ethiopia Yibeltal Assefa National HIV/AIDS prevention and control office. June 14,2007 Kigali. Background . Population around 78 million National adult HIV prevalence- ANC based- 3.5 PLWHAs - 1.3 million (ANC data) Need ART----280,000

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Task shifting and regulatory frame work, Ethiopia Yibeltal Assefa National HIV/AIDS prevention and control office

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  1. Task shifting and regulatory frame work, Ethiopia Yibeltal AssefaNational HIV/AIDS prevention and control office June 14,2007 Kigali

  2. Background • Population around 78 million • National adult HIV prevalence- • ANC based- 3.5 • PLWHAs - 1.3 million (ANC data) • Need ART----280,000 • More than 150, 000 people are started on chronic care. • More than 90,000 people are started on ART

  3. ART Site Expansion

  4. HEW and the Ethiopian heath system • The Ethiopian health system is organised around the concept of the HNW model with different components: • PHC (community, health posts and health centres) providing service for 25,000 people • Hospitals of different levels • HEW are assigned at the Health post

  5. Health extension workers • They are community health workers assigned at the health post • Two HEW provide service for 5000 people at each health post • More than 9000 HEW are already deployed • We have planned to produce 30,000 HEW in total (two per Kebele or health post). • Their main task is preventive and promotive (very little on curative)

  6. The process of introduction of HEW(The regulatory frame work) • MOH raised the need to introduce HEP as a vehicle to attain MDGs • MOH Proposed : • the components of the package and key intervention area • duties and responsibilities of the HEW • Proposed Recruitment criteria • Duration and training Methodology

  7. The process, contnd… • All relevant ministries and bodies were involved from the inception • MOCB- approves Keble level civil service structure • Civil service agency-approves minimum job requirements and grading • MOE • MOFED • CBO/FBO • The process has taken almost two years

  8. Recruitment • Female • Empowerment • Easily accepted by the community • Can stay longer in the community • High school graduates • Selected by the community • Need to speak the local language

  9. Training and Deployment • A one year training • Both class room and practical sessions • After completion they will be certified • They need to go to their locality after graduation • Defined career structure and promotion • System designed for continuous ongoing training • Working condition – 75% outreach and 25% at Health post • Supervises 15-20 Voluntary CHWs

  10. M&E and quality& safety • There is a plan to really evaluate whether the HEW are doing what they are supposed to do • As part of the HNW they are also considered to be mentored by the health centre staff

  11. Summary • HEW has been planned with a greater involvement of the concerned bodies from the very beginning and its implementation is also being monitored with all the concerned parties so that it will be effective and sustainable.

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