Yale University and the William J. Clinton Foundation have launched an official partnership with the Ethiopian Ministry of Health after several months of assessing the needs of the country’s health management infrastructure.
Ethiopian Minister of Health Dr. Tedros Adhanom approached the Clinton Foundation last year requesting help in improving the management of his country’s public health system, prompting the foundation to collaborate with the University to launch the Ethiopian Hospital Management Initiative.
Ethiopia, a country of an estimated 74 million people with an average life expectancy of less than 50 years, faces chronic poverty and health care issues. Dr. Elizabeth Bradley, a professor of public health and director of EMHI at Yale, said infectious and communicable diseases account for 60 to 80 percent of the country’s health problems, and since many medical directors are forced to spend the majority of their time performing clinical activities, administrative tasks are often neglected.
Bradley said the Clinton Foundation asked Yale to be its academic partner based on the university’s reputable public health program. She said Adhanom is eager to reform the public hospitals in his country, and that his initiative in approaching the Clinton Foundation — which was already at work in Ethiopia to facilitate the improvement of drug distribution — is remarkable.
“It was pretty novel for [Adhanom] to come to us and say, ‘This is what we want to do,'” said Josh Pashman EPH ’08 SOM ’08, who will be interning with the School of Public Health this summer.
Bradley said the goal of the initiative is to improve the management capacity of selected hospitals and to develop systems-based methods of improving health-care management that can be exported to hospitals around the country. The project is being funded under the HIV/AIDS Initiative division of the Clinton Foundation and is part of a broader goal to improve treatment for people living with HIV/AIDS.
“The Clinton Foundation has done a superb job of making AIDS drugs available to third-world countries from a dollars-and-cents point of view,” said Martha Dale EPH ’80, director of New Haven’s Leeway AIDS hospice and a member of the EHMI team. “But it’s been found that these countries need help with distribution strategies, and that’s where the hospital administration piece comes in. Yes, this project has a huge, broad approach, but much of it stems from the initial HIV/AIDS initiative.”
Bradley said improving the management of Ethiopian health-care facilities should result in an improvement in the distribution of medications, including HIV/AIDS drugs.
Bradley said she and the team of program coordinators are currently working to find a team of 20 to 25 senior and postdoctorate fellows to train as mentors. These fellows will then spend a year in Ethiopia, working directly with the directors of 10 to 12 hospitals and health bureaus there. Bradley said the goal is to start placing mentors by this July.
“The fellows will work for a year to see what management concerns exist and what can be changed and improved upon,” Pashman said. “It could be as simple as recording patient information in a better data system, or improving the cleanliness of bed sheets, or stocking shelves more efficiently.”
Bradley said he hopes the project will provide Ethiopian health administrators with the skills necessary to effect the changes they need by the time the fellows come back to the United States.
In late January, a needs assessment team spent a week traveling to various Ethiopian hospitals to see which problems are currently the most pressing, and to gauge which fellow will work best at each site, Bradley said. Dale, who was part of the needs assessment team, said she had never traveled to Africa before and found the experience enlightening.
“I am humbled to be part of an effort that is looking to help Ethiopia bring their standards up to those of America,” Dale said. “It is a huge undertaking, and I’m honored to be a part of it. I think that Adhanom, the Clinton Foundation and Yale are all very serious and committed to achieving the goals of the initiative.”
Dale expressed her hope that the EMHI project, should it prove successful, will be replicable in other countries. She said that if the initiative works, it could be an innovative way of infusing expertise into countries struggling with health care administration.