A/Prof. Yibeltal Alemu presents: Strengthening the Capacity of the International Institute of PHC in Ethiopia: Achievements, Challenges, and Lessons for Global Health Programs

Presented by Associate Professor Yibeltal Alemu

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Ethiopia, a low-income country in East Africa with a population of around 120 million, has made significant strides in primary health care (PHC) amidst formidable challenges. Since adopting the Alma-Ata principles in 1978, Ethiopia has pursued successive reforms aimed at expanding healthcare access and improving health outcomes. The 1990s saw crucial health sector reforms and decentralisation efforts that laid the foundation for the Health Extension Program (HEP) in the 2000s. This program emphasised community-based healthcare, resulting in increased PHC facility access, improved vaccination rates, and substantial declines in child and maternal mortality. Ethiopia further intensified its efforts under the Millennium Development Goals and Sustainable Development Goals, focusing on scaling up health infrastructure and achieving universal health coverage.

In 2016, leveraging its successful PHC experiences, the Ethiopian Federal Ministry of Health established the International Institute for Primary Health Care in Ethiopia (IPHC-E) to advance global PHC. The institute has been pivotal in capacity building, policy dialogue, research, and knowledge sharing, training numerous health professionals, fostering international collaborations, and influencing policy regionally. Despite successes, IPHC-E faces challenges such as limited implementation capacity, which it aims to address through strategic partnerships and capacity-building initiatives.

The Institute established a twinning partnership program with the University of Queensland (UQ) in 2022. This initiative focuses on operations management, advocacy, training, and preparing IPHC-E to become a WHO Collaborating Centre for PHC. Initial phases have seen progress in building operational and evaluation capacities, developing advocacy strategies, enhancing technical capabilities through training, and facilitating knowledge exchange through global health institution visits. Despite the challenges, such as logistical complexities, internet connectivity, geopolitical instability, and organisational transitions within IPHC-E, the project has achieved most of its objectives. Looking ahead to 2024, the third phase includes developing a PHC policy analysis course, study tours to Vietnam, PHC performance improvement initiatives, and testing WHO's PHC metrics.

Key lessons from this project emphasise the significance of aligning efforts with the needs of the recipient country, ensuring country ownership and leadership, monitoring of project implementation, leveraging capacity-building initiatives for stronger research outputs, integrating diaspora expertise, learning from others, and maintaining transparency and accountability among partners. These insights guide IPHC-E and UQ as they continue collaborative efforts to build sustainable PHC systems, tackle ongoing health challenges in Ethiopia, and contribute globally to health advancements through the PHC approach.