For every 100,000 live births in Ethiopia, 353 mothers will die. In 2015, this was 11,000 women.
With almost 30% of people living below the poverty line it is no surprise that Ethiopia has one of the highest maternal mortality ratios in Africa with 420 maternal deaths per 100,000 live births. Despite these statistics, Ethiopia has been making significant progress in reducing maternal and newborn deaths.
The country achieved Millennium Development Goal (MDG) 4 – reducing child mortality by two thirds by 2015 from one of the highest under-5 mortality rates in the world. While this is a significant achievement, the MDG 5 target of 267 maternal deaths per 100,000 live births by 2015 was missed and the risk of maternal death remains high with 1 in 67 women at risk of dying from maternal causes.
The Soapbox Collaborative is working with Felege Hiwot Referral Hospital (FHRH) as they strive towards improving quality of care at their facility which is located Bahir Dar, in the Amhara Region of Ethiopia. Felege Hiwot is a busy referral hospital and serves a population larger than Scotland with approximately seven million people.
As part of their five-year strategic plan, FHRH identified improving infection prevention and control (IPC) as a key priority. Soapbox are working with them, in partnership with NHS Grampian, to achieve this goal and in 2014 supported a needs assessment of the Maternal, Newborn and Child Health Building. The assessment highlighted a number of areas for IPC improvement in relation to infrastructure and training.
With the support of Soapbox, FHRH has established an Audit Committee as part of the new Quality Improvement Department. The new committee links with lead doctors from all disciplines and aims to conduct research into current processes and practices to make informed improvements to patient care.
During the initial assessment visit to Felege Hiwot Hospital in July 2014, the Soapbox team were able to work with hospital maintenance staff to start to resolve some of the infrastructure problems faced by the facility. Following this assessment, a team from NHS Grampian led by Gary Mortimer (Director of Acute Services) visited FHRH to share skills and train maintenance staff which resulted in significant improvements to the availability of running water, and increased handwashing facilities. This intervention is crucial in preventing infection, improving hygiene and providing safe care for patients.
In partnership with NHS Grampian and the University of Aberdeen, The Soapbox Collaborative and Felege Hiwot Hospital have developed a Medical Elective Exchange Scheme (MEES). The scheme launched in 2014 and the first student projects at Felege Hiwot began in September 2015 with 5th year medical students conducting research projects in various specialities including obstetrics and gynaecology, paediatrics and anaesthesia. Ethiopian interns also visited Aberdeen at the end of 2016.
Our partnership also supports the bilateral sharing of management skills and FHRH’s CEO, Mr Bizuayehu Gashaw and Medical Director, Dr Siyoum Enkubahiri paid a 7-day visit to Aberdeen to meet with colleagues from Soapbox, NHS Grampian and the University of Aberdeen to develop a strategy to deliver further improvements to patient care. The visit highlighted the multiple benefits of the partnership for professional development, leadership and quality improvement in both Bahir Dar and in Aberdeen.
In Summer 2017, a team from Soapbox and NHS Grampian will take part in a 10-day visit to FHRH in which they will have the opportunity to skill share with their Ethiopian counterparts through a series of scenario based training exercises focused on three specialties: maternity, ICU and trauma. The visit will provide an opportunity for colleagues from FHRH to showcase recent and on-going audits as supported by the newly established Quality Improvement Department.
Over the time of our partnership we have witnessed many improvements to services and Felege Hiwot Referral Hospital was recently awarded lead hospital status by the Federal Ministry of Health and now ranks in the top 15 hospitals in Ethiopia.
- Felege Hiwot Hospital
- Bahir Dar University
- University of Aberdeen
- NHS Grampian