Soapbox worked in partnership with NHS Grampian, Felege Hiwot Comprehensive Specialized Hospital (FHCSH) and Bahir Dar University (BDU) to improve quality of care, particularly maternal and newborn health, and infection prevention and control (IPC) in Bahir Dar, Ethiopia from 2014–2019.
The aims of the Aberdeen - Bahir Dar Knowledge Exchange Partnership are built around capacity strengthening. The four main agendas to improve quality of care are:
- supporting the training of workers in healthcare environments
- developing processes and protocols to support quality research and improvements
- strengthening the infrastructure of healthcare facilities and training maintenance staff
- the bilateral sharing of skills to encourage professional development, leadership and quality improvement.
Download the Aberdeen-Bahir Dar Knowledge Exchange Partnership 2014–2019 summary report
Training
Aberdeen partners have volunteered their time to travel to Bahir Dar to deliver training with their counterparts to support the expansion of services, and quality of care improvements. Examples of training include high-risk obstetric care, post-operative recovery care, maternal sepsis management, IPC, anaesthesia curriculum development and training, pain assessment and management, and Intensive Care Unit care.
Audit and quality improvement
FHCSH is dedicated to quality improvement of services in order to achieve the vision of becoming a centre of excellence in Ethiopia, providing evidence-based health services, education and research. In 2015, FHCSH established a Quality Assurance, Audit and Research Department to gather and analyse data from across the hospital. Soapbox provided financial support to recruit key staff to assist in the creation and development of quality improvement protocols, processes and cycles. The Partnership also supported the establishment of an audit process, forms and a database and the creation of an Audit Committee to assist in project identification, promotion and development to help drive hospital wide, multi-disciplinary improvement of care. The Partnership has found that short student projects are ideal for base data collection and promotion of the audit process, and to date twenty four students have undertaken a variety of audit and quality improvement projects that have provided valuable data and monitoring and evaluation for ongoing projects.
Strengthening infrastructure
Following water, sanitation and hygiene (WASH) and IPC needs assessments carried out in 2014 and 2015, the Partnership quickly prioritised improvements to hospital infrastructure to support IPC practices. In 2015, NHSG’s Director of Acute Services, Gary Mortimer, and hospital engineers Graham Davidson and Malcom Ewen, travelled to Bahir Dar to assist hospital maintenance staff. During their visit, the NHSG team carried out repairs, provided training and drafted maintenance policies and procedures for the Felege Hiwot team to implement going forward. In subsequent visits, partners have been delighted to see that the maintenance team have continued to implement and indeed develop policies to improve infrastructure. However challenges remain given the growing case-load of patients and difficulties of sustaining change and coping with breakdowns, for example the availability of water on the wards.
Management and leadership skills sharing
In 2015, FHCSH’s Chief Executive Officer, Mr Bizuayehu Gashaw and Medical Director, Dr Siyoum Enkubahiri, paid a 7-day visit to Aberdeen to meet with partners, senior NHSG staff and teams including the Quality Improvement (QI) and Health Intelligence & Research teams. Practicing clinicians from Bahir Dar have also had the opportunity to come to Aberdeen to support professional development - for example Dr Bazezew, Consultant Obstetrician and Gynaecologist at FHCSH, spent 10-days in Aberdeen in 2016 to attend a QI course for consultants, spending time with local IPC and QI teams.
Following Soapbox’s completion in June 2019, the Aberdeen-Bahir Dar Partnership will continue to support capacity strengthening and quality improvement activities in Bahir Dar under the leadership of Mr Gary Mortimer, NHS Grampian.
The Knowledge Exchange Partnership has been supported by Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar University, The University of Aberdeen and NHS Grampian.