Ethiopian Private Healthcare at the Crossroads

June 24, 2013

Higher clinics in the country will not operate under the new healthcare facility standard, which is not yet implemented.
Higher clinics in the country will not operate under the new healthcare facility standard, which is not yet implemented.

For the majority of the 350 private healthcare operators gathered at Global Hotel, located on Sierra Leone Street, on Sunday, June 16,2013, to discuss the yearlong standard, introduced to help elevate the health sector, the meeting ended with little resolution regarding their fate.

Organised by the Ethiopian Food, Medicine and Healthcare Administration and Control Authority, which has a mandate to regulate the ‘4 ps’ (practice, premises, professionals and products), the meeting was intended to alert the private healthcare operators about the approaching final date of the grace period to began implementing the standard.

The Healthcare Facility Standard is a set of 39 standards, covering the minimum requirements for the sector, with respect to – practices, premises, professionals and products, or materials put into use for specialty.

After the standard was approved by the Council of Ministers, in June 2012, a year grace period was given to the operators, in order to prepare themselves, since it will be mandatory as of June 2013.

Once the issue was raised at the meeting by Tekleab Zaid (MD), a senior technical assistant at USAID and CEO of the Ethiopian Health Professional Association, participants voiced their concerns over the limited grace period given to them by the government.

“The standard did not consider the current actual capacity of private health care operators,” Abebe Hailu, who owns a primary clinic, said at the meeting.

Abebe was followed by a roar of clapping in support of his argument by most of the participants.

Giving more chances to a couple of participants, Tekleab chaired the meeting in a claim manner. Kidanemariam Gebermichael (PhD), Standard Control Directorate director at the Authority, who sat besides Tekleab, told the participants that the standard’s aim is to ensure quality, rather than forcing the operators out of the business. He is a one of 30 experts in the Authority who crafted the standard.

Led by Legese Gebre, the Ethiopian Standards Agency (ESA), spent the last three years developing and formulating the healthcare standards.

However, the extended period the ESA took to develop the standards has not brought about fruitful results for most private clinics operating in the country.

The standard pushes out the existence of higher and lower clinics, as well as medium and small hospitals, which are currently operating in the country. Instead, it only recognises primary and medium clinics, specialty centres, health posts, health centres, general hospitals, basic and advanced medical labs and specialised hospitals, by setting the minimum requirements for each of them.

Unlike the previous standard, which has been a benchmark for the clinics over the last 18 year, the new standard requires a minimum of 10 rooms for primary clinics and 12 rooms for medium clinics.

The current standard, however, puts a minimum of five rooms for higher clinics and no rooms at all for running medium clinics. The current standard also requires medium clinics to hire nine professionals, while higher clinics should employ at least seven.

It also requires the health facilities to have a laboratory, to hire licensed professionals at all levels and to hire a professional midwife, which the participants strongly reject, since the market does not offer them this.

During the discussion, participants also asked the organisers why they have been invited for discussion, when the standard has already been prepared.

Tekleab, however, rejects their claim.

“We have had a number of stages with regional clinic owners, but most operators in Addis Abeba did not show up when we invited them,” Tekleab told participants. “If you have no seat belt, you have to stop your car until you get a seatbelt; that is what the standard must be.”

It will take up to four million Birr to establish a higher clinic at this moment, one of the participants said. ‘’Implementing the standard means putting an additional burden on to a sector which is not yet matured.’’

“This standard took the level far beyond us and it seems it was planned to drive us out of the sector,” Abebe claimed.

Citing the 60pc health service demand in Addis Abeba, which is covered by private healthcare operators, Fantu Tsegaye, head of the Addis Abeba Health Bureau, told the participants that without their involvement, the health coverage of the city will be in danger.

“The majority of health professionals work in the private sector and pressurising the private sector will put these professionals out of work,” Wondwessen Bekele, (MD), a lecturer at Addis Abeba University (AAU) and the owner of a private clinic told the organisers.

There are close to 700 primary, medium and higher clinics in Addis Abeba, 528 pharmacies and drug vendors and 37 primary hospitals, out of the 126 hospitals the country has, in total.

As the meeting intensified, Kidanemariam asked the participants to form a committee who could negotiate with the Addis Abeba Standard Control Agency, about the extension of the grace period.

Abebe and nine other private healthcare providers were elected from the participants.

There may be room for extended time after the discussion has been held between the committee and different government institutions, Tekleab told the participants.

The operators will discuss, once more, with the various government institution on Thursday, June 27, 2013, to determine the next move.

Source: addisfortune