Ethiopia | Scaling up MDSR across the health system

Evidence for Action (E4A) has been supporting the Federal Ministry of Health to strengthen the maternal death surveillance and response (MDSR) system in Ethiopia over the last five years. In the last quarter, the MDSR system has seen significant scale up, with technical assistance at national level and in Oromia, Amhara and Southern Nations, Nationalities and People’s region to support the extension of coverage of MDSR across Ethiopia.

In Amhara, MDSR training at zonal and woreda level have been held in all zones. Four weeks ago, a round of training was conducted in the region aimed at strengthening hospital facilities to use MDSR, with evidence from the two most functional zonal MDSR systems used to demonstrate the potential impact.

Training on integrating MDSR into the health system has also been conducted in 11 zones in Oromia since the end of February 2015, with over 380 participants attending from previously untrained zones. Three training sessions have been held in the Maji, Mizan and Yirgalem centres in the region to support MDSR integration, attended by a total of 181 participants from five zones.

In addition, the MDSR engagement by stakeholders at all levels of the health system has increased. For example, earlier this year, a special meeting of East Harege Zone representatives together with CEOs and Medical Directors from all five referral hospitals in Dire Dawa and Harar was coordinated and hosted by Ato Ali, Head of East Harege Zone, to discuss the fact that many of the women who die at hospitals in Dire Dawa and Harar are from East Harege Zone. This cross-regional, cross-zonal collaboration established valuable channels for communication about improving the referral process, the early transfer of critical patients, prioritising maternity patients and orientating ambulance drivers on the needs of maternity patients.

Supportive materials have been developed to help promote MDSR, such as a manual for National Public Health Emergency Management / MDSR and a promotional video targeted at leaders and decision-makers has been produced to give an overview of the workings of the MDSR system in Ethiopia. The video encourages institutionalising a ‘no blame’ approach, and uses real life examples to outline the process and purpose of MDSR as well as the importance of engaging staff from all tiers of the health system.

Finally, as E4A Ethiopia DfID funding ended in March and an extended contract supported by the Gates Foundation was implemented from April, a technical symposium has been organised to take stock of lessons learned on MDSR so far and discuss future implications for strengthening the MDSR system to become nationally embedded in Ethiopia.

To read more about the MDSR work in Ethiopia, see the Ethiopia February 2016 newsletter, or look out for the upcoming June 2016 version, here.


This country update was developed based on feedback from Dr Ruth Lawley, Technical Support Unit Coordinator for E4A in Ethiopia, as well as information from the E4A quarterly report and the February 2016 Ethiopian newsletter.