Achieving Excellence in Primary Health Care

Fenot 1.0

Project Overview

Initiated Over a Decade Ago

Fenot 1.0

2015-2021

Funded by the Gates Foundation and led by Ethiopian experts, the Fenot project aimed to increase the capacity of the Ethiopian Ministry of Health and regional health bureaus to build an evidence-based, high-quality health system by focusing on two important technical areas:

1.  Evidence-to-Policy - Improve efficiency, quality and equity of primary health care services by using locally available and relevant evidence for planning, monitoring, decision making, policy analysis, and follow-up action within the Ministry of Health and regional health bureaus.

2.   Health Financing - Strengthening health care financing for improved primary health care systems: generating new revenue from domestic sources; increasing health care resource use efficiency and productivity; and improving financial management and budget utilization in public programs.

To achieve these objectives, Fenot has been: 

  • Embedding evidence-to-policy and health system financing technical experts in the MoH and RHBs to facilitate evidence-based decision-making and policy implementation. 
  • Conducting studies and creating relevant dissemination products (peer-reviewed articles, reports and presentations) to respond to government priorities and other evidence gaps.
  • Establishing knowledge-to-practice structures within the MoH and RHBs that identify, prioritize, and address local issues by co-developing concept notes, analyzing data, and producing and disseminating reports. 
  • Chairing monthly research dissemination meetings in the MoH and RHBs that bring together researchers, health systems, and partner organizations’ leaders and staff to learn about and contextualize evidence for use in Ethiopia.
  • Developing and delivering evidence-to-policy, leadership, and healthcare financing training
  • Continuously conducting an environmental scan and strategic collaborations to mitigate duplications and maximize the synergy of similar efforts in Ethiopia. 

Strategic Objective #1

Evidence-to-Policy

  • Efficiency, quality and equity of primary health care services improved by using locally available and relevant evidence for planning, monitoring, decision making, policy analysis, and follow-up action within the Ministry of Health and regional health bureaus.

Strategic Objective #2

Health Financing

  • Strengthening health care financing for improved primary health care systems: generating new revenue from domestic sources; increasing health care resource use efficiency and productivity; and improving financial management and budget utilization in public programs.

Fenot's

Achievements.

Strengthening Health Policy and Financing

  1. Fenot team members are chairing the Research Advisory Council at the MoH and similar platforms at the Oromia and Amhara RHBs that contextualize global and regional knowledge for use by health managers and policymakers in Ethiopia.
  2. Helped sustain Ethiopia’s bi-annual production of National Health Accounts.
  3. Supported the MoH in launching new strategy and policy analysis offices to support higher-level attention to key priorities such as health system financing.

Innovating in Health Economics and Financing Strategies

  1. Assessment of the resource requirements and gaps in adequately funding Ethiopia’s universal (exempted) services package.
  2. Estimated the revenue-generating potential of innovative financing mechanisms such as earmarking “sin taxes” (tobacco and alcohol) to health.
  3. Facilitated the creation of the first regional Health Financing Unit in Oromia that pioneered a regional health care financing strategy and the first regional health account in Ethiopia, with a similar effort initiated in the Amhara Region.

Enhancing Decision-Making and Training in Health Systems

  1. Delivered multiple rounds of training to hundreds of health system staff and researchers, equipping them with the required skills to interpret and use evidence for decision-making in health system management and financing.
  2. Developed and implemented an innovative in-service sequence of short-term trainings on “Health Economics, Health Financing, and Decision-Science” for government and academic staff to strengthen practical knowledge to improve resource mobilization, use, and efficiency.
  3. Analyses of health facility cost-efficiency and health worker productivity through innovative use of routine Health Information System (DHIS2) data.

Research and Evidence-Based Health System Improvements

  1. Delivered evidence-based assessments to improve cost-efficiency in health systems, including analyzing routine health information data.
  2. Facilitated the application of research outcomes to strengthen universal health service packages in Ethiopia.
  3. Led analysis of current research studies to enhance primary health care service delivery:
  • The maternity care pathway study in Dire Dawa.
  • A national assessment of gaps in reimbursements to facilities providing exempted maternal health services.