Ginnir Hospital Capacity Building Project (GHCBP) Mid-term evaluation report, Ethiopia

Background:
Ginnir Hospital located in the Bale Zone in Oromiya Region, was inaugurated in April 2001. It was built according to national Ethiopian hospital standard for a Zonal Hospital. The hospital has medical, surgical, pediatric, gynecological and labor wards, in all 120 beds. The agreement of Ginnir Hospital Capacity Building Project (GHCBP) for the first project phase was signed between OHB, OFSDPPC, NLM and EECMY/DASSC in December 10th, 2003. The agreement for the second phase (2008 – 2012) was signed between OHB, OBoFED, NLM and EECMY/DASSC in January 2008.

The strategy was to build up the capital capacity by purchasing specific major and minor equipment which should be maintained regularly, as well as building the capacity of hospital staff by training, exchange visits to other hospitals in Ethiopia, seconding expatriate health workers to give in-service training and external consultancy visits.

Purpose/objective:
The evaluation is mainly intended to assess the performance against the agreed plan and other procedural and technical health care issues of the project and provide the outcome of the evaluation to the relevant government bodies and to the implementing agency NLM/EECMY to fill their information gap and improve the service delivery of the concerned organization.

In particular the main objective of the mid-term evaluation is mainly intended to assess the progress of the project and its achievement and the result generated due to this project intervention and to provide the outcome of the evaluation to the government organization and the implementing agency.

Methodology:
In effort to collect the necessary data and information for the purpose of this evaluation, the evaluation team has used the following methods:
• Hold discussion with the project manager at the Hospital level and NLM/ EECMY representatives from the head offices.   
• Reviewed the project document as well as periodical reports/quarter, and mid-term  reports of the project,
• Holding discussion with the medical staffs  of the health facility and   interviewed some of them on individual basis,
• Observation/ visiting of the hospital in order to see the specific contribution of the project and provision of medical equipment to the hospital as per the agreement or at least the minimum standard.

Key findings:
Before the intervention of GHCBP there was not such significant functional medical service in Ginnir hospital.  Access to surgical care like Caesarean Section oxygen concentrator and other life saving apparatus   were non-existing. However, as the catchments area is very vast, the lifesaving services are still without reach for many people.  Quite recently the need of the hospital and the nature of the project are rapidly changing.  Thus, GHCBP would like to continue to keep an extra focus on maternal health and similar other critical health services

Medical and non-medical equipment purchased and fairly supplied to each wards in general and the pediatric & delivery ward equipped very well in particular. In order to improve the skill of health personnel different important books were purchased and given to health personnel and also available in the library. Training and experience sharing has been given to the hospital staff members for a week to a month on different tittles.

Recommendations:
Having reviewed and analyzed the overall status of the GHCBP the evaluation team suggests the following recommendations on issues that need rectification:
• Intimate collaboration and transparency is very important among all stakeholders, especially Zonal District level sector offices in terms of joint planning and implementation. It is mandatory to provide them annual action plan to avoid duplication efforts in health care provision and support.
• It is essential to improve the recording system of the project such as property registration and management and proper handling of inventory report on separate record in order to easily handover the fixed asset at the termination of the project.
• Within the remaining the project lifetime the evaluation team recommends if the project design some income generating activities to insure the financial sustainability
• The mechanism of referral system among the lower health facilities is encouraging. Thus, capacitating the health workers through awareness creation and experience sharing helps further the health worker to easily refer the clients.     
• The intended financial software installation and training should be strengthened so as to improve the poor financial and accounting system of the project.

Comments from the organisation, if any:
Ginnir Hospital Capacity Building Project (GHCBP) is in its final year in 2012. Cooperation and support to Ginnir Hospital will continue as there is strong need for the medical services in the area by strengthening the quality of services and focus on women & Child health through the new project called Reducing Maternal Mortality (RMM) from 2013 onwards.