Getu Molla Tarekegn
Nutrition at Micronutrient Initiative,Ethiopia
Title: Integrating micronutrient interventions into health systems for program sustainability; a case study on vitamin A supplementation (VAS) in Ethiopia.
Biography
Biography: Getu Molla Tarekegn
Abstract
Statement of the Problem: Integration of micronutrient interventions into a country’s health system is a means for achieving sustainability of high impact and cost-effective interventions. The biggest challenge with integration is to maintain high coverage achieved through less integrated interventions. To address this concern, Micronutrient Initiative (MI) developed a framework for integrating micronutrient interventions into health systems. The framework was used in the design of a 4-year program (2011-2015) on integrating vitamin A supplementation into the Ethiopian health system to maintain the high VAS coverage which had been achieved through non integrated intervention. The purpose of this paper is to examine the extent to which VAS has been integrated into the Ethiopia health system, & trends in VAS coverage achieved through integrated delivery, and the lessons learnt. Methodology: A situation assessment on the extent of integration of VAS into the Ethiopian health system was done using the MI’s framework for integration to determine the baseline and set targets. The framework was adopted from WHO Health System Building Blocks which includes; service delivery, human resource, procurement and supplies, M&E, financing, Stewardship & Governance. Findings: Strong health system support at all levels allowed relatively high VAS coverage to be maintained while shifting to an integrated routine system. The integration score has improved from 17 to 25 point score during the four years of program implementation. Conclusion & Significance: The MI’s framework for integrating micronutrients into health system has so far successfully guided Ethiopia to design a project that has helped the country to systematically transition from less to more VAS integrated intervention. Government ownership & the clear framework for integration has contributed to the good results achieved so far. Recommendations are made to do a cost analysis to determine the direct costs of reaching children with VAS through integrated intervention.