Aberdeen-Bahir Dar Partnership: Working to strengthen obstetric care in Ethiopia

Felege Hiwot Referral Hospital (FHRH) is situated in Bahir Dar in the Amhara region of Northern Ethiopia and serves as a regional referral hospital to 7 million people. FHRH has 400 beds and over 800 members of staff employed by the Hospital and associated University of Bahir Dar (BDU). FHRH faces a number of challenges typical to a low resource setting serving a high population from a broad geographical area.

The Soapbox Collaborative is a research-based charity focussed on prevention of healthcare associated infections, which works with research groups, NGOs, and health facilities in 7 countries in Africa and Asia. The Soapbox Collaborative formed a partnership with FHRH in 2014.

In 2015, University of Aberdeen (UoA) and FHRH collaborated on a Johnson & Johnson funded one year quality improvement project to improve high risk obstetric care. This included training of trainers in obstetric emergencies and neonatal resuscitation, piloting the WHO safe childbirth checklist, and support with improving peri-operative obstetric case management through the WHO surgical safety checklist, improved recovery facility and introducing a modified maternal early warning score system. These interventions were met positively by staff and the early warning system was found to improve monitoring of mothers and earlier detection of complications. The WHO Safe Childbirth checklist remains in regular use and our experience was shared at a recent WHO meeting on the topic, as we were one of 34 worldwide sites to pilot the checklist, and the Ministry of Health were in attendance and are rolling out the checklist to other facilities nationally.

The partnership has also supported restoration of water supply in the maternity unit, functioning laundry and maintenance and hand hygiene training, and collaborative research has been conducted on caesarean section wound infection rates and on water requirements for labour and delivery.

As a result of the grant we’ve been able to go from strength to strength in the last three years. We have expanded our support to multiple clinical areas and development of the Aberdeen-FHH-BDU partnership including the University of Aberdeen, NHS Grampian and Bahir Dar University. We have had a number of exchange visits both to and from Ethiopia and this has really helped us to improve both training and practices with our colleagues in Ethiopia as well as furthering our own skills in the UK. The partnership now supports a student elective program with students undertaking audit and quality improvement projects at FHRH aligning projects with local needs and this has really been great to engage a new generation of health workers with these projects.

It has been fantastic to see the continued growth of the programme, from the expansion of the ICU, improved post-operative recovery care, development of resuscitation stations and training, sepsis and maternal sepsis management bundles, to improving pain assessment and management. The quality and research department has been a strong focus with development of a dedicated quality team, a local audit committee with audit proposal procedures and monthly meetings, and currently development of research procedures. NHS Grampian have also been supporting the development of the new teaching hospital at Bahir Dar University.

Developing this partnership has enabled staff and service developments on both sides and we are optimistic that it will continue to grow and improve patient care.

Authored by: Jolene Moore, UK Partnership Lead