Ethiopia: Improving Prevention of Mother-to-Child HIV Transmission Services at Bella Hospital (April 2007)


With support from PEPFAR, Bella Hospital in Ethiopia has been recognized for its high-quality prevention of mother-to-child HIV transmission (PMTCT) program, which was assessed using a nationally developed PMTCT performance standard. The performance assessment takes into consideration all the inputs and processes needed to provide a high-quality PMTCT program. According to the performance standards, hospitals that scored at least 80 percent in each of the assessment areas would be recognized for the quality of their PMTCT programs. Many initially considered the 80 percent target performance standard to be unreachable in the general context of health system performance in the country. Bella Hospital proved this thinking wrong.

With support from the Emergency Plan, the hospital began implementation of standards-based management for a high-quality PMTCT program. The hospital held a series of modular workshops that were carried out at three-month intervals. During the first stage of implementation, the hospital promoted agreed-upon standards, changed management practices, and conducted a baseline assessment of services. The next steps in the process included gap identification, cause analysis, intervention selection, and gap filling.

After implementing interventions to address performance gaps, a final external assessment of PMTCT services at Bella Hospital was conducted, and the hospital scored above the 80 percent standard of excellence. This was a great success for both the hospital staff and the partners, who worked closely through each step of the implementation process. The hospital's success shows that a standards-based management approach can successfully improve health care, even in resource-limited settings.


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