Rahel Gizaw, MLI Country Lead, Ethiopia

Honorable Minister Tedros recently expressed his appreciation for MLI, stating, “Although Ethiopia is a country with a significant number of donors, one thing that drew our attention to MLI is its emphasis in building the management and leadership capacity of the Ministry.”

With support from MLI, the Federal Ministry of Health (FMOH) in Ethiopia has begun working to scale up and implement the Balanced Scorecard (BSC) throughout the entire health sector. The BSC is a tool for planning, monitoring and managing health sector development activities efficiently and effectively in order to positively impact health sector goals. There is a strong and urgent commitment on behalf of the FMOH to use the BSC as the planning and monitoring tool for the new health sector development plan (HSDPIV) to be launched in 2010.

BSC activities kicked off in August 2009 when consultants from the Balanced Scorecard Institute arrived in Ethiopia.   We had an introductory meeting with the Policy and Planning Directorate of the FMOH and developed a detailed plan of action for the first phase of BSC assignment: the assessment. The assessment covered 13 directorates, 4 agencies, 5 Regional Health Bureaus (A.A, Oromia, SNNPR, Amhara and Tigray), 2 specialized hospitals and 1 zonal hospital. 

Minister Tedros and Dr. Nejmudin Kedir provided some key comments and suggestions as we began the BSC activities:

• The BSC needs to be used both for measuring individual performance and the management of organizational performance as well as aligning individual employee’s day to day work with the health sector’s mission and vision.
• The BSC needs to connect performance measurement with the health sector targets.
• BSC implementation needs to be aligned with the health sector plan. 
• Coordination with the Ministry of Capacity Building, who will oversee the future government-wide implementation of a BSC approach, is critical for the long term success of the BSC.

Following the assessment, over 100 individuals in the health sector were trained on the BSC through two rounds of 3-day Leadership Development workshops, two rounds of master level professional certificate trainings, and two rounds of mid level trainings. The trainings were very successful and helped to fill in the BSC knowledge gaps and to provide the participants with the required tools for designing and implementing the BSC in their respective organizations.

During the two leadership development workshops, the participants developed the health sector strategic map and objective commentaries which will be used to identify strategic initiatives and performance measures and to develop through a “cascading” process two BSCs – one at the Medical Services Directorate of the FMOH and one at a specialized hospital level.  Starting in January 2010 our BSC efforts will focus primarily on engaging key sector leaders and stakeholders to align and transition the BSC framework with the new health sector development plan.