Assessment of skills/knowledge gap in Health and Education ... · 3.1.1 Knowledge and skills gap in teaching and learning in technology institutions 13 ... Factors behind low quality

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Assessment of skills/knowledge gap and investment opportunities

in Health and Education sectors in Ethiopia

FINAL ASSESSMENT REPORT

ADDIS ABABA, ETHIOPIA November 2018

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International Organization for MigrationSpecial Liaison Office, EthiopiaKirkos Sub city, Wereda 8, YeMez buildingP.O.Box: 25283. Code 1000Addis Ababa, Ethiopia Tel: +251 11 557 1707Fax: +251 11 557 1802E-mail: [email protected]: Ethiopia.iom.int

International Organization for Migration Special Liaison Office, Ethiopia

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Assessment of skills/knowledge gap and investment opportunities

in Health and Education sectors in Ethiopia

FINAL ASSESSMENT REPORT

This report was prepared for the International Organization for Migration (IOM) by Forum for Social Studies (FSS).

ADDIS ABABA, ETHIOPIANovember 2018

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Executive SummaryThe Government of Ethiopia (GoE) has now more than ever before recognized the need for a structured mechanism to engage members of the diaspora and harness the developmental potential of the diaspora community. As an initial step, the GoE has prioritized mapping the potential of Ethiopian diaspora and identify skills and knowledge gaps in the two prioritized sectors of education and health. To systematically address this, a comprehensive assessment is required to identify the knowledge and skills gaps needs and investment opportunities and design effective strategies. With this objective, the knowledge and skills gap assessment has been conducted in tertiary teaching-referral hospitals and universities located in four regional states – Tigray, Amhara, Oromia and SNNPR – and one administrative city – Addis Ababa. A total of 6 science and technology universities/institutes and 6 tertiary teaching-referral hospitals have been purposively selected based on criteria of years of services since establishment, availability of graduate programs, focus on science and technology innovation. Both qualitative and quantitative approaches were used to collect data. Quantitative data were collected through questionnaire survey and desk review. Qualitative data were collected through key informant interviews held with officials of the institutions and focus-group discussion with students/residents, and through limited observation.

The findings show that there is both qualitative and quantitative difference in the extent of knowledge and skills gaps among the institutions under study. In the technology institutes, the distribution of academic staff is too much skewed towards lower degrees and ranks, extreme male domination, and in favour of those institutions that are located in Addis Ababa. Similarly, the number of specialists/sub-specialists for medical training and clinical services were found to be very low in most of the tertiary teaching-referral hospitals. The availability of advanced technologies that facilitate teaching, research and clinical services and the corresponding knowledge and skills to operate and maintain the technological equipment was found to be inadequate. Those institutions based in Addis Ababa, are exceptionally advantaged in the number of qualified staff, availability of advanced academic programs and technologies, and types and quality of medical services. The closest match is observed between the identified diaspora potential and knowledge and skills gap assessment. Large proportions of diaspora were found to have the necessary knowledge and skills on areas where gaps were identified. The major mismatch is on the locations where diaspora are interested to invest/engage, many being attracted to Addis Ababa while the knowledge and skills gap is high in institutions based in the regions.

To optimally utilize diaspora potential, the government of Ethiopia, in collaboration with development partners and diaspora associations, needs to develop implementation strategies of the diaspora engagement/investment in the institutions, establish organization structures and regulatory frameworks, and develop data bases and viable websites that can facilitate accessibility of information about potential diaspora resources and gaps in the country of origin.

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AcknowledgementsThe Forum for Social Studies (FSS) gratefully acknowledges the contribution of the following institutions covered by the assessment:

Adama Science and Technology University

Addis Ababa Institute of Technology –Addis Ababa University

Addis Ababa Science and Technology University

Ethiopian Institute of Technology -Mekelle

Hawassa University Institute of Technology

University of Gondar, Institute of Technology

Adama Hospital Medical College

Ayder Referral Hospital

Gondar University Hospital

Hawassa Referral hospital

St Paul’s Hospital Millennium Medical College

Tikur Anberssa Specialized Hospital –Addis Ababa University

With short notice handed to them, they made the data collection efforts of the researchers smooth and fruitful. The officials of the universities were instrumental in facilitating the work and in providing valuable information about their respective institutions.

Our thanks also go to the Diaspora Directorate of the Ministry of Foreign Affairs and the various Federal and Regional Diaspora focal persons and teams that cooperated in informing the assessment whenever they were called up on.

Finally, FSS appreciates the contribution of the staff of the International Organization for Migration (IOM) –Ethiopia for their tireless efforts in providing valuable comments and suggestion for the designing to the final report preparation of the assessment.

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Table of Contents

Executive Summary iiAcknowledgements iiList of Tablesv iii1. Introduction 8

1.1 Purpose of the assessment 81.2 Scope of the assessment 91.3 Objectives 9

2. Methods and Instruments 102.1 Methods 102.2 Sources of data 102.3 Sample selection 102.4 Instruments 12

2.4.1 Types of Instruments 123 Data Analysis and Findings 13

3.1 Knowledge and skills gap in science and technology intensive tertiary educational institutions 133.1.1 Knowledge and skills gap in teaching and learning in technology institutions 13

3.1.1.1 Availability of specialization programs in technology institution 133.1.1.2 Profile of academic staff in technology 143.1.1.3 Major challenges related to technological teaching and learning 15

3.1.2 Knowledge and skills gap in technological research 173.1.2.1 The state of technology research 173.1.2.2 Challenges in technology research 18

3.1.3 Knowledge and skills gap in technology institutions’ management and leadership 183.1.3.1 The state of technology institutions’ management and leadership 183.1.3.2 Challenges in technology institutions’ management and leadership 20

3.2 Knowledge and skills gap in health sectors in Ethiopia 213.2.1 Knowledge and skills gap in medical education and training 21

3.2.1.1 Availability of specialty and sub-specialty programs in medicine 213.2.1.2 Profile of academic/clinical staff in specialty and sub-specialty programs in medicine 213.2.1.3 Challenges related to medical education and training 22

3.2.2 Knowledge and skills gap in medical/health research 233.2.3 Knowledge and skills gap in medical services 23

3.2.3.1Availability of specialist medical services 233.2.3.2 Population seeking health care in the teaching-referral hospitals 253.2.3.3 Number of beds in the hospitals 253.2.3.4 Availability of common diagnostic technologies in the hospitals 263.2.3.5 Challenges related to diagnostic technologies in the hospitals 27

3.2.4 Knowledge and skills gap in hospital management and leadership 283.2.4.1 Problem of decision making 283.2.4.2 Problem of staff turnover 293.2.4.3 Poor use of ICT infrastructure for organizational efficiency 293.2.4.4 Problems related to purchasing and procurement 29

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4. Diaspora engagement/investment in education and health sectors in Ethiopia 304.1. Experience/contributions of diaspora engagement/investment 304.2. Diaspora engagement/investment opportunities in education and health sectors in Ethiopia 314.3. Challenges in diaspora engagement/investment – institutional, structural/ organizational and attitudinal 314.4. Initiatives of the Ethiopian Government to address knowledge and skills gaps utilizing the Potential of Diaspora 32

5. Matching the knowledge/skills gaps and investment needs with the diaspora potentials 345.1 Matching diaspora potential and institutional human resource need 345.2. Diaspora engagement/investment interest and institutional situations/opportunities 35

6. Conclusions, Recommendations and Roadmap 366.1. Conclusions 366.2. Recommendations 366.3. Roadmap to inform knowledge/skills transfer programs in Ethiopia. 37

References 39Annexes: 41

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Table 1: Number of students by program level and sex (2017/18) 12

Table 2: Academic qualification of Ethiopian and Expat staff by type

of degree and sex (2017/18) 13

Table 3: Number of Ethiopian and Expatriate staff by academic rank and sex (2017/18) 13

Table 4: Number of Ethiopian and Expatriate staff by academic rank and sex (2018) 14

Table 5: Major challenges to the teaching-learning process (2018) 15

Table 6: Research and research training facilities (2018) 16

Table 7: Factors behind low quality research outputs (2018) 17

Table 8: Collaborative engagement (2018) 18

Table 9: Failure to optimally utilize facilities and resources (2018) 18

Table 10: Factors behind failure to optimally utilize facilities and resources (2018) 19

Table 11: Number of specialty programs (2018) 20

Table 12: Profile of teaching/clinical staff in specialty and sub-specialty medicine (2018) 21

Table 13: Number of medical services provided in the teaching-referral

hospitals (N = 51) (2018) 23

Table 14: Types of expected medical services not available in the tertiary

teaching-referral hospitals 23

Table 15: Total population seeking health care in the hospitals per year 24

Table 16: Total number of functional beds in the hospitals (2018) 25

Table 17: Types of common diagnostic technologies available in the hospitals (N = 6) (2018) 25

Table 18: Number teaching-referral hospitals with functional diagnostic

laboratory services (2018) 26

Table 19: Matching diaspora potential and institutional human resource need (2018) 33

Table 20: Matching diaspora engagement/investment interest and institutional

situations/opportunities 34

Table 21: Roadmap to inform knowledge/skills transfer programs in Ethiopia 36

List of Tables

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1 Introduction1.1 Purpose of the assessment

Although one of the oldest nations, Ethiopia is also one of the poorest, where a significant portion of the population reportedly lives below the poverty threshold. However, Ethiopia has been registering double-digit economic growth with key development objectives of poverty eradication and ensuring food security at the household level. Agricultural Development-Led Industrialization (ADLI) strategy has been the central pillar to all policies and programs. Following implementing successive Poverty Reduction Programssince1990s, the government has implemented a five-year Growth and Transformation Plan (GTP I) during 2010–2015, and started the second phase five-year GTP II from 2016–2020, which is more comprehensive and multi-sectoral national development plan. Under the GTP II, several sector-specific development plans were developed. This plan recognizes the importance of broad-based collaboration among government, donors, the private sector, non-profits and the diaspora community.

Speaking of the diaspora as a resource, it is believed that the potential wealth and knowledge existing in the Ethiopian Diaspora is enormous. Ethiopia has significant number of its population living in the US and major European countries. There are also Ethiopian diaspora community in Africa and Asia. It is estimated that more than two and half million members of the Ethiopian diaspora currently reside in North America, Europe, the Middle East, Oceania, and Africa. This will require targeted new enterprise in areas that can enhance food supply, healthcare services, and educational solutions, which will also present a great opportunity for the diaspora to explore business development prospects in the country.

As the issue here is the huge, but largely untapped resource that is available with the Ethiopian diaspora community it needs designing a sound strategy that ensures the community’s active participation in the economic activities. With this, the Government of Ethiopia (GoE) has now more than ever before recognized the need for a structured mechanism to engage members of the diaspora and harness the developmental potential of the diaspora community. As an initial step, the GoE has prioritized mapping the Ethiopian diaspora and accordingly requested IOM, a leading inter-governmental organization in the field of migration, to provide support in formulating and implementing diaspora mapping exercises. This is reflective of the need for developing the knowledgebase that identifies the skills and knowledge gaps in the two prioritized sectors of education and health where the diaspora resources can be deployed effectively. More specifically, there is a need to map out the sectors and identify investment opportunities for members of the diaspora to engage in business and play an active role in the economy.

To systematically address this, a comprehensive assessment is required to identify the needs and investment opportunities and design effective strategies. Accordingly, this research project is conducted in the context of the national perceived knowledge gaps on the available investment opportunities in public sectors. Specifically, it assesses the knowledge and skills gaps in the Education and Health sectors and identify investment opportunities with special emphasis on the role of science and technology in these sectors.

1.2 Scope of the assessmentWith the primary objective of assessing gaps in knowledge and skills in education and health sectors in Ethiopia and indicate investment opportunities in these two sectors for the Ethiopian diaspora, the project covered purposively selected teaching hospitals and universities located in four regional states – Tigray, Amhara, Oromia and Southern Nations, Nationalities and Peoples – and one administrative city – Addis Ababa.

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1.3 ObjectivesThe project aimed to assess gaps in knowledge and skills in the education – tertiary – health – teaching hospitals – sectors in Ethiopia and identify investment opportunities with special emphasis on the role of science and technology in the two sectors. In particular, the project aims to achieve the following specific objectives:

Identify skills/knowledge gaps and investment opportunities in the two sectors, focusing on

science and technology and employing a gender sensitive lens;

Match the identified skills/knowledge gaps and diaspora investment with resources identified in the diaspora through the diaspora mapping exercise;

Propose appropriate interventions/strategies to effectively address the identified skills/knowledge gaps and promote investment opportunities through the contribution of members of the Ethiopian diaspora; and

Develop a short, medium and long-term based roadmap to inform knowledge/skills transfer programs in Ethiopia.

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2 Methods and Instruments2.1 Methods

Quantitative and qualitative methods were employed. The first refers to the collection of numerical data pertaining, among others, to the available specialties, experts, post-graduate training, etc.; and employed desk review and questionnaire based assessment.

The qualitative methods include key informant interview (KII), focus-group discussion (FGD) with students/residents, and limited observation.

2.2 Sources of dataBoth primary and secondary sources were used, but the chief sources of the study were the primary sources. The major sources of primary data were the officials of science and technology universities/teaching-referral hospitals (e.g. vice-presidents, directors, deans and heads of relevant faculties and colleges), experts of ICT and human resource departments, and postgraduate students and residents. Additionally, Diaspora focal persons in the Federal Ministry of Health, Education and Foreign affairs and in the corresponding regional bureaus also served as primary sources of data. Secondary sources included websites and statistical abstracts /reports of the institutions.

2.3 Sample selectionMultistage purposive sampling was employed to collect pertinent data from a manageable number of universities and hospitals in order to achieve the study objectives. Accordingly, well-established graduate degree offering universities and tertiary-teaching referral hospitals were already selected in the first stage; and relevant colleges/institutes were selected from within these universities and hospitals in the second stage in consultation with resource persons at the universities and hospitals.

Although there are 45 fully operational public universities in the country at present, 11 of them were established over the past couple of years. Similarly, even if there are around 29 tertiary-teaching referral hospitals in the country, not all of them are of high standard. Since this study has the objective of determining gaps in skills/knowledge at higher educational institutions and public hospitals that are capable of making good use of diaspora knowledge and skills and absorbing diaspora investments, and also given the limited resources available, the study concentrated its direct assessment efforts on only a manageable few.

Hence, six target universities were selected purposively using the criteria of being in operation for more than 15 years, run well-established graduate programs, focus on science and technology innovation and are therefore amongst the well-known centres of excellence in the country.

Accordingly, four of the following universities were selected from the four regional states of Amhara, Oromia, Tigray and SNNP:

University of Gondar, (Amhara; est. 1954)

Mekelle University (Tigray; est. 1991)

Adama Science and Technology University (Oromia, est.1993/2005)

Hawassa University (SNNP; est. 1976)

In addition to the above, two universities were selected from Addis Ababa:

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Addis Ababa University (Est. 1951),

Addis Ababa Science and Technology University (Est. 2008)

In addition, a total of 6 hospitals were selected, on the criteria of length of service and being teaching and referral hospitals. The public referral-teaching hospitals that were purposively selected to be the focus of the study are those that are teaching referral institutions of relatively long standing (of not less than 10 years in operation). Accordingly, the following four hospitals were selected from Amhara, Oromia, Tigray and SNNP regions:

Gondar University Hospital (Amhara, est. 1954)

Ayder Referral Hospital (Tigray, est. 2008)

Adama Hospital Medical College (Oromia, 1946/2011)

Hawassa Referral hospital (SNNP, est. 2006)

Then, two hospitals, from Addis Ababa were selected, namely:

Tikur Anberssa Specialized Hospital/Addis Ababa University College of Medicine

and Health Sciences (Est. 1972)

St Paul’s Hospital Millennium Medical College (Est. 1968/2007)

As for the second stage of the purposive multistage sampling, relevant institutes were purposively selected from among the four universities of Addis Ababa, Gondar, Hawassa and Mekelle in consultation with their respective officials and based on the actual situation on the ground. As the potential of absorbing high-level diaspora engagement and investment to fill the skills/knowledge gaps in educational and health institutions is the central focus of the assessment, the main criterion of selecting the institutes at this stage was the extent to which they functionally relate to advanced science and technology. On the contrary, the two science and technology universities of Adama and Addis Ababa were assessed in their entirety, without undergoing any second stage sampling, because they are as a whole dedicated to science and technology. Likewise, those six teaching and referral hospitals that were selected in the course of the first stage were assessed as single wholes, with no departments being singled out, since the medical treatment, research and teaching operations are intertwined as to make any separate assessment of their individual units unnecessary and probably impractical.

2.4 Instruments2.4.1 Types of Instruments

Desk Review Checklists (one each for education and health): To identify existent public investment in higher education and health sectors and their gaps, Annual Statistical Abstracts; annual performance reports; state of science and technology – mainly on ICT services and imaging procedures for the purposes of diagnosis and/or treatment in hospitals; outputs of previous assessments on knowledge/skills/technology assessments; and reports by the sector ministries themselves were reviewed. Furthermore, the strategic plans of the universities and hospitals were reviewed for possible gaps in skills/knowledge they might have identified.

Assessment Questionnaires (one each for the education and health): As a follow-up of the above, a gap assessment questionnaire was employed in order to canvas initial quantitative information from the selected establishments. Only a single questionnaire was filled out on behalf of the relevant institution under study, i.e. 6 questionnaires have been filled by directors/chief executives of teaching-referral hospitals and the other 6

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questionnaires have been filled by heads/deans/vice presidents of institutes of technology.

Key Informant Interview Guides (one each for the education and health): To identify gaps in knowledge and skills at tertiary educational institutions and teaching-referral hospitals that need to be filled, identify contributions already being made by the diaspora in training, education and networking as well as gather possible responses according to the particular challenges in areas of ICT, medicine and health education, and science technology, interview were held with the relevant officials and staff that are listed as primary data sources above. A minimum of 4 key informant interviews have been conducted in each sampled institution (both technology and hospital arms), giving a total of 48 key informant interviews.

Focus-Group Discussion Checklists (one each for education and health): Addressed to groups of students of graduate programs and students/residents of teaching-referral hospital, in order to identify gaps in knowledge/skill transmission that are perceived by students/residents. In each sampled institution, one FGD (of four to eight individuals) was conducted with the participation of postgraduate students/residents of the sampled teaching and training institutes.

Observation checklists (one each for education and health): Whenever necessary and appropriate, the researchers took notes of the state of observable information, such as material shortage, use and abuse of material resources such as valuable equipment due to the availability or lack of knowledge/skills or sheer creativity/neglect etc. Obviously, such observation also served to trigger on the spot (in situ) discussions with informants. The relevant data were gathered via observation in person or visiting universities’ websites.

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3 Data Analysis and Findings3.1 Knowledge and skills gap in science and technology intensive tertiary educational institutions

As has been already described in the foregoing method section, the six tertiary educational institutions were selected for being technology intensive centres of excellence of long-standing by the country’s standards. However, as the findings that are presented in the following sub-sections clearly show, there are marked quantitative and qualitative differences even among them in terms of the sizes of their various aspects, their experiences as well as the knowledge and skills that are available, or lacking, within them in particular.

3.1.1 Knowledge and skills gap in teaching and learning in technology institutions

Chief among the valid indicators of the level and state of knowledge and skills, or the lack of them, in the teaching and learning activity of any tertiary educational institution of high standard are the numbers of specialty and sub-specialty programs it runs, the size of its graduate student population, the profile of its academic staff both in terms of qualification and rank.

3.1.1.1 Size of Graduate student population in technology institution

Table 1: Number of students by program level and sex (2017/18)

Institute/ University of Technology

Total Number of Students

PhD M.Sc. B.Sc.

M F M F M F

Adama Sc & Tech University 65 2 306 45 5,036 1,189

Institute of Technology - HU 4 0 904 NA 10,124 NAInstitute of Technology - GU 0 0 51 NA 5,647 NAMekelle Institute of Technology 10 1 698 180 5,702 2,148AA Institute of Technology - AAU 92 0 3,651 NA 12,959 NAAddis Ababa Sc & Tech Univ. 90 0 1,000 NA 6,000 NA

Source: Compiled from various sources: written reports, web info, assessment questionnaire and face-to-face interviews administered for the purpose of the assessment

3.1.1.2 Profile of academic staff in technology

Table 2: Academic qualification of Ethiopian and Expat staff by type of degree and sex (2017/18)


Total Number of Ethiopian and Expat (within parentheses) Staff by Academic Qualification

PhD M.Sc. B.Sc.M F M F M F

Adama Sc & Tech Univ. 33+(65) 1+(4) 206+(13) 15 7 1Inst of Tech -Hawassa U 15 0 179 6 127 28Inst of Tech -Gondar U 0 0 107 2 38 3Eth Inst of Tech -Mekelle 20+(24) 0+(4) 180 24 80 53AA Inst of Tech –AAU 68+(8) 1 143 17 180 38AA Sc & Tech Univ.1 57+(50) 4+(2) 307+(22) 53+(5) 137 27

Totals 193+ (147) 6+(10) 1,122+(35) 117+(5) 569+(0) 150+(0)

Percent Share of Expats 43.2 62.5 3.0 4.1 - -1 According to a recent source, the total number of expatriate staff currently teaching at AASTU is well above the sum of those figures given within parenthesis, and actually numbers 97 (90 Indian, 4 Pilipino, 2 Chinese and 1 German).

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Table 3: Number of Ethiopian and Expatriate staff by academic rank and sex (2017/18)


Total Number of Ethiopian and Expat (within parentheses) Staff by Academic Rank

Prof Assoc Prof Asst Prof Lecturer &Other

M F M F M F M F

Adama Sc & Tech Univ. (2) 0 (8) 0 98+(13) 1 206 15

Inst of Tech -Hawassa U 0 0 3 0 30 0 402 42Inst of Tech -Gondar U 0+(1) 0 0+(1) 0 0+(6) 0 148 2Eth Inst of Tech -Mekelle 0 0 1+(11) (1) 7+ (13) (3) 260 77AA Inst of Tech-AAU 4+(1) 0 19+(1) 1 49+(4) (1) 265 30AA Sc & Tech Univ. 1+(8) 0 3+(10) 0 54+(32) 4+(2) 372+(22) 62+(5)Total 5+(12) 0+(0) 26+(31) 1+(1) 238+(68) 5+(6) 1,653+(22) 223+(5)Percent Share of Expats 70.6 - 54.4 50.0 22.2 54.5 1.3 2.2


Taken together, the above three tables and the fourth table that is annexed (Annex 1A) show the extent to which the number of higher level academic staff is inadequate when compared to the large number of specialty and sub-specialty programs the educational institutes run and the their large student intake. Furthermore, the over all, the distribution of academic staff is too much skewed towards (a) lower degrees and ranks (b) extreme male domination, and (c) in favour of those institutions that are located in Addis Ababa.

The AA Institute of Technology (AAiT) of Addis Ababa University, being the largest and oldest engineering institute in the country, exhibits a better staff profile as compared to all other universities in the nation. In spite of other technology intensive institutes that are catching up with it, AAiT still plays critical role in supporting engineering education in most of the universities across the nation. It trains instructors of other universities and delivers courses in their programs through visiting professors

Furthermore, Tables 2 and 3 also reveal the dominant position held by expatriates among academic staff with higher qualifications and ranks. The fact that close to three-quarters of the full professors, over half of the associate professors, and even nearly a quarter of the assistant professors of the three top-ranked instructors, as well as 43.2% of the male and 62.2% of the female PhD holders working in the six institutes taken together are expats says a lot concerning the paucity of qualified academic staff in Ethiopian science and technology institutions. This can be taken as a valid indirect indicator of the gap in knowledge and skill that would have remained open had it been left for the nation to address them with its own trained manpower. It is also worth mentioning that, the current level of expat participation should not be taken as something that fully indicates the gap or need of qualified academic staff in these higher educational institutions. It is possible to surmise that the level of expat participation could have even been much higher had it not been for the limitations of resources -- particularly finance -- that has possibly put a cap on the expat recruitment. An interesting case in point that supports this assertion is the fact that a number of expats have recently departed from many universities and institutes of the country following the newly imposed 30% income tax on their salary. Such, for instance is the case with four Pilipino full professors who were processing their clearance to leave Addis Ababa Science and Technology University as the data for this assessment was being collected.

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These facts that are indicated by the above tables are supported by the qualitative data collected from the staff and students of the six institutes through key informant interviews and focus group discussion.

3.1.1.3 Major challenges related to technological teaching and learningTable 4: Number of Ethiopian and Expatriate staff by academic rank and sex (2018)


Major Shortcomings

Academic Staff

Leadership & Management

Equipment/ Infrastructure/ Procurement

Adama Sc & Tech Univ. √ √ √Inst of Tech -Hawassa U √Inst of Tech -Gondar U √Eth Inst of Tech -Mekelle √ √AA Inst of Tech -AAU √ √AA Sc & Tech Univ. √

Source: Assessment questionnaire

Table 4, above, shows that one major challenge that is faced by all of the science and technology universities and institutes covered by the assessment concerns the inadequacy of their academic staff to academic staff. Even the remaining shortcomings (those if equipment, infrastructure and material procurement) that were identified by half of them are things that impede the teaching and learning activities.

Table 5: Major challenges to the teaching-learning process (2018)


Major challenges to the Teaching-Learning - Instructors’ lack of:

Subject Mater Knowledge

Pedagogical Skills

ICT Skills Others

Adama Sc & Tech Univ. √ √ √ _Inst of Tech -Hawassa U - - - Numerical sufficiencyInst of Tech -Gondar U √ √ _ -Eth Inst of Tech -Mekelle √ - √ -AA Inst of Tech -AAU √ - -AA Sc & Tech Univ. - - - Overall qualification


Instructors’ lack of foundational knowledge in their respective disciplines appears to be the most common shortcoming among institutions of higher technology institutes. The table shows that such is the case in two-thirds of the assessed institutes. The responses of the remaining two institutes, namely, the Institute of Technology at Hawassa University and Addis Ababa Science & Technology University, are not far from the majority view, since they have identified lack of instructors’ “numerical sufficiency” and “overall qualification” as their major shortcomings. In fact, the qualitative data invariably suggest that this is a widespread malady permeating, albeit to different degrees, the totality of the assessed institutes. By extension, it is safe to say, this holds true for the rest of the nations tertiary educational establishment the standard of which is definitely below those of the assessed institutes.

The qualitative assessment has revealed no serious gaps in the undergraduate programs of the institutes covered by the study in general. The problem faced on account of inadequate academic staff is acute in the teaching-

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learning process of postgraduate programs. Informants of the assessment invariably indicated that many more full professors and associate professors are needed to strengthen both the graduate and undergraduate programs, and the current practice of using MSc degree holders with the rank of lecturer to teach postgraduate courses that is quite common must be corrected. Furthermore, the qualitative data gathered from the same six educational institutes indicate the existence of inadequate knowledge and skills in the area of ICT and its use.

3.1.2 Knowledge and skills gap in technological research3.1.2.1 The state of technology research

Obviously, the state of research in any tertiary educational institution is by and large part and parcel of the teaching-learning process that it reflects. Hence, the findings that are presented in the foregoing sub-section showing the gaps in knowledge and skills. The unavailability of qualified staff to supervise the research work of students is a crucial gap that impacts research negatively. Finding supervisors that have knowledge and skill that is required by the research subject students are interested in, for instance, is a major stumbling block for many promising graduate students. On the side of qualified supervising instructors who, in almost all of the six institutes, are few in number, finding the time to effectively supervise the research work of their students is a daunting task.

Table 6: Research and research training facilities (2018)

Institute/ University of TechnologyNumber of Research and Research Training Facilities

Special Classroom

Science Lab

Tech Lab/ Workshop ICT Lab

Adama Sc & Tech Univ. 26 26 4 19Inst of Tech -Hawassa U 0 0 22 27Inst of Tech -Gondar U 51 0 (Tech and ICT Labs together) 41Eth Inst of Tech –Mekelle 3 1 11 1AA Inst of Tech –AAU 11 0 2 10AA Sc & Tech Univ. 6 0 17 1


Moreover, the quality of technology research is negatively impacted by the shortfall in research training facilities, which is the case in most of the assessed technology institutions. Table 5, above, gives the numbers of various research and research training related facilities in the six institutes that were assessed. However, responses to follow-up questionnaire items, key informant interviews and focus group discussions with students have revealed the fact that many such facilities are not in use in many cases, for various reasons chief among which is their mismanagement that is a topic for the next sub-section.

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3.1.2.2 Challenges in technology research

Table 7: Factors behind low quality research outputs (2018)

Institute/University of Technology

Factors Behind Low Quality Research Outputs - Lack of

Res

earc

h sk

ills

Col

labo

ratio

n

ICT

Skill

s

Com

mun

icat

ion

skill

s

Org

aniz

atio

nal s

kills

Fund

ing

Adama Sc & Tech Univ. √Inst of Tech -Hawassa UInst of Tech -Gondar U √ √ √ √Eth Inst of Tech –Mekelle √ √ √AA Inst of Tech –AAU √ √ √ √AA Sc & Tech Univ. √ √ √ √


The assessment has uncovered the fact that research and research training in the six technology institutes face several challenges on top of shortage of competent staff to supervise the research undertaking of students. The above table points out seven of these challenges that are identified from four to a single one of the institutes. The most notable of these are lack of research skills, and collaboration; followed by lack of communication/language skills and funding.

Lack of well-equipped laboratories with state-of-the-art instruments, software, and perishables is identified as a primary hindrance in nearly all of the science and technology institutes assessed by this study. Most of the laboratories in the institutes are outdated with most of the labs being used as classrooms Well-furnished laboratories where the researches can conduct experiments are in shortage. Specifically, lack of proper calibration, maintenance, and repair makes even the equipments that have been purchased at great cost to lie around without being used to serve their purposes.

3.1.3 Knowledge and skills gap in technology institutions’ management and leadership

3.1.3.1 The state of technology institutions’ management and leadership

The assessment has focused its efforts on management and leadership that are closely related to the capacity and gap. In particular, it has looked into the managerial and leadership effectiveness and efficiency in managing collaborative relations with partners and utilizing existent facilities.

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Table 8: Collaborative engagement (2018)


Type of Collaborating Partners

Eth

iopi

anD

iasp

ora

Loc

al In

dust

ry

Inte

rnat

ion

al

Indu

stry

Afr

ican

H

ighe

r E

du

cati

on

al

Inst

itutio

ns

Inte

rnat

ion

al

Hi

gh

er

Ed

uca

tio

na

l In

stitu

tions

Adama Sc & Tech Univ. √ √ √Inst of Tech -Hawassa U √Inst of Tech -Gondar U √ √Eth Inst of Tech –Mekelle √ √ √AA Inst of Tech –AAU √ √ √ √AA Sc & Tech Univ. √ √ √ √


The above table testifies to the existence of a reasonable collaborative networking between the six technological institutes in question and their partners that range from four to two types save for one single case (Hawassa) that has only a single type of partner. However, key informants of the study have pointed out that such collaborative engagements are often hampered by a number of pitfalls chief among which are the bureaucratic and inefficient management of the institutes.

The table that follows gives the common mismanagement that pervades the utilization of the facilities and resources of the technology institutes covered by the assessment. It is quite clear that these facilities and resources that are not so easy to come by stand still without being optimally used for lack of personnel with appropriate knowledge and skills to utilize, maintain, and repair them.

Table 9: Failure to optimally utilize facilities and resources (2018)


Unutilized or Underutilized facilities or Resources

Sc

ie

nc

e L

abor

ator

y

Spec

ial C

lass

room

Dig

ital L

ibra

ry

ICT

Faci

litie

s

Web

site

and

Soc

ial

Med

ia

Adama Sc & Tech Univ. √ √ √Inst of Tech -Hawassa U √Inst of Tech -Gondar UEth Inst of Tech –Mekelle √ √ √ √AA Inst of Tech –AAUAA Sc & Tech Univ. √ √ √


Qualitative data collected by the assessment have shown that there is widespread lack of knowledge and commitment on the part of the management, particularly in budgeting and prioritization. This makes sense when one considers the fact that while even in those cases where there is enough finance available, the preference is to allocate much of it to the construction of fancy offices and even stadiums. The tech labs that need to be equipped with modern instruments are given less attention.

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Moreover, the assessment has learnt that the problem of shortfall in teaching and research materials that are essential to the activities of the universities and institutes is not just a matter of lack of finance or procurement. Even when equipments and instruments are available, there is a demonstrated skills shortfall hampering their efficient utilization.

3.1.3.2 Challenges in technology institutions’ management and leadership

One of the sources of managerial problems in tertiary educational institutions is that most, if not all, of their leaders and managers are recruited from within the academic establishments themselves, and not from among those trained in educational management. Furthermore, the existent gaps in knowledge and skills common among these institutes translates itself in inadequacy and ignorance of their staff to properly utilize the facilities and resources in their hands.

Table 10: Factors behind failure to optimally utilize facilities and resources (2018)


Factors Behind Lack of Utilization or Underutilization Facilities or Resources

Inadequacy of Personnel

Ignorance of their Availability

Ignorance of their Utilization

Adama Sc & Tech Univ. √ √Inst of Tech -Hawassa U √Inst of Tech -Gondar UEth Inst of Tech –Mekelle √ √ √AA Inst of Tech –AAUAA Sc & Tech Univ. √ √


3.2 Knowledge and skills gap in health sectors in Ethiopia

3.2.1 Knowledge and skills gap in medical education and training

3.2.1.1 Availability of specialty and sub-specialty programs in medicine

All of the health science colleges/hospitals included in the assessment provide medical education and training to medical students. A range of academic programs are underway at undergraduate and post graduate levels in various categories of qualifications and specializations in medicine. The post graduate programs include MSc, PhDs and specialty and sub-specialty programs in medicine and nursing fields of study. In this assessment, due attention is given to the types and number of specialty and sub-programs. As indicated in Table 10 the types and number of specializations in medicine vary widely between the sampled health science colleges. Health science colleges of Addis Ababa University/TASH and St. Paul Hospital Millennium Medical College run large number of academic programs in residence (Specialty medicine) and fellowship (sub-specialty medicine). Health science colleges based in regional cities provide limited training opportunities for medical students interested in residence and fellowship programs. Adama Hospital Medical College has the least number of specialty programs in medicine as compared to those based in regional cities.

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Table 11: Number of specialty programs (2018)

Health science colleges/Teaching-referral hospitals

Number of programs

Residence (specialty) Fellow (sub-specialty)

AdHMC 4 0CHSc-HU 6 0CHSc-UG 8 3CHSc-MU 11 3CHSc-AAU 23 25SPHMMC 16 4


3.2.1.2 Profile of academic/clinical staff in specialty and sub-specialty programs in medicine

The largest number of specialists/sub-specialists is based in the college of health science in Addis Ababa University and St. Paul Hospital and Millennium Medical College. All other tertiary teaching-referral hospitals and medical colleges have nearly 1/4th of the specialists/subspecialists compared to those based in the capital city of Ethiopia. In terms of gender composition, the number of women specialists/sub specialists is very few in number. Interestingly, those tertiary teaching- referral hospitals based in Addis Ababa again are the place for large number of women with advanced training in medicine. This implies that the medical education and training institutes/colleges have a long way to go in terms of increasing the number of qualified staff for running teaching and learning activities in different categories of programs in residence and fellowship programs.

Table 12: Profile of teaching/clinical staff in specialty and sub-specialty medicine (2018)

CategorySpecialists/sub-specialists General practitioners

Male Female Total Male Female TotalAdHMC 51 1 52 11 4 15CHSc-HU 56 6 62 11 5 16CHSc-UG 70 13 83 123 35 158CHSc-MU 41 5 46 12 9 21CHSc-AAU 202 53 255 94 171 265St.PHMMC 222 129 351 7 9 16


3.2.1.3 Challenges related to medical education and training

In qualitative interviews held with academic and hospital directors and students, the shortage of staff with qualifications in various fields of specialty and sub-specialty programs in medicine was found to have huge implications to the quality of training and education. However, the shortage of sub-specialists for residence programs is a common problem for health science colleges included in this study. In many cases resident programs are run by generalist specialists. The college of health science of Addis Ababa University is exceptional in that shortage of staff with advanced training and qualification was not mentioned as an issue for most postgraduate programs. The St. Paul Hospital Millennium Medical College is also relatively better positioned in terms of qualified staff required to run specialty and sub-specialty programs.

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A range of other factors influencing the quality of medical education have also been identified from qualitative interviews. Poor devotion and commitment of teachers, lack or shortage of teaching aids such as simulation equipment in the skill laboratories, low use of ICT technologies for teaching and learning, lack of local and international exchange programs including attachment in similar public and private training institutes for experience sharing and learning, and lack of platform for exchange of experienced and senior teachers from institutes to institutes are among these factors. The common challenges related to medical education and training are outlined as follows.

Common challenges related to medical education and training

- Shortage of sub-specialists in specific fields like urology, oncology, plastic and reconstructive surgery, etc.

- Lack/shortage of exchange and experience sharing programs

- Poor devotion/interest among teachers to teach

- Limited adoption/use of recent technologies – old approaches and procedures are dominantly utilized

- Poor quality of educational leadership and management

- Curriculum insistency between colleges

- Low attention to basic science and research while more time is being given to practice

- Lack/shortage of simulation instruments and other skill laboratory equipment

- Shallowness of course delivery due to block based system

- Low use of ICT technologies for teaching and learning – e.g. lack of e-learning, video conferencing, etc.

- Lack of experience in exchanging teachers between institutions

- Inadequacy/lack of public-private partnerships – students are being attached only to public hospitals/health facilities while there are technologically well furnished private health facilities

3.2.2 Knowledge and skills gap in medical/health research

The engagement of clinical and teaching staff and students in health research was found to be inadequate. This has been attributed to some of the factors outlined below.

- The inadequacy of incentives and poor governance of research are some of the factors limiting staff engagement in health or medical research.

- Due to shortage of staff in specialty fields/advanced qualifications, students are less motivated to engage in problem solving projects and research activities

- There are few learning opportunities for students to participate in workshops, conferences, symposiums, seminars and public lectures

- The inadequacy of lab facilities limits the engagement of both teachers and students in health/medical research

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3.2.3 Knowledge and skills gap in medical services3.2.3.1 Availability of specialist medical services

The specific types of specialist medical services assessed in the teaching-referral hospitals included in this study were adapted from the outline of medical services of National Department of Health, South Africa (2003). A total of 51 types of medical services expected in the referral hospitals have been checked by clinical service directors of each hospital included in the study. From the stated medical services, the majority are provided in Ayder referral hospital (Mekelle), Tikur Anbessa Specialized Hospital (Addis Ababa) and St. Paul Hospital and Millennium Medical College. At the time of this study, all of the teaching-referral hospitals had a plan of expanding/scaling up existing services including addressing large number of population seeking the services and commencing new medical services that are highly needed by the population in their catchment area. The construction of buildings was under way in all of the hospitals included in the study as part of the service expansion plan. This would increase the number of services provided in the hospitals in the years to come.

Table 13: Number of medical services provided in the teaching-referral hospitals (N = 51) (2018)

Teaching-referral hospitals Number of medical services available Medical services available in %

AdHMC 21 41.2HCSPH 29 56.9GUH 36 70.6AydCSH 44 86.3TASH 47 92.2St.PHMMC 46 90.2


Some of the medical services not provided/not available in the teaching-referral hospitals at the time of this study are outlined in the table...

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Table 14: Types of expected medical services not available in the tertiary teaching-referral hospitals (2018)

AdHMC HCSPH GUH AydCSH TASH St.PHMMC- Burns unit (Burns

ICU and operating theatre

- Clinical pharmacology

- Gastroenterology- Nephrology

(tertiary dialysis and nephrology service

- Pediatric surgery - Plastic and

reconstructive surgery

- Rehabilitation centre

- Respiratory medicine

- Trauma centre (tertiary major trauma centre)

- Cardiology Cardiothoracic surgery

- Clinical immunology

- Cranio-maxillofacial surgery

- Endocrinology - Genetics - Geriatrics - Hematology - Medical and

radiation oncology - Nuclear medicine - Renal transplant - Orthopedic surgery

(orthopedic oncology)

- Pediatric ICU- Hemodialysis - Cath Lab- Diagnostic

pathology - Endoscopy and

colonoscopy - Chest and Vascular

surgery - Maxillo-

odontology

- Burns unit (Burns ICU and operating theatre

- Clinical pharmacology

- Gastroenterology- Nephrology

(tertiary dialysis and nephrology service

- Plastic and reconstructive surgery



- Trauma centre (tertiary major trauma centre)

- Cardiology Cardiothoracic surgery

- Clinical immunology

- Endocrinology - Genetics - Geriatrics - Hematology - Nuclear medicine - Renal transplant - Orthopedic surgery

(orthopedic oncology)

- Hemodialysis - Forensic and

sexual assault - Cath Lab- Endoscopy and

colonoscopy - Chest and Vascular

surgery - Maxillo-

odontology

- Plastic and reconstructive surgery



- Endocrinology- Genetics- Geriatrics- Medical and

radiation oncology

- Renal transplant- Orthopedic

surgery (orthopedic oncology)

- Forensic assault- Cath Lab- Chest and

Vascular surgery

- Maxillo-odontology

- Nuclear medicine

- Ophthalmology- Orthopedic

surgery (sub-specialty orthopedics)

- Genetics- Geriatrics - Radiation

oncology - Renal transplant - Nuclear

medicine

- Burns unit (specialized burns ICU and Operating theatre)

- Genetics - Geriatrics - Forensic assault

- Cardiothoracic surgery

- Geriatrics - Nuclear

medicine - Chest and

vascular surgery


3.2.3.2 Population seeking health care in the teaching-referral hospitals

The total catchment population served by the hospitals and the largest number of people seeking for outpatient, inpatient and emergency services contributes for the knowledge and skills gap in the hospitals, creating more demand for human and infrastructural resources. Even though all of the hospitals have a defined population to be served, there is no clear demarcation line which limits people visiting the hospitals outside of their catchment areas. In this regard, some hospitals are overburdened due to the large number of visiting patients outside of the catchment area. In this regard, the teaching-referral hospitals based in the regional and capital city of Ethiopia serve the largest number of people. On average, as HMIS data from the hospitals indicate, 265, 245 (range 29,585

24

– 430,000) people have visited the hospitals in the end of 2010 E.C fiscal year. Similarly, on average, 35,124 (range 11,103 – 99,090) people visited the sampled hospitals for inpatient specialist medical services. The average number of people who received emergency services in 2010 E.C fiscal year was 30,684 (range 11,212 – 45, 884).

Table 15: Total population seeking health care in the hospitals per year

Teaching-referral hospitals

Catchment population (in

millions)

Outpatient services Inpatient services Emergency services

AdHMC 5 264,412 9,990 32,511HCSH 18 106,612 11,103 11,212GUH 7 430,000 30,000 28,000AydCSH 8 29,585 16,632 29,585

TASH All over the country 384,859 20,618 36,910

St.PHMMC All over the country 376,000 33,298 45,884

3.2.3.3 Number of beds in the hospitals

The number of beds in the hospitals can be an indication for the gap in the knowledge and skills in the hospital. As indicated in Table 15those hospitals with low number of beds also had low number of doctors in a variety of specialties. Without considering the expansion plan of the hospitals, Adama Hospital Medical College and Hawassa Comprehensive Specialized Hospital were found to have the lowest number of beds. In the qualitative interviews, the directors of all the hospitals/medical colleges indicated that there is a plan to increase the number of beds to meet the increasing number of patients for inpatient medical services in a range of categories/wards. The major challenge of the hospital directors anticipated is the shortage of human resource in different fields of specializations.

Table 16: Total number of functional beds in the hospitals (2018)

Teaching-referral hospitals Number of functional beds in hospital

AdHMC 194HCSPH 340GUH 600AydCSH 500TASH 525St.PHMMC 509


3.2.3.4 Availability of common diagnostic technologies in the hospitals

a. Diagnostic radiology technologies

It is widely known that the availability of advanced diagnostic technologies is an important requirement for improving the quality of medical services. Among others, the availability of X-ray, CT scan, ultrasound, fluoroscopy, mammography, colour Doppler and MRI are some of the most common types of diagnostic radiology technologies expected in the tertiary teaching-referral hospitals. All of the sampled hospitals have at least one functional X-ray machine and Ultrasound. The least available/functional diagnostic radiology technologies in the hospitals were MRI, Mammography and Fluoroscopy machines.

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Table 17: Types of common diagnostic technologies available in the hospitals (N = 6) (2018)

Types of diagnostic radiology technologies

Number of hospitals having functional diagnostic radiology technologies out of 6

X-ray 6CT scan 5Ultrasound 6Fluoroscopy 3Mammography 3Colour Doppler 5MRI 3


b. Diagnostic Laboratory technologies

Among the most advanced diagnostic laboratory technologies, the most important ones such as hormonal analysis, coagulation profile, clinical chemistry, electrolyte analysis and immunology have been assessed. Only clinical chemistry diagnostic technology was available in all of the sampled hospitals. In three of the sampled hospitals, MRI, Colour Dopplor, mammography and fluoroscopy diagnostic technologies are not available

Table 18: Number teaching-referral hospitals with functional diagnostic laboratory services (N=6) (2018)

Types of diagnostic laboratory technologies

Number of hospitals having functional diagnostic laboratory technologies out of 6

Hormonal analysis 4Coagulation profile 5Clinical chemistry 6Electrolyte analysis 4Immunology 3


3.2.3.5 Challenges related to diagnostic technologies in the hospitals

A range of challenges related to diagnostic radiology and laboratory technologies have been reported in qualitative interviews held with directors, students and experts.

a. Quality, quantity and functionality of diagnostic technologies

The first important challenge is the quality and functionality of existing radiology technologies. The X-ray technology in all the sampled hospitals operates manually. The need of digital X-ray technology was high in the hospitals. Compared to the total number of population visiting hospitals for a variety of services, the quantity of diagnostic machines was reported to be insufficient. The existing advanced machines are not used to the optimum level, e.g. MRI is used for the routine activities done by X-ray machines. The non-functionality of the existing machines was also additional challenge. A significant number of diagnostic laboratory and radiology machines do not provide the required services. Some of the reasons as indicated by the experts include:

- Overloading of machines – due to large number of people seeking the services, the machines perform above the minimum standard that increases the probability of dilapidation of the machines.

- Lack of maintenance skills – some machines such as CT scan, MRI and other diagnostic laboratory machines remain unmaintained due to capable personnel. As a result, the patients are referred to

26

private diagnostic laboratories. In all of the hospitals, there exist biomedical engineers to do the task of maintenance and engineering works related to the machines. However, their capacity to fix the machines is very limited. In some cases, the company that supplied the technologies keep them password protected making it inaccessible for the biomedical engineers. As one key informant indicated, “the diagnostic radiographic fluoroscopy is not functional due to a minor problem” (Radiologist, Male, 50 years). Once the machines get dilapidated, the services stop for at least three to six months. In the meantime, the patients are forced to pay exorbitant fees for getting the services in private clinics/hospitals.

- Lack/shortage of reagents/consumables - The presence of functional machines/devices/technologies does not necessary mean that the services are being provided in the hospital. In many cases, the lack of reagents and other forms medical supplies/consumables limit the extent of diagnostic and therapeutic services patients need.

b. Shortage of operational staff

Shortage of qualified staff in relation to operation of diagnostic technologies and utilization of diagnostic outcomes is a major challenge for most of the hospitals included in the assessment. As one of the informant indicated,

I am the only radiologist in this hospital. There are technologists. But, they only do the technical role. I am responsible for reading radiology cases that can be covered by 30 radiologists. There is huge workload. As a result, we train the GPs and sometimes nurses to assist us. However, this compromises the quality of care we provide to patients. (Key informant, radiologist, Male, 36 years).

c. Lack of capacity building opportunities

Apart from shortage of skilled staff, there are also limited opportunities for the operational and technical staff for advancing their operational and maintenance skills. Most of the operation staff is either self-trained using the default systems of the machines or received in onetime application oriented training. The depth of trainings provided to the operators of diagnostic technologies by the company personnel is very shallow. In addition, on the job training opportunities were also indicated as inadequate.

3.2.4 Knowledge and skills gap in hospital management and leadership

3.2.4.1 Problem of decision making

The challenges related to the management and leadership of hospitals starts from the organizational structure of the hospitals. In the qualitative interviews held with chief executives, the affiliation of the teaching-referral hospitals with other university programs is believed to create either limitations on either autonomous decision making or contributing for misunderstanding and miscommunication with higher authorities on issues related with budget and other infrastructural resources. St. Paul Hospital Millennium Medical College and Adama Hospital Medical College were found to have relative autonomy, not being affiliated with other academic programs. The former is accountable to Ministry of Health while the later is accountable to Oromia Regional Health Bureau.

3.2.4.2 Problem of staff turnover

The other important challenge related to the management and leadership of hospitals is staff turnover. Tertiary teaching-referral hospitals based in regional cities are facing huge problem of staff turnover. Apart from those who leave their jobs, the number of specialists who do not reinstate after completing their study is many. Once they finish their study, the specialists and sub-specialists prefer to pay the cost rather than providing the services for number of years of services they signed commitment.

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3.2.4.3 Poor use of ICT infrastructure for organizational efficiency

In most of the sampled hospitals, the use of ICT for hospital management and leadership is very poor. The St. Paul Hospital Millennium Medical College and Ayder Comprehensive Specialized Hospital have made remarkable efforts to support the hospital management and leadership with information and communication technologies. Patient recording systems (electro-medical recording systems), radiology information systems, laboratory information systems, and human resource information systems were some of the most important ICT supported systems in the stated hospitals. However, the ICT infrastructure of most of the tertiary-teaching referral hospitals is very poor. Reliance on manual processes of communication in most hospitals contributes for the loss of patient records and laboratory results. It also makes auditing of available, missing and expired medicines in the pharmacy and other equipment in the hospital difficult. Moreover, the available ICT systems are also not interfaced for making the overall organizational communication salient.

3.2.4.4 Problems related to purchasing and procurement

The problems related to purchasing and procurement were common in the studied tertiary-teaching referral hospitals. Though the overall purchasing and procurement systems are governed by the national policies and proclamations, the poor management and leadership in the hospitals/medical colleges has its own role in poor quality of purchasing and procurement systems. The timeliness, quality, and quantity of the required facilities in the hospitals are highly compromised due to the problems related to purchasing and procurement systems. As data from qualitative interviews indicate the inadequate and delayed supply of consumables/reagents and accessories cause interruption of the required services in the hospital. The poor quality of the purchased equipment is also a major challenge – “the capacity of performance, output, quality, and power resistance capacity of the machines is extremely poor” (Key informant interviewee, radiologist, male, 48 years). This is directly related to the inefficiency of purchasing and procurement systems.

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4 Diaspora engagement/investment in education and health sectors in Ethiopia

4.1 Experience/contributions of diaspora engagement/investment

As compared to the large extent of knowledge and skills gap in the tertiary technology-intensive institutions and health science colleges/hospitals, the experience of diaspora engagement/ investment was found to be meagre. In most cases, the studied institutions lacked organizational structures and strategies to make use of Ethiopian diaspora potential. The international linkages and network platforms are either less prioritized or not established. Moreover, the efforts to establish international collaborations and invite Ethiopian diaspora into the institutions are largely made personal efforts of authorities and experts in the institutions. In some cases, Ethiopian Diaspora themselves visit the institutions through friendship networks during their vacation times. Some of the technology institutes and hospitals, e.g. Institute of Technology-HU and Adama Hospital Medical College reported absence of any experience of Diaspora engagement/investment. The St. Paul’s Hospital and Millennium Medical College is exceptional in having established international networks and affiliations that facilitate the flow of Ethiopian Diaspora. It attracts relatively larger number of Ethiopian Diaspora through Diaspora fellowship program affiliated with Michigan State University in the United States. Altogether, the lack of established organizational structure and international collaboration platforms limits the experience of diaspora/engagement in the institutions.

In general, the limited experiences of diaspora engagement/investment were observed dominantly in some of the tertiary teaching-referral hospitals. Some of the areas where the contributions of Ethiopian Diaspora have been reported are outlined as follows:

- Establishment of gynaecology centre/department, improvement of organizational operation and efficiency such as improving ICT systems in human resource and other departments – the case of St. Paul’s Hospital and Millennium Medical College

- Establishment of neonatology unit and provision of clinical services in adult ICU for over six months bringing with them some important equipment– the case of Hawassa comprehensive Specialized Hospital

- Serving as international focal persons for the hospital to facilitate international partnerships, identify volunteers and coordinate foreign specialists that campaign for medical services such as surgery, cervical cancer treatments, ENT, heart surgery, and in many other areas. There is also a time Ethiopian Diaspora woman directly involved in providing medical services such as cervical cancer screening bringing with her a machine named ‘Termocagulation’ - a machine that helps in screening cervical cancer at earlier stage. She also trained our staff with using the machine, as our staff knowledge and skills. There was another one who helped with skin graft machine. Many come here and become instrumental in creating the contact and the network for the hospital – the case of Ayder Comprehensive Specialized Hospital.

As compared to clinical services, the involvement of Ethiopian diaspora in teaching and learning is very limited. This is partly attributed to extended period of time and fixed schedule needed to teach courses compared to clinical services that could be done in the form campaigns in short period of time. An of the key informants indicates,

The medical service is better in exploiting the knowledge and skills of Ethiopian diaspora. This may be because teaching courses may require longer period of involvement, whereas the treatments and surgeries are done in a campaign which takes short period of time.(Key informant, Male, Medical Doctor, Academic program coordinator).

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4.2 Diaspora engagement/investment opportunities in education and health sectors in Ethiopia

In qualitative interviews held with directors/students/experts, the following diaspora engagement/investment opportunities have been identified.

- Teaching and research collaboration (Teaching courses, advising or co-advising students)

- Capacity building (e.g. establishing units/departments/centres, upgrading skill laboratories, training and experience sharing)

- Joint venture (providing low cost but quality services in education and medical services for which there is high demand)

- Consultancy (E.g. Business process reengineering/organizational leadership and management).

- Consultancy (E.g. ICT development, automation, networking)

- Supply/donation of standard medical/technological equipment, consumables and reagents

- Maintenance equipment and transfer of skills in maintenance

- Diaspora can invest/engage in strengthening sub-specialty programs in medical education and training – e.g. transferring knowledge and skills in neuroradiology and interventional radiology or supply/donation of such technologies to the hospitals

- Financial support for strengthening health and education systems

- Improving the ICT systems of hospital services or medical training – contributing to the improvement of electro-medical recording systems, interface/inter-operability of ICT systems, HR systems, payment systems, purchasing and procurement systems, logistic management systems, tele-medicine systems, and automation of teaching and learning

4.3 Challenges in diaspora engagement/investment – institutional, structural/organizational and attitudinal

Challenges that diaspora are likely to face in the Ethiopian public institutions are outlined as follows:

- Lack of rules and regulations for governing the engagement/investment of diaspora in the institutions.

- Lack of platforms such as viable websites and database and independent organizational structures for facilitating international collaborations and partnerships.

- Lack of established partnerships and collaborations with international organizations with which Ethiopian diaspora members are affiliated with.

- Inconvenience of working environment in the institutions, e.g. poor working culture, poor time management, poor responsiveness, etc.

4.4 Initiatives of the Ethiopian Government to address knowledge and skills gaps utilizing the Potential of Diaspora

Health and education sectors are believed to be the major areas affected by brain drain in Ethiopia. On the other hand, these sectors have shown a remarkable progress with the growing number of technology-intensive training institutes and tertiary teaching referral hospitals. Apart from horizontal expansion, the tertiary educational institutions and teaching-referral hospitals in all regions and administrative cities also have consistently growing number of advanced academic programs and medical services. This created a pressing need for qualified professionals in the sectors. As observed in this study, most of the institutions included in the assessment had

30

serious shortage of professionals with advanced skills and knowledge. It was therefore widely believed that the contributions of Ethiopian diaspora would play a great role in filling the identified gaps.

The government of Ethiopia has long recognized the untapped potential of diaspora in contributing to its overall development endeavours. This was demonstrated in various forms of initiatives. It launched its official diaspora policy in 2013 (MoFA 2013). One of the core components of the diaspora policy is to enhance knowledge and technology transfer from the diaspora. The GoE is also implementing various interventions towards ensuring effective implementation of the policy and boosting the participation of Ethiopians in the development activities of the country. Efforts have been made to establish a strong institutional arrangement for the Ethiopian diaspora. Institutional management with efficient and effective professionals is a crucial for successful achievement of goals. Any plan or objective to work with Diaspora definitely needs a body to take care of it (Joseph, 2004).

Ethiopia, however, does not have a specific ministry that is responsible for Diaspora engagement [as in the case of Ghana, Nigeria and India] that is charged with multiple objectives but has several departments [in different ministries] working on different aspects of Diaspora engagement (Kuschminder and Siegel, 2010:11). Under the Ministry of Foreign Affairs (MoFA), the Diaspora Engagement Affairs Directorate (with three divisions) that solely deals with the issues of diaspora engagement has been launched. There are also 11 diaspora coordination offices at the 9 regional states and 2 administrative cities of Ethiopia. Moreover diaspora focal persons/desks are established in about 15 relevant federal offices/ministries, including the Ministries of Health and Education. There is also a MoFA-led consultative forum (consisting of all the relevant actors), which gathers every quarter to discuss the challenges and opportunities with regard to enhancing diaspora engagement. IOM Ethiopia also participates in this forum as a member. (https://www.connectingdiaspora.org/en/countries/ethiopia/) The Ethiopian Investment Agency and the Development Bank of Ethiopia are financial institutions under the Ethiopian National Bank that are involved in Diaspora engagement. Proclamations that grant a range of privileges to diaspora such as Provision of Identification Card for Foreign Nationals of Ethiopian Origin, citizenship rights, duty and tax free entitlements, residential houses, diaspora bond (Tariku, 2017). Diaspora trust fund is another recent initiative to enhance the engagement of Ethiopian diaspora in the development activities of the country.

The implementation of diaspora policy through the aforementioned institutional arrangements has resulted in a positive contribution of the diaspora in the Ethiopian economy. However, it can be still said that the government has not utilized the potential of the diaspora to the fullest extent. (https://hornaffairs.com/2016/11/05/perspectives-relationship-ethiopia-diaspora-government/). This is partly accounted by the lack of competent man power for rendering effective delivery of services for their customers in the institutions. One can easily observe bureaucratic difficulties and the prevalence of corruption as another challenge in these institutions (Tariku 2017).The lack of political and economic environments like execution capacity, inefficient government bureaucracy, weak institutions and corruption, lack of good governance at the grass root level and strong political commitment to democratize the state on behalf of the government are some of the factors that obstruct the return of diaspora. More than any other issue, building a democratic political culture at home is an important prerequisite for the return of Diaspora. In this regard, Ethiopia needs to create an enabling environment and establish strategic collaborations and partnerships with all its Diasporas. The remarkable efforts being made by the current Prime Minister of Ethiopia to sensitize and reach for the diaspora is a promising opportunity to upgrade the participation of diaspora in the economic and social affairs of the country. However, the government has not yet devised a platform for the public education and health institutions that can help them tap the diaspora potential.

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5 Matching the knowledge/skills gaps and investment needs with the diaspora potentials assessed under the framework of the study “Mapping of Ethiopian Diaspora Residing in the United States of America, IOM (2018)”

5.1 Matching diaspora potential and institutional human resource need

As indicated in Table18 there is a great deal of match in the diaspora potential and the human resources needs of the studied institutions. In areas where the studied institutions had gaps in the quality and composition of human resource, the diaspora were found to have a rich potential. For instance, there is acute shortage of academic staff with PhD and other advanced professional degree in the technology and medical training institutes (particularly in those based outside of the capital of Ethiopia). Interestingly, the largest proportion of diaspora involved in the mapping1had postgraduate levels of education. The only area where a mismatch was observed is in installation, maintenance and repair occupations. Though there is a huge need for experienced and skilled personnel in such skills in the studied institutions in Ethiopia, the number of diaspora (who were involved in the mapping exercise) with installation, maintenance and repair skills is insignificant.

Table 19: Matching diaspora potential and institutional human resource need (2018)

Diaspora potential Institutional human resource need in education and health dimensions

Diaspora potential in terms of age and educational levels Limitations in educational qualifications of staff

- Large number of diaspora in productive age groups (18-64 years)

- Large number of diaspora with postgraduate or professional degree

- Shortage of teaching and clinical staff with advanced educational levels e.g. shortage of PhD holders, associate and full professors for teaching in technology institutes health science colleges and shortage of specialists/sub specialists for medical education and clinical services

Diaspora potential in terms of gender and educational levels compared Limitations in terms of gender composition of staff

- Limited number of women with PhD and above though the number of women having a master’s degree is proportional to men

- Limited number of women having both Masters and PhD degrees

Diaspora potential in terms of occupational category Extent of knowledge and skills gap in the occupational categories of institutions

- Large number of diaspora with business and financial operational skills

- High level of inefficiency in financial management, purchasing and procurement

- Large number of diaspora with architecture and engineering skills

- Shortage of experienced, skilled personnel with advanced level of training in all fields of engineering in technology training institutes

- Large number of diaspora with computer and mathematical skills

- Shortage of staff with better experience and advanced skills in computer science and mathematics in technology institutes

- Large number of diaspora engaged in education, training and library science

- Low quality of education and training, e.g. rigidity of curriculums, shortage of laboratory facilities and teaching aids, and lack of ICT supported teaching and learning and library systems

- Large number of diaspora engaged in management - High level of inefficiency in organizational leadership and management in both health and education institutions

- Large number of diaspora engaged in health care occupation

- Huge gap in specialist medical/clinical services and specialist nursing care

- Lack of diaspora engaged in installation, maintenance and repair occupation

- Shortage of skilled personnel with maintenance and operational skills for advanced machines and equipment in the teaching-referral hospitals


2 Mapping of Ethiopian Diaspora Residing in the United States of America, IOM (2018).

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5.2 Diaspora engagement/investment interest and institutional situations/opportunities

The match between the diaspora engagement/investment interest and the situations of and opportunities in the institutions is interesting. Data from qualitative interviews show that the institutional capacity to make reasonable payment for the contributions of diaspora is very limited. In this regard, the perception of diaspora regarding voluntarism, charitable donation and investment in Ethiopia as a fulfilment of moral and social obligation and personal accomplishment is an important asset for the institutions. On the other hand, there is huge need in the institutions to make use of such advantages. However, the motivations of diaspora to engage/invest in Ethiopia is dominantly oriented to the capital city while the gap in the knowledge and skills of the institutions based in Addis Ababa is low as compared to those based in the regional cities.

Table 20: Matching diaspora engagement/investment interest and institutional situations/opportunities (2018)

Diaspora engagement/investment interest Institutional situations/opportunities

- Large number of diaspora perceiving voluntarism in Ethiopia as a fulfilment of moral and social obligation

- The capacity of institutions to pay for the valuable contributions Diaspora could make is very limited.

- Large number of diaspora perceiving investment in Ethiopia as a personal duty and fulfilment of personal accomplishment

- The supply of advanced technological equipment and corresponding reagents, accessories, consumables including maintenance is made mostly by foreign companies.

- Large number of diaspora having interest in charitable donations

- The institutions lack consistent supply of reagents, consumables, accessories and equipment which contribute to inefficiency or inadequacy of services

- Large number of diaspora interested to invest in education, ICT, health care

- Though institutions lack internal policies for governing diaspora investment, there are opportunities to engage in joint business/joint venture, e.g. supply of consumables and equipment, providing services to clients of the institutions where there is gap in quality and timeliness of services

- Large number of diaspora to engage/invest in Addis Ababa, the capital of Ethiopia

- There is huge gap in the knowledge and skills in the institutions based outside of Addis Ababa


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6 Conclusions, Recommendations and Roadmap6.1 Conclusions

There is huge gap in knowledge and skills in both education and health sectors in which the diaspora potential can be tapped.

There is huge gap in knowledge and skills in both education and health sectors in which the diaspora potential can be tapped.

There is lack of institutionalized system in tertiary educational institutions and teaching-referral hospitals for identifying, motivating, mobilizing and engaging diaspora in the affairs of the organizations.

Though limited, those Ethiopian diaspora involved in health sectors (particularly in medical services have made significant contributions) which can be taken as a great lesson for diaspora investment in Ethiopia.

There is weak public-private collaboration and business partnership platforms in order to promote the engagement of diaspora in public education and health institutions

6.2 Recommendations

Implementation policy and strategy: The Ethiopian Diaspora policy enacted a few years ago is an important opportunity to enhance the diaspora engagement/investment in the development endeavours of the country. However, the diaspora policy sets a general platform for institutionalizing the diaspora connection with their country of origin. It does not specify the roles of various stakeholders and the strategies that can guide the involvement of the stakeholders in utilizing the diaspora potential. Moreover, there is no clear guideline for the local public institutions regarding the rights and benefits of diaspora as they engage in filling the knowledge and skills gap in the institutions they visit. As observed in this assessment, the engagement/investment of Ethiopian diaspora in public health and educational sectors is highly fragmented and implemented in a disintegrated fashion. Thus, there must be a binding implementation strategy of the diaspora engagement/investment in public health and education sectors. Additionally, there should be a clear strategy for Ethiopian diaspora in conducting business investments in or with the public sectors in Ethiopia.

Institutional websites: The websites of public educational and health institutions should establish a viable website that can provide up-to-date and detail information about the ongoing and planned activities, gaps in the quality and composition of staff to perform the activities, and opportunities for the interested diaspora to invest/volunteer in the institutions.

Database: A database that can provide detail information about knowledge and skills gaps in the demand side and the potential of capacity of the diaspora to fill the gaps should be readily available.

Awareness creation: To tap the diaspora resources into the public education and health sectors, awareness creation about the diaspora potential should be made to the decision makers and staff of the organizations. Efforts

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should be made to positively shape the attitude of Ethiopian diaspora towards their country of origin in that they should be genuinely presented about the real challenges they could face as they engage/invest in the public health and education sectors. From the demand side, the local public institutions should be encouraged to improve the work culture and interpersonal skills of their staff so that a good working environment can be created for the diaspora invited to/investing in the institution.

Structural/organizational preparedness: The public health and education sectors should be encouraged to create organizational structures which facilitate the identification of the knowledge and skills gaps of the institutions to which the Ethiopian diaspora can contribute. The established organizational structure should also either create new or use existing platforms through which the diaspora potential can be identified and utilized and mobilize minimum resources/logistics required by the diaspora. The personal or interpersonal efforts made by authorities of the organizations are not sustainable. There must be established regulatory systems in the organizations for governing the engagement/investment of Ethiopian diaspora. Additionally, the created organizational structures should work on establishing strategic partnerships with international organizations with which the Ethiopian diaspora are affiliated with and contribute to their country of origin.

6.3 Roadmap to inform knowledge/skills transfer programs in Ethiopia.

The findings identified from the diaspora mapping exercises and the assessment of knowledge and skills gaps in the public education and health institutions demonstrated the need of concerted efforts of various actors in enhancing the engagement and investment of Ethiopian Diaspora. To optimize the utilization of diaspora potential, the government institutions and development partners should collaborate performing a range of activities as shown in Table… on short, mid and long term basis.

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diaspora towards their country of origin in that they should be genuinely presented about the real challenges they could face as they engage/invest in the public health and education sectors. From the demand side, the local public institutions should be encouraged to improve the work culture and interpersonal skills of their staff so that a good working environment can be created for the diaspora invited to/investing in the institution.

Structural/organizational preparedness: The public health and education sectors should be encouraged to create organizational structures which facilitate the identification of the knowledge and skills gaps of the institutions to which the Ethiopian diaspora can contribute. The established organizational structure should also either create new or use existing platforms through which the diaspora potential can be identified and utilized and mobilize minimum resources/logistics required by the diaspora. The personal or interpersonal efforts made by authorities of the organizations are not sustainable. There must be established regulatory systems in the organizations for governing the engagement/investment of Ethiopian diaspora. Additionally, the created organizational structures should work on establishing strategic partnerships with international organizations with which the Ethiopian diaspora are affiliated with and contribute to their country of origin.

6.3 Roadmap to inform knowledge/skills transfer programs in Ethiopia.

The findings identified from the diaspora mapping exercises and the assessment of knowledge and skills gaps in the public education and health institutions demonstrated the need of concerted efforts of various actors in enhancing the engagement and investment of Ethiopian Diaspora. To optimize the utilization of diaspora potential, the government institutions and development partners should collaborate performing a range of activities as shown in Table… on short, mid and long term basis.

Table 21: Roadmap to inform knowledge/skills transfer programs in Ethiopia

Stakeholders Short term activities Mid-term activities Long term activities Government institutions

Ministry of Foreign Affairs

- Developing an inventory of skills and knowledge of Diaspora

- Developing an inventory of knowledge and skills gaps that diaspora can contribute

- Enhance the awareness of local institutions about diaspora potential

- Enhancing the awareness of diaspora about the knowledge and skills gaps in local institutions

- Enhance the responsiveness of embassies and consular offices for diaspora interested to

- Developing regulatory frameworks for governing diaspora investment and

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Stakeholders Short term activities Mid-term activities Long term activities Ministry of Health

- Create awareness of officials of the institutions about diaspora potentials

- Develop an inventory of knowledge and skills gaps of the teaching referral hospitals

- Build the capacity of focal persons and desks

- -

- Enhance the institutional capacity of tertiary teaching-referral hospitals so as to attract the engagement/investment of diaspora

- Create organizational structures in the tertiary teaching referral hospitals that manage the engagement of diaspora

- Strengthen international networks and collaborations of the institutions

- Develop institutional policies and strategic plans regarding the engagement/investment of diaspora

- Develop regulatory frameworks that govern the engagement/investment of diaspora

-

Ministry of Education

- Create awareness of officials of the institutions about diaspora potentials

- Develop an inventory of knowledge and skills gaps of technology institutes and health science colleges

- Build the capacity of focal persons and desks

- Enhance the institutional capacity of tertiary teaching-referral hospitals so as to attract the engagement/investment of diaspora

- Create organizational structures in the tertiary teaching referral hospitals that manage the engagement of diaspora

- Strengthen international networks and collaborations of the institutions

- Develop institutional policies and strategic plans regarding the engagement/investment of diaspora

- Develop regulatory frameworks that govern the engagement/investment of diaspora

Development partners

IOM and others

- Provide capacity building training to the officials of institutions on the identified diaspora potential and knowledge and skills gaps

- Conduct sensitization workshops with the participation of government officials and diaspora members

- Assist development of organizational structures in the institutions that can facilitate the engagement/investment of diaspora

- Assist the development of implementation policies and strategies in consultation with government of Ethiopia

Table 21: Roadmap to inform knowledge/skills transfer programs in Ethiopia

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References

Addis Ababa University 2017/18 (2010 E.C) Academic Staff Profile. Addis Ababa University Office of the Academic Staff Affairs. 2018.

Addis Ababa Institute of Technology Website http://www.aait.edu.et/

Addis Ababa Science and Technology University Website http://www.aastu.edu.et/

Addis Ababa Diaspora Association Website http://www.addisababadiasporaassociation.org/

Adama Science and Technology University Website http://www.astu.edu.et/

Alliance for Brain Gain and Development (ABIDE) Website http://abideforethiopia.org/

Ayder Comprehensive Specialized Hospital. http://www.mu.edu.et/chs/index.php/ayder-referral-hospital

Ethiopian Diaspora Association Website http://ethiopiandiasporaassociation.org/

Ethiopian Institute of Technology - Mekelle Website http://www.mu.edu.et/index.php/25-academic/institutes/ethiopian-institute-of-technology-mekelle-eit-m

Federal Democratic Republic of Ethiopia. (FDRE) 2010. Growth and Transformation Plan I: Addis Ababa, Ethiopia: Ministry of Finance and Economic Development, FDRE.

Federal Democratic Republic of Ethiopia. (FDRE) 2016. Growth and Transformation Plan II: Addis Ababa, Ethiopia: Ministry of Finance and Economic Development, FDRE.

Federal Ministry of Health Federal Democratic Republic of Ethiopia 2017/18 Health management Information System (HMIS)-Ethiopia.

Hawassa Comprehensive specialized Hospital. http://www.uog.edu.et/academic-units/college-of-medicine/

Hawassa University Website http://www.hu.edu.et/

International Organization for Migration (IOM) 2018 Mapping of Ethiopian Diaspora Residing in the United States of America, (Assessment Report).

40

Kuschminder, K. and Siegel, M. 2010 Understanding Ethiopian Diaspora Engagement Policy, Maastricht Graduate School of Governance.

St Paul’s Hospital Millennium Medical College. http://www.sphmmc.gov.et/

Tariku Raga Lencho 2017 The Potential Contribution of Ethiopian Diaspora in Development: The Presenting Absent Partners.Humanities and Social Sciences, 5(1): 14-25. doi: 10.11648/j.hss.20170501.14Joseph, Yalab (2004) “Reversing Ethiopian Brain Drain: National imperative,” atwww.ethiopiadiaspora.Com assessed on June, 6, 2015.

Tikur Anbessa Specialized Hospital. http://www.aau.edu.et/services/hospital/

University of Gondar, Institute of Technology Website http://www.uog.edu.et/

University of Gondar referral hospital. http://www.uog.edu.et/academic-units/college-of-medicine/

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39

References

Addis Ababa University 2017/18 (2010 E.C) Academic Staff Profile. Addis Ababa University Office of the Academic Staff Affairs. 2018.

Addis Ababa Institute of Technology Website http://www.aait.edu.et/

Addis Ababa Science and Technology University Website http://www.aastu.edu.et/

Addis Ababa Diaspora Association Website http://www.addisababadiasporaassociation.org/

Adama Science and Technology University Website http://www.astu.edu.et/

Alliance for Brain Gain and Development (ABIDE) Website http://abideforethiopia.org/

Ayder Comprehensive Specialized Hospital. http://www.mu.edu.et/chs/index.php/ayder-referral-hospital

Ethiopian Diaspora Association Website http://ethiopiandiasporaassociation.org/

Ethiopian Institute of Technology - Mekelle Website http://www.mu.edu.et/index.php/25-academic/institutes/ethiopian-institute-of-technology-mekelle-eit-m

Federal Democratic Republic of Ethiopia. (FDRE) 2010. Growth and Transformation Plan I: Addis Ababa, Ethiopia: Ministry of Finance and Economic Development, FDRE.

Federal Democratic Republic of Ethiopia. (FDRE) 2016. Growth and Transformation Plan II: Addis Ababa, Ethiopia: Ministry of Finance and Economic Development, FDRE.

Federal Ministry of Health Federal Democratic Republic of Ethiopia 2017/18 Health management Information System (HMIS)-Ethiopia.

Hawassa Comprehensive specialized Hospital. http://www.uog.edu.et/academic-units/college-of-medicine/

Hawassa University Website http://www.hu.edu.et/

International Organization for Migration (IOM) 2018 Mapping of Ethiopian Diaspora Residing in the United States of America, (Assessment Report).

40

Kuschminder, K. and Siegel, M. 2010 Understanding Ethiopian Diaspora Engagement Policy, Maastricht Graduate School of Governance.

St Paul’s Hospital Millennium Medical College. http://www.sphmmc.gov.et/

Tariku Raga Lencho 2017 The Potential Contribution of Ethiopian Diaspora in Development: The Presenting Absent Partners.Humanities and Social Sciences, 5(1): 14-25. doi: 10.11648/j.hss.20170501.14Joseph, Yalab (2004) “Reversing Ethiopian Brain Drain: National imperative,” atwww.ethiopiadiaspora.Com assessed on June, 6, 2015.

Tikur Anbessa Specialized Hospital. http://www.aau.edu.et/services/hospital/

University of Gondar, Institute of Technology Website http://www.uog.edu.et/

University of Gondar referral hospital. http://www.uog.edu.et/academic-units/college-of-medicine/

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Annexes:

Annex 1A: Schools/Centres/Departments and programs of the Science and Technology Institutes /Universities

Adama Sc & Tech University

Hawassa Univ. Inst

of Tech

University of Gondar

Inst of Tech

Eth Inst of Tech -

Mekelle

Addis Ababa Institute of Technology - AAU

Addis Ababa Sc & Tech University

School of Applied Natural Sciences Programs • Biology • Chemistry • Geology • Mathematics • Physics

School of Civil Eng& Architecture Programs • Architecture • Civil Eng • Construction Technology & Management

• Urban Planning & Design

• Water Resource Eng

School of Electrical Eng& Computing Programs • Computer Science &Eng

• Electronics & Communication Eng

• Electrical Power & Control Eng

School of Mechanical, Chemical & Materials Programs • Chemical Eng • Materials Science &Eng

• Mechanical Design & Manufacturing Mechanical Systems & Vehicle Eng

• Thermal & Aerospace Eng

Construction Technology & Management

Computer Science Information system

Information technology Civil Engineering

Department of Biomedical Engineering Department of Electrical & Computer Engineering Department of Mechanical Engineering School of Architecture & Construction Management Engineering School of Civil & Hydraulic Engineering

Department of Chemical Engineering Department of Mechanical Engineering Department of Electrical & Computer Engineering Department of Chemical Industrial Engineering Department of Civil Engineering Department of Computer Science Department of Architecture & Urban Panning

School of Chemical & Bio Eng • Chemical Eng • Leather Technology • Process Eng • Environmental Eng • Food Eng • Biochemical Eng

School of Civil & Environmental Eng • Geotechnical Eng • Hydraulic Eng • Structural Eng • Construction Technology & Management

• Road & Transportation Eng

• Hydropower Eng • Water Supply & Sanitation Eng

School of Electrical & Computer Eng • Electronic Communication Eng

• Power Eng • Industrial Control Eng • Computer Eng • Microelectronics Eng

School of Mechanical & Industrial Eng • Industrial Eng • Manufacturing Eng • Mechanical Design • Thermal Eng • Motor Vehicle Eng • Railway Eng

School of Multi-Disciplinary Eng (SMDE) • Centre of Biomedical Eng • Centre of Energy Technology

• Centre of Railway Eng • Centre of Material Science &Eng

ITSC Centre

College of Architecture & Civil Eng College of Biological & Chemical Eng • Department of Biotechnology

College of Electrical & Mechanical Eng • Department of Electrical & Computer Eng

• Department of Electromechanical Eng

• Department of Mechanical Eng

• Department of Software Eng

College of Applied Sciences

• Department of Industrial Chemistry

• Department of Geology

College of Natural & Social Sciences

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Annex 1B: Medical Specialty/sub-specialty programs

Programs

St.PHMMC TASH AydCSH HCSH UGRH

AHMC

Specialty programs

-‐ Anesthesiology -‐ ENT -‐ Emergency

medicine -‐ Forensic

medicine -‐ Gynecology

and obstetrics -‐ Internal

medicine -‐ Maxillofacial -‐ Neurosurgery -‐ Ophthalmology -‐ Orthopedics -‐ Pathology -‐ Pediatrics -‐ Psychiatry -‐ Radiology -‐ Surgery -‐ Uro-surgery

-‐ Internal medicine -‐ Emergency and

critical care medicine

-‐ Family medicine -‐ Psychiatry -‐ Pediatrics and

child health -‐ Gynecology and

obstetrics -‐ Anesthesiology -‐ Radiology -‐ Oncology and

radiation medicine

-‐ Otolaryngology, head and neck surgery

-‐ Oral and maxillofacial surgery

-‐ Orthopedic surgery

-‐ Pathology -‐ Neurology -‐ Dermatovenerolo

gy -‐ General surgery -‐ Uro surgery -‐ Plastic and

reconstructive surgery

-‐ Neurosurgery -‐ Pediatric surgery -‐ Cardiothoracic

surgery -‐ Opthalmology -‐ Nuclear medicine

-‐ Internal medicine

-‐ Surgery -‐ Pediatrics -‐ Obstetrics and

gynecology -‐ Orthopedics -‐ ENT -‐ Forensic

medicine -‐ Radiology -‐ Pathology -‐ Dermato-

neurology -‐ Neuro-

surgery

-‐ Optalmology

-‐ Obstetrics and Gynecology

-‐ Pediatrics -‐ General

surgery -‐ Orthopedic

surgery -‐ Pathology -‐ Internal

medicine

-‐ Surgery -‐ Internal

medicine -‐ Obstetrics

and gynecology

-‐ Pediatrics

Sub-specialty progra

-‐ Family planning

-‐ Maternal fetal medicine

-‐ Cardiology -‐ Endocrinology -‐ Infectious

diseases

-‐ Urogynacology

-‐ Pain-palliative care

Not available

Not available

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Programs


AHMC

ms -‐ Gynecological oncology

-‐ Urogynacology -‐ Reproductive

endocrinology and infertility

-‐ Cardiology -‐ Gastroenterolog

y-hepatology -‐ Nephrology -‐ Physical

medicine and rehabilitation

-‐ Pediatrics neonatology

-‐ Pediatrics cardiology

-‐ Pediatrics nephrology

-‐ Pediatrics pulmonology

-‐ Pediatrics endocrinology

-‐ Surgical trannsplant

-‐ Hematology -‐ Nephrology -‐ Pulomonary and

critical care -‐ Gastroenterology

and hepatology -‐ Fetomaternal

medicine -‐ Gyneocology -‐ Reproductive

endocrinology and fertility

-‐ Otology

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43

Programs


AHMC

ms -‐ Gynecological oncology

-‐ Urogynacology -‐ Reproductive

endocrinology and infertility

-‐ Cardiology -‐ Gastroenterolog

y-hepatology -‐ Nephrology -‐ Physical

medicine and rehabilitation

-‐ Pediatrics neonatology

-‐ Pediatrics cardiology

-‐ Pediatrics nephrology

-‐ Pediatrics pulmonology

-‐ Pediatrics endocrinology

-‐ Surgical trannsplant

-‐ Hematology -‐ Nephrology -‐ Pulomonary and

critical care -‐ Gastroenterology

and hepatology -‐ Fetomaternal

medicine -‐ Gyneocology -‐ Reproductive

endocrinology and fertility

-‐ Otology

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Annex 2A- Assessment instruments for Educational Institutions

FORUM FOR SOCIAL STUDIES

Title: Study on knowledge and skill gaps in Ethiopian higher educational institutions

Desk-review Checklist

Introduction

The following questions will guide review of secondary sources for information on skills and knowledge gap in science and technology teaching, research and projects in selected colleges in Ethiopian public universities:

I. Manpower capacity at universities: 1. Academic – disaggregated by sex, academic qualification 2. Technical – disaggregated by sex, academic qualification 3. Administrative – disaggregated by sex, academic qualification

II. Facilities and resources at universities: 1. #Science laboratory _______ 2. #Science laboratory _______ 3. #Smart classroom _______ 4. #Digital library _______ 5. #Language and communications laboratory _______ 6. #ICT facilities _______ 7. #Computer laboratory _______ 8. #Website, social media, blogs _______ 9. #Medical equipment _______ 10. #Medical facilities_______ 11. #Technology equipment _______

III. Policy, strategies and practices in science and technology advancement inpublic universities IV. Human resource development and management policy, strategies and practices in public

universities V. Assessment results on existing challenges in public universities in:

1. Teaching – foundational knowledge;; 2. Teaching – technical skills;; 3. Teaching – soft skills;; 4. Research – foundational knowledge;; 5. Research – technical skills;; 6. Research – soft skills

VI. Existing policies, strategies and practices for teachers’ continuous professional development (CPD) in selected public universities;;

VII. University-industry/diaspora linkages and partnerships in running effective, relevant curriculum to local, national and global realities

VIII. University teaching performance assessment results IX. University research performance assessment results X. University leadership and management performance assessment results XI. University resource and facilities administration performance assessment results

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Title. Study on knowledge and skill gaps in Ethiopian public universities

Key Informant Questionnaire

Introduction

In collaboration with the IoM, Forum for Social Studies is conducting a study to assess the knowledge and skill gaps in selected Ethiopian public universities to identify investment opportunities for the Ethiopian diaspora. The study aims to collect reliable data to, specifically, devise appropriate and effective intervention strategies as well as develop short, medium and long-term roadmap to inform knowledge/skills/technology transfer programs with the Ethiopian diaspora at the center. Your university is one of the seven purposively selected public universities located in four regional states i.e. Tigray, Amhara, Oromia and Southern Nations, Nationalities and Peoples Regional State and one city administrations i.e. Addis Ababa. The criteria for the purposive selection were 15 years of operation and strong science and technology programs.

This questionnaire is a mix of close-ended and open-ended questions and it will not take more than 30minutes of your time. Some of the questions may not be applicable to you or your office. In such cases, please skip them but indicate why they are not applicable on the margins. Participation in this study is based on your freewill and you can turn down the chance to participate in this study or, when you decide to do, skip any question you don’t want to respond to and proceed to subsequent questions. As a reminder, however, incomplete information would make the research results inconclusive and its policy recommendations ineffective.

Ifyou decide to participate in the research by filling out this questionnaire, please respond to questions by circling the appropriate letter or writing in Amharic or English in the space provided. If you don’t have adequate or complete information on certain questions, your best estimate or approximations will suffice for the purpose of the research.

If you have inquiries about the purpose and objectives of the study, please contact:

Dr Yeraswork Admassie Forum for Social Studies Executive Director Phone. +251 111 545608 Email. [email protected]

Thanking you in advance

Section I. Background information. Please respond to a few questions about you and your position below. Provide your answers by circling the applicable response or writing on the space provided against questions.

1. Sex 00. Male 01. Female

2. Academic qualification 00. BA/BSc 03. DVM 01. MA/MSc 04. PhD 02. MD

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3. Current academic rank? 00. Graduate Assistant (I&II) 03. Associate Professor 01. Lecturer/Assistant Lecturer 04. Professor/Professor Emeritus 02. Assistant Professor

4. Current position in the university (Please choose the closes position) 00. Dean, College/Faculty/School 06. Vice President. Administration 01. Vice President, Academic Affairs 07. Director. Academic Programs 02. Vice President, Research/technology 08. Director. Quality Assurance 03. Director, ICT 09. Director, Human Resource 04. Director, Registrar/Alumni/Partnership 10. Others (Please specify) _________

5. Years of active work experience i.e. excluding study leave: 00. Teaching (If you are fully an admin staff, please write skip to Q.6) _____________ 01. Administration _____________ 02. Management and leadership _______________

6. University academic/technical staff profile:

a. Number of academic staffs (specify in number by their academic rank and sex) a. Full professors: Males ______ Females: ______ b. Associate Professors: Males: ______ Females: ______ c. Assistant Professors: Males: ______ Females: ______ d. Lecturers: Males: ______ Females: ______ e. Assistant Lecturers: Males: ______ Females: ______ f. Graduate Assistants: Males: ______ Females: ______ g. Technicians: Males: ______ Females: ______ h. Laboratory Assistants: Males: ______ Females: ______

b. Number of academic staffs qualification (specify their number and sex) a. PhD: Males: ______ Females: ______ b. MSc: Males: ______ Females: ______ c. BSc: Males: ______ Females: ______ d. Others: Males: ______ Females: ______

c. Number of classrooms (specify in number by category) a. Regular classrooms (without smartboards) ___________ b. Special classrooms (with smartboards) __________ c. Sciencelaboratory i.e. physics, chemistry, geology, etc. _______ d. Technology workshop/laboratory i.e. ICT, wood/metal works, etc. ________

00. Undergraduate students (BSc). Current count _____ 01. Graduate students (MSc). Current count _____ 02. Postgraduate students (PhD). Current count _____

Section II. University profile. Now, please provide information on the following questions pertaining to teaching-learning process, research, community engagement activities of your university. Provide your answers by circling the applicable category or writing on the space provided against questions.

7. To achieve its vision, mission and objectives, does your university face any challenges? 00. Yes 01. No

8. If Yes to Q.7, what are the main causes of these challenges? (Maychoose more than one.)

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00. Manpower–academic 03. Leadership and management 01. Manpower – administrative 04. Others (Please specify) _______________

9. Are there challenges in the university’s teaching and learning process? 00. Yes 01. No

10. If Yes to Q.9, what are these challenges? (May choose more than one) 00. Trainers lack foundational knowledge 03. Trainers lack social skills 01. Trainers lack pedagogical skills 04. Trainers lack social skills 02. Trainers lack ICT skills 05. Others (Please specify) _______________

11. Are the university’s research outputs good in quality? 00. Yes 01. No

12. If No to Q.8, what causes low quality research outputs? (May choose more than one.) 00. Lack proper research skills 05. Lack communication skills 01. Lack social skills 06. Lack organizational skills 02. Lack proper collaboration skills 07. Lack of funds 03. Lack ICT skills 08. Others (Please specify) _______________ 04. Lack research language skills

13. Do personnel in teaching science and technology at your university fully competent? 00. Yes 01. No

14. If No to Q.13, what are these gaps in knowledge and skills related to? 00. Knowledge of subject matter 06. Adaptability 01. Analytical thinking and problem solving 07. Professionalism 02. Collaborative/teamwork 08. Organizational skills 03. Communication skills 09. Reading for information/knowledge 04. Pedagogical skills 10. Locating information 05. Technical skills 11. Networking skills

12. Others (Please specify) _______________ 15. Does the university prioritize technology transfer as an important agenda in teaching-learning and

researches? 00. Yes 01. No

16. If Yes to Q.15, how effectively is this priority taken up by teachers, technicians, practitioners and researchers? 00. Very effectively/Effectively 01. Very ineffectively/ineffectively

17. If No to Q.15 (or ‘Ineffectively/Very ineffectively’ to Q.16), what are the main reasons why? ____________________________________________________________________________________________________________________________________________________________

18. Is the university currently collaborating/partnering with individuals/firms/institutions to support the teaching-learning process and research undertakings? 00. Yes 01. No

19. If Yes to Q.18, what were these collaborators or partners? 00. The Ethiopian diaspora 03. Higher educational institutions – Ethiopian 01. The industry – local 04. Higher educational institutions – African 02. The industry – international 05. Higher educational institutions – world

06 Others (Please specify) _______________

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20. Are there any underutilized/unused teaching, research, training, communications/networking facilities or resources on campus? 00. Yes 01. No

21. If Yes to Q.13, what are these facilities, resources or equipment? (May choose more than one) 00. Science laboratory 05. Computer laboratory 01. Smart classroom 06. Website, social media, blogs 02. Digital library 07. Medical equipment 03. Language and communications lab 08. Medical facilities 04. ICT facilities 09. Technology equipment

10. Others (Please specify) ________________ 22. If Yes to Q.21, what are the main reasons behind the underutilization or unemployment of these

facilities or resources for teaching, research, training, projects, networking? 00. Inadequate number of personnel to run 02. Lack of knowledge – of use/application 01. Lack of knowledge – of their availability 03. Lack of skills – of use/application


Title. Study on knowledge and skill gaps in Ethiopian higher educational institutions

Key informant interview guide.

Introduction

In collaboration with the IoM, Forum for Social Studies is conducting a study to assess the knowledge and skill gaps in selected Ethiopian universities to identify investment opportunities for the Ethiopian diaspora. The study aims to collect reliable and sound data to, specifically, devise appropriate and effective intervention strategies as well as develop short, medium and long-term roadmap to inform knowledge/skills/technology transfer programs with the Ethiopian diaspora at the center. Your university is one of the 6 purposively selected Ethiopian public universities from four regional states i.e. Tigray, Amhara, Oromia and Southern Nations, Nationalities and Peoples Regional State and two city administrations i.e. Addis Ababa and Dire Dawa.

This key informant interview guide contains a few guiding questions on knowledge and skills gaps at your university and it will not take more than 30minutes of your time to compete. Participation in this study is based on your freewill and you can refuse to take part in the study altogether or skip any question you don’t feel comfortable in responding to. As a reminder, however, incomplete information would make the research results inconclusive and its policy recommendations ineffective.


Dr Yeraswork Admassie Executive Director Forum for Social Studies Phone. +251 111 545608 Email. [email protected] Thanking you in advance

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Part 1: Background information. We will start the interview with a few background information about you and your office.

1. Sex 00. Male 01. Female

2. Academic qualification 00. BA/BSc 03. DVM 01. MA/MSc 04. PhD 02. MD

3. Current position at the university 00. Vice President (Please specify) ___________________________ 01. Director (Please specify) ________________________________ 02. Dean (Please specify) __________________________________ 03. Chair (Please specify) __________________________________ 04. Others (Please specify) _________________________________

4. Years of service – excluding time on study leave 00. Since first employment _________________________________ 01. In leadership _________________________________________

Part 2: Knowledge and skills gap in public universities

5. Challenges of the university – in teaching, research, management 6. Challenges related to competency and performance – in teaching, research, management 7. Solutions/coping mechanism to address these challenges, especially in science and technology

a. In teaching (probing) b. In research (probing) c. In management and leadership (probing)

8. The experience of the university in creating partnerships/networks to build competencies in teaching, research, management, especially in science and technology programs

9. Future plans to address issues performance and competency in teaching, research and management

a. In teaching (probing) b. In research (probing) c. In community-engagement, projects (probing) d. In management and leadership (probing)

10. The role of the diaspora in this plan to address issues of performance and competency in teaching, research, management

11. Looking ahead. Recommended changes or modifications – policy, strategy, practice – in order to accommodate the contributions of the Ethiopian diaspora in the above specified roles



FGD guide. Introduction

In collaboration with the IoM, Forum for Social Studies is conducting a study to assess the knowledge and skill gaps in selected Ethiopian universities to identify investment opportunities for the Ethiopian diaspora. The study aims to collect reliable and sound data to, specifically, devise appropriate and effective intervention strategies as well as develop short, medium and long-term roadmap to inform knowledge/skills/technology transfer programs with the Ethiopian diaspora at the center. Your university

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is one of the 6 purposively selected Ethiopian public universities from four regional states i.e. Tigray, Amhara, Oromia and Southern Nations, Nationalities and Peoples Regional State and two city administrations i.e. Addis Ababa and Dire Dawa.

This FGD guide contains a few guiding questions on knowledge and skills gaps at your university and it will not take more than 30minutes of time. Participation in this study is based on your freewill and please respect each other’s views while discussing the study themes. Please let us speak one at a time to make the discussion fruitful and seamless.


Dr Yeraswork Admassie. Forum for Social Studies. Executive Director. Phone. +251 111 545608 OR +2519112473 Email. [email protected] Thanking you in advance, we will start by asking you some basic information about yourself and your education.

Participant# Age Sex Department Year of Study

College

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Focus Group Discussion Checklist

1. Thechallenges public universities in achieving their stated mission, vision and objectives – in teaching, research, management.

2. Specific challenges of your respective program in teaching, research and management. a. Challenges related to trainers b. Challenges related to facilities c. Challenges related to equipment d. Challenges related to management, leadership and administration

3. Classes/lectures/programs abandoned/collapsed due to manpower or facility shortage/inadequacy 4. Competency issues among trainers/educators

a. Foundational knowledge b. Technical skills c. Soft skills

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5. The role of the Ethiopian diaspora at this university a. Teaching b. Research c. Management d. Networking e. Capacity building – acquiring book, equipment, etc. f. Others

6. Recommended changes in education policy, strategy, program, etc. in enhance the role of the diaspora in the higher education sector



Observation checklist. The following questions will guide the researchers’ observations on skills and knowledge in science and technology teaching, research and projects in selected colleges in Ethiopian public universities:

1. Classroom use – employed/underemployed/unemployed 2. Science laboratory use – employed/underemployed/unemployed 3. ICT laboratory use - employed/underemployed/unemployed 4. Campus management – well managed/undermanaged/ill-managed 5. Medical equipment management – well managed/undermanaged/ill-managed 6. Technology facility management – well managed/undermanaged/ill-managed – facility running

smoothly without undue interruptions 7. Human resource management – well managed/undermanaged/ill-managed 8. University management and leadership – effective, efficiency, participatory, inclusive (gender,

disability, etc.) 9. Prioritization of science and technology – priority in notices, billboards, activities, etc.

Annex 2B –

Data collection tools and checklists for knowledge and skills gaps in tertiary hospitals

Desk review checklist

a. Policy environment for diaspora investment in health sectors in Ethiopia - National policy/plan for addressing knowledge and skills gaps of hospitals in Ethiopia - Conduciveness of policy environment for diaspora investment in health sectors b. Experiences of diaspora investment in Health sectors in Ethiopia - Trend of Ethiopian diaspora investment in health sectors - Experiences of diaspora investment in tertiary hospitals in Ethiopia (contributions, challenges and

lessons learnt)

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c. Scope of medical services in tertiary-referral-teaching hospitals in Ethiopia - Types of services - Gaps in the scope of services and associated factors - Human resource capacity(gender disaggregated) d. Common knowledge and skills gaps of health workers in hospitals in Ethiopia

- Knowledge and skills gaps of health workers in clinical services - Knowledge and skills gaps of health workers in relation to use of ICT services - Knowledge and skills gaps of health workers in relation to use and operation of

diagnostic technologies - Knowledge and skills gaps in relation to use and operation of surgical technologies - Knowledge and skills gaps of health workers in relation to hospital leadership and

governance(leadership, budgeting, finance, hygiene and sanitation, etc.) - Knowledge and skills gaps of teachers/trainers, students/residents in relation to medical

training/competencies (clinical, technical and administrative) - Knowledge and skills gaps of health workers, teachers/trainers, students/residents in

relation to research and innovation e. Common knowledge and skills gaps of supportive staff

- Knowledge and skills gaps of supportive staff in relation to hospital leadership and governance(human resource, material and logistic, buildings and rooms, etc)

f. Opportunities and challenges to addressing knowledge and skills gaps in hospitals - Learning opportunities for improving knowledge and skills (trainings, courses, experience sharing

events, further study) g. Needs and opportunities for diaspora investment - Opportunities and challenges for diaspora investment in the hospitals - Specialist services/medical training programs/courses and hospital management and

administration where diaspora investment is highly needed


Title. Study on knowledge and skill gaps in public health sectors in Ethiopia

Assessment Questionnaire (to be checked with responsible body in the hospital)

Introduction

In collaboration with the IoM, Forum for Social Studies is conducting a study to assess the knowledge and skill gaps in selected Ethiopian Tertiary-Teaching-Referral Hospitals to identify investment opportunities for the Ethiopian diaspora. The study aims to collect reliable and sound data to, specifically, devise appropriate and effective intervention strategies as well as develop short, medium and long-term roadmap to inform knowledge/skills/technology transfer programs with the Ethiopian diaspora at the center. Your hospital is one of the seven purposively selected Ethiopian tertiary educational institutions from four regional states i.e. Tigray, Amhara, Oromia and Southern Nations, Nationalities and Peoples Regional State and two city administrations i.e. Addis Ababa and Dire Dawa. The criteria for the purposive selection were 15 years of operation and strong science and technology programs.

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This questionnaire contains *** number of questions. The questionnaire will not take more than 30minutes of your time. Some of the questions may not be applicable to you or your office. Participation in this study is based on your freewill and you can turn down the chance to participate in this study or, when you decide to do, skip any question you don’t want to respond to and proceed to subsequent questions. As a reminder, however, incomplete information would make the research results inconclusive and its policy recommendations ineffective.

If you decide to participate in the research by filling out this questionnaire, please respond to questions by ticking in the appropriate space provided. If you don’t have adequate or complete information on certain questions, your best estimate or approximations will suffice for the purpose of the research.


Dr Yeraswork Admassie. Dr Abebayehu Tora Forum for Social Studies. Wolaita Sodo University Executive Director. Principal Investigator Phone. +251 111 545608. Cell. +251 913 190253. Email. [email protected] Email: [email protected]

Name of Hospital …………………………………………

Region/city ………………………………………………...

a. Hospital profile

No. Category Number 1. Total catchment population served by the hospital 2. Total number of beds 3. Total population receiving emergency services per

year

4. Total population receiving outpatient services per year 5. Total population receiving inpatient services per year

b. Number of medical students in the medical college No. Category Gender Total

Male Female 1. Undergraduate 2. Post graduate specialization 3. Post graduate sub-specialization

c. Academic programs/departments in the college(Get detail outline of academic programs

from the registrar in print out)

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No. Types of programs Number of specializations 1. Undergraduate 2. Post graduate specializations 3. Post graduate sub-specialty

d. Employees of the hospital/medical college on further study (Get detail outline of types of specializations employees of the hospital are studying)

No. Category Number of employees on further study

1. Undergraduate 2. Post graduate specializations 3. Post graduate subspecialty

e. Employees in the hospital

No. Type of profession Currently providing the service

Male Female Total

1. Specialists/sub-specialists Surgeons Gynecologists Oncologists Pediatricians Internal medicine Psychiatrists Neurologists Orthopedists Pathologists Ophthalmologists Cardiologists Dermatologists Other specialists

2. General practitioners 3. Health officers 4. B.Sc. Nurses 5. Midwives (all type) 6. Nurses (diploma all type) 7. Nurses (certificate all type) 8. Laboratory technician (all type) 9. Pharmacy (all type)

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10. X-ray/radiology (all type) 11. Others (physiotherapy, etc) 12. Supportive/administrative staff 13. Diaspora providing services

currently

14. Diaspora served in the hospital (in the last 5 years)

f. Types of specialist services in the hospital (Please tick all that apply) No. Types of services Yes No

1. General medicine 2. Emergency services 3. Mental health (psychiatry and psychology) 4. Burns unit (specialized burns intensive care unit

and operating theatre)

5. Clinical pharmacology specialist 6. Dermatology 7. Infectious disease 8. General surgery 9. Ear, nose, and throat surgery 10. Gastroenterology 11. Diagnostic radiology 12. Nephrology (tertiary dialysis and nephrology

service)

13. Obstetrics and gynecology 14. Pediatric care 15. Ophthalmology 16. Orthopedic surgery (subspecialty orthopedics) 17. Pediatric surgery (specialist pediatric surgery

service)

18. Plastic and reconstructive surgery 19. Rehabilitation center 20. Respiratory medicine 21. Trauma (Tertiary major trauma center) 22. Urology 23. Cardiology 24. Cardiothoracic surgery 25. Clinical immunology 26. Cranio-maxillofacial surgery 27. Diagnostic radiology (MRI) 28. Endocrinology 29. Genetics 30. Geriatrics

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31. Hematology 32. Medical and radiation oncology 33. Neurology 34. Neurosurgery 35. Renal transplant (renal transplant unit) 36. Orthopedic surgery (Orthopedic oncology) 37. Diabetes clinic 38. Neonatal ICU 39. Pediatric ICU 40. Adult ICU 41. MSH/ANC 42. Hemodialysis 43. Forensic and sexual assault 44. Cervical Cancer screening and treatment 45. Cath Lab 46. Diagnostic pathology 47. Endoscopy and Colonoscopy 48. ENT surgery 49. Chest and Vascular Surgery 50. Maxillo-Odontostomatology 51. Nuclear medicine 52. Others

E. Types of diagnostic radiology technologies (Please tick all that apply) No. Category Yes No

1. X-ray 2. Multislice CT scan 3. Ultrasound 4. Fluoroscopy 5. Mammography 6. Color Doppler 7. MRI 8. Other

F. Types of diagnostic laboratory technologies (Please tick all that apply)

No. Category Yes No 1. Routine diagnostic medical laboratory

services

2. Hormonal Analysis 3. Coagulation Profile 4. Clinical Chemistry 5. Electrolyte Analysis 6. Immunology 7. Other

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Key informant interview checklist

Introduction


This key informant interview guide contains a few guiding questions on knowledge and skills gaps in your hospital and it will not take more than 30minutes of your time to compete. Participation in this study is based on your freewill and you can refuse to take part in the study altogether or skip any question you don’t feel comfortable in responding to. As a reminder, however, incomplete information would make the research results inconclusive and its policy recommendations ineffective.



Background

1. Name of hospital …………………………………… 2. Socio-demographic characteristics of informants

Age …………… Gender …………….. Qualification/field of specialization ………….. Level of education ……………… Position in the hospital ………………. Years of service (work experience) ………………..

Knowledge and skills gaps

3. Missionsand vision of the hospital 3.1. Opportunities to achieve the stated missions and vision 3.2. Challenges related to stated mission and vision of the hospital

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4. Gender composition of medical/academic/clinical staff a. Implication of gender imbalance (if there) to the knowledge and skills gaps in the hospital

5. Major types of medical services provided in the hospital a. Types of services highly demanded but not provided in the hospital b. Reasons for incompleteness of services c. Future plans to expand clinical/specialist services in your hospital d. Anticipated challenges related to expansion of specialist services

6. Knowledge and skills gaps in: a. Surgical services b. Emergency services c. General medicine d. Gynecology e. Orthopedics f. Oncology g. Pediatrics h. Rehabilitation services i. Psychiatry j. Radiology k. Laboratory l. Hospital leadership and governance (financial, human, material and logistic management)

8. Challenges in technology use a. Surgical technologies b. Treatment technologies c. Diagnostic technologies d. ICT services

9. Research and innovation practices 9.1. The useof research and innovation outcomes for improving medical services 9.2. Perception of knowledge and skills gaps of staff in research and innovation activities 9.3. Opportunities for staff to improve their research and innovation knowledge and skills

7. Opportunities and challenges related to addressing knowledge and skills gaps 9.4. Opportunities for continuous professional development 9.5. Challenges related to continuous professional development

10. Experience of Ethiopian Diaspora medical services and medical training 10.1. Specific specialist services/medical professions diaspora investment is highly needed 10.2. International linkage and network platforms of the hospital/medical college 10.3. Experience of diaspora investment in the hospital/medical college 10.4. Lessons learnt from diaspora investment in the hospital/medical college 10.5. Opportunities for diaspora investment in the hospital/medical college 10.6. Suggestions for improving diaspora invest in health sectors in Ethiopia can be improved

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Focus Group Discussion Checklist (will also be used for academic directors of medical college as

KII guide)

Introduction


This Focus Group Discussion guide contains a few guiding questions on knowledge and skills gaps in your hospital and it will not take more than 30minutes of your time to compete. Participation in this study is based on your freewill and you can refuse to take part in the study altogether or skip any question you don’t feel comfortable in responding to. As a reminder, however, incomplete information would make the research results inconclusive and its policy recommendations ineffective.



a. Socio-demographics of participants/residents (age, gender, years of training, program:

undergraduate, postgraduate specialization)

No. Name of participants Gender Age Program (under graduate/post graduate)

1. 2. 3. 4. 5. 6.

b. Knowledge and skills gaps in medical training 1. Perceive quality of medical training 7

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a. Adequacy academic programs in filling service and skills gaps b. Factors compromising quality of medical training (skilled and experienced professionals,

Availability of (access to) teaching facilities and technologies(diagnostic, surgical and treatment technologies, laboratory, libraries, books, internet, journals, etc)

8. Technology and medical training a. Availability of cutting technologies for medical training (technologies for treatment,

surgery, ICT/hospital management and treatment b. Challenges related to use of technologies c. Implications of technology for quality of medical training

9. Research and innovation knowledge and skills of teachers/students a. Experience of students/teachers in research and innovation b. Extent the medical training is supported by research and innovationactivities c. Factors influencing research and innovation knowledge of students/teachers d. Challenges and opportunities related to engagement in research and innovation

10. Perception of diaspora investment in medical education/training a. Specific areas of medical training diaspora potential can be tapped into b. Previous experiences with Ethiopian diaspora (types or number of courses taught by

diaspora and benefits gained)

Limited observation checklist

• Types of service-specific operational guidelines available in different departments • Types of advanced diagnostic or surgical operation technologies in use or abuse • Types of ICT technologies in use or abuse • Types of communication mechanisms among various departments (whether communication is

made through messengers or through online using ICT systems) • Material/logistics management/arrangement (whether materials, disposables, and other equipment

are properly managed) • Spatial management of hospital buildings and rooms (Whether hospital buildings and spaces are

managed and used properly for the type of service they are supposed for) • Hospital hygiene and waste disposal mechanisms • Sanitary management (availability/mechanisms of sanitary management, whether sanitary

management is supported by modern technologies, and associated problems) • Compound beautification/decoration and associated problems

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Assessment of skills/knowledge gap in Health and Education ... · 3.1.1 Knowledge and skills gap in teaching and learning in technology institutions 13 ... Factors behind low quality

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