June 14, 2011
The Balanced Scorecard (BSC) epitomizes strengthening health systems through strengthening governance. Rahel Gizaw, MLI Country Lead for Ethiopia, told the audience at the Global Health Council’s annual conference that the BSC strengthens Ethiopia’s Federal Ministry of Health through capturing performance measures, targets and initiatives. With more clarity, more can be accomplished.
As a featured panelist on the Abt Associates’ session, ‘Integrating Governance into Health Systems Strengthening,’ Gizaw explained how the BSC, who’s roll out was supported by MLI, has created change over the last year for the majority of the health sector. This was only accomplished, she stated, through the commitment of leaders within the ministry. The government’s dedication was contagious.
“The BSC is now the only strategic planning and management tool for the Government of Ethiopia,” Gizaw said. And that it “has been used as a framework for (HSDP IV) – a 5 year strategic plan for the sector.”
While the BSC might seem like an easy success story, Gizaw stressed that the government’s implementation of and dedication to the BSC did not happen overnight. It was a gradual process that continues to this day.
Behind its roll out has been a south-to-south peer learning tour to Botswana, a country that already successfully implemented the tool, and training sessions for leaders and managers within the Federal Ministry of Health, Medical Service Directorate, St. Paul Hospital and the Medical College. The trainings enabled vital capacity building of existing human resources for over 125 staff members from the various institutions. The building of a hefty support system was integral to the success experienced by Ethiopia so far.
However, Gizaw, who has co-authored a case study of the progress made by St. Paul’s Hospital, was cautionary in noting that this initiative did meet challenges both during the conception and implementation stages. She explained to the audience and fellow panelists that major issues arose around competing sector priorities, limited time and resources, donors having limited interest in this effort and lastly, the perception that this was a measurement tool and not a strategic one.
Despite these challenges, Gizaw told the audience, the BSC is assisting the Federal Ministry of Health to judge its performance against their top health priorities, allowing to make identified changes for stronger health outcomes.