Modifying Technical Assistance for Acceleration of Results in Ethiopia

USAID Transform: Primary Health Care is a five year activity (2017-2022) that partners with the government of Ethiopia to prevent child and maternal deaths by strengthening the country’s health system. The activity takes appropriate action in collaboration with the public sector to improve quality of service delivery across the primary health care units’ continuum of care. The activity delivers technical assistance using cluster offices which are organized to reach districts, facilities, and communities.

The activity used the collaborating, learning, and adaptation (CLA) framework to intentionally and effectively adapt its technical assistance intervention, utilizing its established learning system and experience. The zonal technical assistance approach was a new initiative, designed to address a complex set of interventions with reduced resources and reach. Understanding the implementation areas’ performance status, targeting the intervention, and creating a consensus with zonal health departments and other implementing partners were key steps taken to effectively implement the adaptation. CLA enabled a smooth transition of the interventions, through the activity’s fostering of a structured approach to learning and adapting. The new approach of delivering technical assistance through zonal health departments required some additional steps in design and adaptation in order to be able to deliver interventions or technical assistance with limitation of resources and staff. This was done by focusing on low-performing districts, while also helping high-performing ones to address challenges, sustain performance, and share successful strategies/lessons with lower performing districts. The activity has collected and documented various case stories that show the contribution of CLA in program implementation and outcome level improvements.