Differentiated Service Delivery in Ethiopia

Responding to the increased demand in HIV services, ICAP in Ethiopia is conducting an appointment spacing pilot project. Appointment spacing is a facility-based differentiated care model in which stable patients are offered the option of shifting from quarterly to twice-yearly appointments. Rather than returning to the health facility every three months for clinical assessments and refills, patients can return every six months, creating efficiency both for patients and for the health system.

Under the leadership of the Federal Ministry of Health (FMOH), the CDC-funded pilot, which began in October 2016, is underway at six high-volume hospitals: Zewditu Memerial Hospital in Addis Ababa, Nekemte Hospital in Oromia, Dessie Hospital in Amhara, Hawasa University Referral Hospital in SNNP, Mekele Referral Hospital in Tigray, and Hiwot Fana Hospital in Dire Dawa.

Based on the promising early results from the pilot, appointment spacing is now being scaled up to hundreds of health care facilities nationwide. In 2018, with the support of the CQUIN network, ICAP in Ethiopia will conduct a study of health worker and patient reactions to the introduction of appointment spacing, exploring barriers and facilitators to successful scale-up.