Abstract

Strengthening health systems is an international priority as highlighted by the World Health Organization, World Bank and major donor groups. Central to health systems strengthening is enhancing the management capacity within a health-care delivery system. The vast majority of capacitybuilding efforts, however, have focused on enhancing medical and public health skills. Less attention has been directed at developing health-care managers despite their potentially important role in improving the functioning and quality of health-care delivery systems.

Although management capacity is needed at all levels of health systems, hospital management is particularly important for several reasons. First, hospitals are typically institutions with substantial complexity requiring effective coordination of resources and managerial problem solving. Second, hospitals typically account for more than half of the health-care spending in a country, suggesting the need for effective management of hospital resources. Finally, hospitals play a crucial part in the referral system and provide public confidence that treatment for serious illnesses is accessible.

Accordingly, we sought to develop an effective and sustainable model for enhancing capacity in hospital management. The model includes as a cornerstone a Masters of Hospital and Health-Care Administration (MHA) degree program, delivered at Jimma University in Ethiopia, and has been implemented as a core component of the Ethiopia Hospital Management Initiative (EHMI), a collaborative effort of the Ministry of Health (MoH) of Ethiopia, The William Jefferson Clinton HIV/AIDS Initiative (CHAI), Jimma University and Yale University.