USAID Health Financing Improvement Program Quarterly Performance Report – Year 1, Quarter 1 (October 25, 2018 – December 31, 2018)

The program builds on previous investments in health care financing reform by USAID and the government of Ethiopia. The consortium implementing the program is led by Abt Associates, and includes core partners Breakthrough International Consultancy, Dimagi, Institute for Healthcare Improvement, and Results for Development, and resource partner Harvard School of Public Health. The program has four intermediate results: increasing domestic resource mobilization for enhanced provision of quality primary health care services, streamlining pooling of risk-sharing/insurance mechanisms for wider access to primary health care services with reduced financial barriers, facilitating strategic purchasing of health services from public and private health providers, and improving governance, management, and evidence-generation for health financing reforms and health facilities. By the end of the program in 2023, Ethiopia's health sector is anticipated to have more resources available for primary health care services, with an increase in domestic financing of health care services from 64 percent in 2014 to 70 percent, and more people having insurance coverage, including the poorest. The program's Year 1, Quarter 1 performance report covers the period of October 25 – December 31, 2018. During this quarter, activities primarily focused on mobilization and start-up, and the development and on-time submission of the program's implementation and monitoring, evaluation, and learning (MEL) plans. The main technical assistance/programmatic activities and accomplishments are described in the following section. The program's implementation is led by Abt Associates, with core partners Breakthrough International Consultancy, Dimagi, Institute for Healthcare Improvement, and Results for Development, and resource partner Harvard School of Public Health. The program team will work on purposefully and systematically building local capacity to institutionalize and transition program responsibilities to these institutions for sustainable and continuous implementation. The program's objectives are aligned with the government of Ethiopia's health sector development plan, which aims to increase access to quality health services, improve health outcomes, and reduce financial barriers to health care. The program's implementation will be monitored and evaluated through a robust MEL system, which will track progress against program objectives and provide evidence for decision-making. The program's quarterly performance report provides an update on program activities, accomplishments, and challenges during the first quarter of the program. The report highlights the program's progress in mobilizing resources, developing implementation plans, and establishing a robust MEL system. The report also identifies challenges and constraints encountered during the quarter, including administrative and coordination issues, and outlines steps taken to address these challenges. The program's implementation will be supported by a range of technical assistance and programmatic activities, including capacity building, training, and technical assistance to government institutions, health facilities, and other stakeholders. The program will also support the development of policies, guidelines, and standards for health financing, and will provide technical assistance to support the implementation of these policies and guidelines.