Widening the gateway to health care in Ethiopia

 

 

Kathleen Poer (front row, center) and fellow Abt Associates staff at a meeting in Addis Ababa, Ethiopia. Poer manages a USAID program to increase TB and HIV treatment availability. Photo by Leah Ekbladh

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Ethiopia's fight against HIV/AIDS received a boost in February when the country's top health ministry officials agreed to allow private health care clinics to provide patients with antiretroviral medicines.

The officials reached the agreement during a meeting with a contractor for USAID. Representing that contractor was former Rotary Foundation Ambassadorial Scholar Kathleen Poer.

"I could navigate this complex policy issue because I understood the cultural milieu, listened carefully to the advice of my Ethiopian colleagues, and tried to think about how local norms would influence the meeting," she says.

Since 2007, Poer has worked in Ethiopia for Abt Associates, one of the world's largest government and business research and consulting firms. She manages USAID's five-year Private Sector Program for HIV and Tuberculosis, which aims to increase the capacity of private health care providers to deliver services through a public-private sector partnership.

When Poer, a native or Colorado, USA, arrived in Ethiopia, she worked to strengthen an existing program for the prevention and treatment of TB and HIV in the workplace and to expand a pilot program to integrate TB and HIV services into private-sector clinics. After Abt Associates completed a successful pilot that introduced TB treatment to 20 private clinics, she oversaw the expansion of care to 100 more clinics.

"One way of increasing case detection is to have more sites providing TB diagnosis services," says Poer of the expansion of TB care, which had been legal only in government-run clinics. "This is particularly true with TB because it is stigmatized and people may prefer to go to a clinic where they are not known."

Additionally, Poer has overseen mobile teams of local caregivers who operate out of tents and cooperate with community clinics and health bureaus to provide HIV testing and counseling services. From June 2007 to June 2009, the teams helped test over 100,000 people.

"I think we've gone pretty far pretty fast, and you can see the attitude of the public sector changing dramatically during that time to greater openness," she says.

Before moving to Ethiopia, Poer spent 18 years working for Abt Associates to improve health care systems in Albania, Egypt, Jordan, Kazakhstan, Kyrgyzstan, Russia, and Uzbekistan.

She studied as a 1985-86 Ambassadorial Scholar at Jawaharlal Nehru University in New Delhi, sponsored by the Rotary Club of Durango, Colorado, USA. Poer volunteered with a number of clubs on service projects, including installing energy-efficient cooking stoves and developing avenues of rural income generation. She also participated in polio immunization campaigns.

"It's difficult as a foreigner to just go and visit poor rural villages," Poer says. "You wouldn't do it unless you happened to be involved with the Rotarians. They had this active network of projects, and I tried to go with them as frequently as possible. It was my experience in India that made me want to work in development."

Written for Reconnections