A Meaningful Week in Ethiopia: Creating Lasting Health Change with Amref

As of 2019, ORTEC works in collaboration with Amref Flying Doctors, owned by Amref Health Africa. Due to our collaboration, Amref can increase their impact on African healthcare by optimizing their business processes, making their projects quantifiable and the outcome of these projects visible. As part of the collaboration, some of ORTEC’s consultants recently visited Amref Ethiopia to work on two projects: one aimed at shaping strategies used in projects, and another to improve the effectiveness and efficiency of their workforce. This article is a story by one of those consultants: Lotte van Hezewijk, Analytics Consultant.

Prior to departure to Ethiopia

At the beginning of ORTEC’s collaboration with Amref, some of my colleagues conducted an assessment on project selection. This uncovered the most relevant assignments, of which we selected two projects that were related to the Amref Ethiopia office:

1. Creating a snapshot of the healthcare needs of women in Ethiopia, given the ARAG* data over the years of 2017-2019
   – Goal: To shape strategies and interventions used in projects *ARAG: Amref Representative Advisory Group – women all over Ethiopia were asked about their life and health
2. Enabling the management team to make data-driven estimates about workforce requirements
   – Goal: To improve the effectiveness and efficiency of the workforce

Ethiopia, here we come!

In March 2020, my colleagues Edwin, Dasha, and I visited the Amref Ethiopia office in Addis Ababa to work on the two projects described above. Prior to departure, we had already finished the data analysis for the first project and put our findings together in a presentation. For the second project, we already conducted some preliminary calls with employees from the Ethiopian office to get a feeling of- and insights into the issues. Being well prepared, we went to Schiphol Airport (which is a major partner of Amref, btw) on Saturday the 7th of March to board a plane for this new and exciting chapter of our collaboration: a visit to the Amref Ethiopia office to further work on our projects.

A brief cultural deep dive
Upon arrival in Ethiopia, we were amazed by the friendliness and helpfulness of the people. After making some final touches to the preparation of our work for the coming week, we had some time to explore Addis Ababa and get to know the local people and culture. We got to know the importance of coffee here, as Ethiopia is the home of the coffee arabica plant, providing 16% of the population with a livelihood. After enjoying some delicious coffee and tea in a local ‘shop’, a taxi driver showed us his beloved city and explained more about the people, locations, and culture. After this amazing day, we were very excited to start our work.

Getting to work
After some free time, it was time to get to work. We were welcomed by the members of the management team of Amref Ethiopia who very openly described their work and problems they faced, and how we could help them. This was mainly related to data-driven estimations for their workforce requirements for projects they work on. We found that estimates were based on the experience of the people making the estimate, which led to many inconsistencies in the estimates among different projects. In their work, this led to various questions, such as: What to do when a project ends? What part of the staff is then redundant? And what resources are needed if there is a new project starting soon? 

Decisions based on data instead of a gut feeling
In the first days, we had lots of conversations with the management team, project staff, and support staff to understand their work, and to find out what factors influence the level of effort (LOE) they need to support a project. 

We got access to piles of data, including complete budgets of all active projects, as well as the estimates of how employees spent their time divided over the projects. Based on these estimates, we knew the input (the attributes of the project) and the required output (level of effort of the employees). For all of the workforce roles, we aim to create a regression model that predicts the level of effort based on the attributes of the project. For one of the roles (the accountant), we already implemented this during our visit. From this model, we found that the accountant’s level of effort is mainly influenced by the budget he/she must control, as well as by other partners involved in the project.

“Previously we’ve mainly used our heart in decision-making, and this is the head part. Let’s use both now!” – Amref Ethiopia

After closing the office at 11pm on Wednesday, we got a short rest before it was time to present the results on Thursday morning. After presenting our approach and the results, Amref’s management team was very happy that they could now base their decisions on data, instead of just their gut feeling: “Previously we’ve mainly used our heart in decision-making, and this is the head part. Let’s use both now!” 

That’s just the beginning: let’s do more
So far, we had been focusing solely on the ‘indirect/support’ workforce, such as Human Resources, Finance/Accounting, and Procurement employees. Based on the first results that week, Amref got excited to work on more. They asked us about additional opportunities and to extend the estimates from solely indirect staff to direct project staff as well. 

When we presented the results of the ARAG data analysis, we also had some interesting discussions on WASH (Water, Sanitation, and Hygiene), FGM (Female Genital Mutilation), and health insurance in Ethiopia. The data analysis gives insights into what type of interventions seem to reduce the prevalence of negative health outcomes, and which groups of the population are in need of change mostly.

Continuing our journey

As a follow-up to the work we did at the office, we traveled to Debre Birhan later that week, which is located 130 km northeast of Addis Ababa. Here, we learned about the projects that Amref realizes in that region, and visited several facilities:

• A health center where Amref helped with constructing the buildings, as well as creating a ‘Youth Friendly’ facility. This facility allows young people to have access to Sexual and Reproductive Health, which is still a taboo in Ethiopia;
• A Health Science College where Amref supports building classroom facilities and providing learning materials for students. In collaboration with the government, Amref also provides training for future health workers;
• A brick manufacturing site: this income generation project is meant to alleviate women out of poverty, so they can improve their health. The manufacturing site is owned by a group of five young women who were trained by Amref and the government on entrepreneurship and brick manufacturing. The group got provided with some startup money and the site location, so they could start their own business. They employ other adolescents from the area and make business connections at the local bazar to sell their (exceptionally strong) bricks for construction work.

The end of a week of very meaningful work

The inspiring visit to Debre Birhan concluded our week of very meaningful work in Ethiopia. It was incredible to see the passion of the employees of Amref to create lasting health change in Africa and to work on providing healthcare to everyone, even in the remotest areas of the country. It has been a big privilege to be part of this sustainable project and help improve the world using our passion for mathematics and knowledge. I look forward to continuing this collaboration! – Lotte van Hezewijk, Analytics Consultant at ORTEC (left on the below picture)

About Amref Health Africa in Ethiopia

Amref Health Africa is a non-governmental organization founded in 1957. Their programs support health change at the community level while creating stronger health systems at the regional and national levels. One of their offices is in Addis Ababa, Ethiopia, which we visited in March 2020 as part of our collaboration with Amref Ethiopia. More information on Amref Ethiopia can be found here.

The article was first published on ORTEC: https://bit.ly/2YHITcr