A new hospital accreditation standard has been introduced, requiring hospitals to be accredited for all their services, unlike the previous system, which covered only laboratories and infrastructure.
The draft standard, currently open for public review, evaluates all aspects of hospital services, including reception, doctor communication, labelling, complaint platforms, patient satisfaction, governance structure, and outsourced services. However, hospitals will not be forced to seek accreditation.
The new standard, developed by the Ministry of Health (MoH), the Institute of Ethiopian Standards (IES), and the Ethiopian Accreditation Service (EAS), moves away from the minimum compliance-based approach.
Previously, accreditation functioned as a checklist, ensuring hospitals met basic standards. The new framework, however, focuses on service quality and patient safety, going beyond structural compliance. It also assesses cleaning protocols and allows hospitals to outsource services, provided those services also meet compliance requirements.
Hospitals will now be required to establish a clear governance structure for quality management, including defined roles, responsibilities, and documented procedures.
In terms of patient safety, hospitals must implement documented safety protocols, strict patient identification procedures, and an incident reporting system. Medication management policies must cover prescription, administration, and monitoring, ensuring comprehensive oversight.
Hospitals must also establish an infection prevention & control (IPC) programme to reduce healthcare-associated infections.
Hospitals will need secure and reliable data storage infrastructure to protect health information. Policies for data archival, retention, and interoperability with other systems must comply with legal and best practice standards.
The standard mandates that hospitals and their employees uphold patient dignity, cultural sensitivity, privacy, and confidentiality. Informed consent must be obtained before treatment, and patients should actively participate in decisions regarding their care.
Hospitals are also expected to implement health education programmes to help patients understand their conditions, self-care practices, and preventive measures. Additionally, feedback mechanisms must be established to enhance service quality and patient experience.
Abas Hassen (MD), a health system innovation & quality improvement leader at the MoH, stated that while accreditation is not yet mandatory, hospitals may be required to comply in the future. The primary goal is to enhance service quality and patient safety, ultimately reducing patient mortality.
The accreditation programme will extend beyond hospitals to healthcare centres, laboratories, and diagnostic centres. To ensure alignment with international standards, the MoH has studied accreditation systems in South Africa, Turkiye, and Indonesia.
“We are working to get this accreditation recognised by the World Health Service Quality Society,” Abas told Fortune.
To encourage hospitals to seek accreditation, the Ministry is planning incentive packages, including free professional training, duty-free imports, and favourable terms with insurers. Ethiopia currently has 400 hospitals and over 4,000 healthcare centres, with policies promoting public-private partnerships (PPP) and the construction of more tertiary hospitals.
"It is a big step for us," Abas said.
Hospitals must pass four levels of evaluation before accreditation. They will cover the costs associated with the process. The accreditation license must be renewed annually, with reaccreditation required every four years. Inspections will occur twice a year, and an audit will be conducted every three years.
The EAS will oversee the process. Bonsa Bayissa, EAS director general, says that although the organisation has 13 years of experience, it has mostly accredited laboratories and specific hospital sections rather than entire hospitals.
“It might take hospitals some time to get accredited,” he said.
Hospitals will need to submit a self-assessment report, which will be reviewed and verified by EAS inspection teams. Bonsa confirmed that guidelines are being drafted, and hospitals will progress through accreditation levels before achieving full accreditation. He said inspectors will undergo intensive training to ensure sector-specific expertise.
To date, the EAS has accredited over 50 medical labs, with 10 additional facilities accredited through inspection and 14 institutions accredited in testing.
Markos Feleke (MD), CEO and founder of ABH Group and Washington Health Care, expects Washington Tertiary Hospital to be among the first accredited facilities when it opens in six months.
"I believe we will be the first hospital to be accredited," he said.
He claims Washington Tertiary Hospital was built according to the Joint Commission Standard (JCS), making it a strong contender for accreditation. The hospital’s two-phase construction has cost 240 million dollars, with 70 million dollars spent on the first phase and 170 million dollars allocated for the ongoing second phase.
Public hospitals are also showing interest. Tegenu Guta, national reform & accreditation team leader at St. Paul Millennium Medical College's Hospital, stated that his team is in the final stages of compliance with international standards.
"We are organising documentation and expect to be accredited soon," he said.
Currently, 77pc of inpatients at St. Paul’s Hospital report high satisfaction, though outpatient services, particularly radiology, require improvements, according to Tegenu.
However, shortcomings such as medicine shortages, reagent shortages in laboratories, and a lack of professionals persist. Tegenu argues that the standard should specifically address reception, nursing, and paediatrics.
Mulatu Sisay, Director General of the Ethiopian Healthcare Federation (EHF), urged the Ministry to customise the standard to the country’s healthcare landscape. While private hospitals are eager to gain accreditation, Mulatu warned that it will become “a matter of existence” for them.
He compared the current accreditation push to previous hospital ranking competitions, which encouraged hospitals to improve quality to achieve high scores.
However, Mulatu argues that mandatory 24/7 electricity and water supply requirements, given regional infrastructure limitations, is unattainable. Meeting these demands would increase operational costs, potentially leading to higher service fees for patients.
To ensure fair representation, he recommended that the private sector be included on the evaluation board, just as the Ministry represents public hospitals.
However, Desalegn Tigabu (PhD), a public health expert, says the standard is service-focused, rather than infrastructure-heavy. Basic infrastructure like water and electricity is already part of the minimum operational requirements.
Desalegn believes that hospital accreditation will increase public trust in healthcare services.
“Patients will feel more confident seeking treatment in accredited hospitals,” he said.
He argues meeting the new standards will not require overwhelming investments, dismissing concerns over excessive financial burdens.
PUBLISHED ON
Feb 16, 2025 [ VOL
25 , NO
1294]
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