A sweeping reform entailing a board of directors establishment across hospitals and health centres under the purview of the Addis Abeba Health Bureau is initiated as part of a radical overhaul of healthcare administration and governance.

A seven-member board of directors will lead the six hospitals while the 98 health centres will be overseen by a nine-member board comprised of representatives from employees, civic society, the community and the city administration.

The modality proposed under the bill awaiting approval expects the six hospitals to report to the Bureau while health centres will be accountable to their respective district health bureau offices. The members are granted a three-year appointment in a maximum of two terms.

Health Bureau officials suggest that reforms to administrative structures will bring autonomy, transparency and accountability, which in turn will improve healthcare services.

According to Mulugeta Endale (MD), deputy head of the Bureau, the committee established to lead the health sector was not functioning properly. He attributed it to poor planning skills and inability to make administrative decisions.

Mulugeta considers boards to be better structured in passing down administrative services while maintaining an economic organisation in a health sector poised for deepening decentralisation.

"It'll take some burden off our shoulders," he told Fortune.

Boards are expected to facilitate linkages, determine services to outsourced third-party contracts, and examine and approve annual plans of the facility while maintaining follow-ups on overall activities receiving sitting allowances for their services.

Informal boards comprised of Wereda and regional officials, vestiges of decentralisation efforts in the early 1990s, had been discarded by the Addis Abeba Health Bureau two years ago as it started to draft the administrative reform.

Unrepsponiveness to public needs and a laboured administrative structure had prompted the health bureau to undertake supervision responsibilities as a regulatory framework was crafted over the past two years.

A study by Columbia's Mailman School of Public Health indicates that a lack of clear instructions at the central level and inadequate dissemination of information has resulted in Ethiopia failing to achieve universal health care despite successive plans since the 1970s.

Staff at the 91-year-old Ras Desta Damtew Hospital, serving close to half a million patients yearly, claim the institution has been wrought with disputes and declining quality of health service over the years due to the absence of a functional board.

Its Medical Director, Teshome Hunde (MD) is one of 200 practitioners who expressed joy over the proposed reforms to the administrative structure. The lack of functional management to oversee finances and formulate annual strategic directions has hampered the hospital's expansion capabilities, according to Teshome.

"It'll improve quality of service," he told Fortune.

Ras Desta had an operational budget of 365 million Br last year, with 17pc being internal revenues while the rest is allocated by the Health Bureau. However, a persistent lack of supplies had caused delays in service provision, according to Teshome.

"A board will do us good with proper implementation," he told Fortune.