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ToT ME Ethiopia

Training of Trainers in Medical Ethics (ToT ME) in Ethiopia

How to increase awareness, skills and knowledge in medical ethics among clinicians in Ethiopia? This overarching question lead to the collaboration between the University of Addis Ababa (UAA), School of Medicine, Ethiopia, and the research group on Global Health Priorities, University of Bergen (UiB), Norway. In February 2017 we officially opened the first center of its kind in Ethiopia: The Center for Medical Ethics and Priority Setting (CMEPS) located at the campus of Addis Ababa University, College of Health Sciences.

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The center is lead by Dr. Dawit Desalegn and coordinator is Dr. Frehiwot Berhane. Both of them are are in addition to their commitments in Ethiopia, also PhD candidates in medical ethics at the University of Bergen. Assistant coordinator is Yeshanew Negussie.

The Program Director of the Ethics Collaboration is Associate Professor Ingrid Miljeteig. Professor Ole Frithjof Norheim and Miljeteig have committed themselves to support the Centre as well as initiatives by the Ethiopian Medical Association and the Ministry of Health to increase awareness, skills and knowledge among students and health workers in the fields of medical ethics and priority setting.

In addition to support from AAU, the development of the center has been supported by the University of Bergen and Haukeland University Hospital, Norway.

CMEPS is located in the library building at the hospital campus. It has office spaces and a meeting room for the clinical ethics committee. Researchers working on ethics and priority setting will have the office as their workplace. 

Training of Trainers in Medical Ethics Course (TOT ME)

The training of trainers in medical ethics course is collaboration between the Ministry of Health Ethiopia, the Centre for Medical Ethics and Priority setting (CMEP) at Addis Ababa University and the research group Global Health Priorities (GHP), University of Bergen. The course includes participants from all the 28 medical faculties, taking part in a two-year training program where essential theories, methods, cases and didactic tools in teaching in medical ethics will be thought and discussed.

After finishing the two-year program and doing the assessments and passing the exam, the participants should have sufficient skills to teach medical students as well as other health care students and health care staff. They will also be trained to lead ethical deliberations, provide input to ethical guidelines and participate in decision-making processes where values are at stake.

The total course-package will last for two years, consisting of four meetings (with three full days) every 6 months. Between the meetings the participants will have reading assignments, reflection groups with colleagues and preparatory work for the next meeting. In the final meeting the participants will have a smaller exam and a presentation of a given task (such as making a lecture, a seminar, or leading a reflection group).

Lecturers are: 

  • Program Director for Ethics Collaboration, Associate Professor in Medical Ethics Ingrid Miljeteig, UoB
  • Professor in Medical Ethics, Ole F. Norheim, UoB and Adjunct Professor, Harvard TH Chan School of Public Health
  • Associate Professor Dawit Desalegn, MEPS, AAU and PhD-candidate at UoB
  • Dr. Frehiwot Berhane, PhD-candidate at UoB
  • Dr. Alex Voorhoeve, philosopher, London School of Economics and NIH
  • Staff from AAU (MEPS and members of Clinical Ethics Committee)
  • Invited internationally renowned ethicists. 

 

Research programs at CMEPS

  • A Study of Ethiopian Physicians Experiences of Ethical Dilemmas and Bedside Rationing in Clinical Practice

    • Principal investigators:

      • Frehiwot Berhane (MD, PhD, PhD-candidate University of Bergen, Norway)

      • Ingrid Miljeteig (MD, PhD, main supervisor, University of Bergen, Norway)

      • Ole Frithjof Norheim (MD, PhD, co-supervisor, University of Bergen, Norway)

      • Marion Danis (MD, PhD, head of Bioethics Unit, National Institute of Health, USA, co-supervisor)

  • Increasing awareness, skills and knowledge in medical ethics among Ethiopian health workers to build a caring, respectful and compassionate health system

    • Principal investigators:

      • Dawit Desalegn (MD, PhD, PhD-candidate University of Bergen, Norway)

      • Ingrid Miljeteig (MD, PhD, main supervisor, University of Bergen, Norway)

      • Ole Frithjof Norheim (MD, PhD, co-supervisor, University of Bergen, Norway)

  • Mapping out implications of the law regulating abortion services: A qualitative study on health workers experiences from health institutions in Ethiopia

    • Principal investigators:

      • Emily Mclean (PhD student, University of Bergen, Norway)

      • Ingrid Miljeteig (MD, PhD, main supervisor, University of Bergen, Norway)

      • Dawit Desalegn (MD, PhD, co-supervisor, Addis Ababa University)

      • Astrid Blystad (Professor, Center for International Health, University of Bergen)

  • Accessibility and utilization of newborn health care services: A qualitative study on intra-household resource allocation among Ethiopian families experiencing neonatal illness

    • Principal investigators:

      • Kristine Onarheim (MD, PhD student, University of Bergen, Norway)

      • Ingrid Miljeteig (MD, PhD, main supervisor, University of Bergen, Norway)

      • Mitike Sisay (Professor, co-supervisor, School of Public Health, Addis Ababa University)

      • Karen Marie Moland (professor, University of Bergen, Norway)

  • Ethical challenges and decision making in Emergency Care Units: Experiences of physicians and nurses in all public hospitals in Addis Ababa, Ethiopia

    • Principal investigators:

      • Wakuma Chala (BSc, Masters students Addis Ababa University)

      • Lemlem Beza (MSC, Emergency Unit, Addis Ababa University)

      • Dr. Biruk Girma, Dr. Menbau Sultan, Dr.Finot Debebe,  Dr.Hywet Emgda (MD, Assistant Professors of Emergency Medicine, Addis Ababa University)

      • Dr. Aklilu Azaha( MD, Associate Professor of Emergency Medicine, AAU)

      • Ingrid Miljeteig (MD, PhD, main supervisor, University of Bergen, Norway)

  • Priorities 2020 - Ethiopia

    • Principal investigators:

      • Mieraf Tadese (MD, PhD student, University of Bergen, Norway)

      • Kjell Arne Johansson (MD, PhD, main supervisor, University of Bergen, Norway)

      • Ole Frithjof Norheim (MD, PhD, co-supervisor, University of Bergen, Norway)

      • Stephan Verguet (professor, Harvard School of Public Health)

  • Disease Control Priorities – Ethiopia

    • Principal investigators:

      • Kjell Arne Johansson (MD, PhD, University of Bergen, Norway)

      • Ole Frithjof Norheim (MD, PhD, University of Bergen, Norway)

      • Stephan Verguet (professor, Harvard School of Public Health)

      • Will recruit seven master’s students, two PhD students, and two post-doctoral fellows from Ethiopia, to build capacity in health economics and priority setting for the Federal Ministry of Health. 

  • Ethical issues relating to provision of sustainable renal care in sub-Saharan Africa

    • Principal investigators:

      • Dr Valerie A. Luyckx (Institute of Biomedical Ethics, University of Zurich)

      • Dr. Addisu Meklieejigu, (Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University)

      • Prof Nikola Biller-Andorno, (Institute of Biomedical Ethics, University of Zurich)

      • Ingrid Miljeteig (MD, PhD, University of Bergen, Norway)

      • Prof John Porter, (London School of Hygiene and Tropical Medicine)