CCM/E Oversight Committee Field Visit Report

Background

From May 19 to 23, 2025, the Country Coordinating Mechanism for Ethiopia (CCM/E) Oversight Committee (OC), in collaboration with  CCM/E members, the Ministry of Health (MoH) colleagues, and the CCM/E Secretariat, conducted field visits across three regions: Amhara, Somali, and Benishangul-Gumuz. The purpose of these visits was to provide hands-on oversight of Global Fund (GF) grant programs and to ensure they are being implemented effectively, ethically, and in alignment with grant objectives.

The oversight field visit teams were divided into three groups for the three regions . These visits enabled  the Oversight committee  to understand how to meaningfully engage the  local health authorities and stakeholders and provided an opportunity to directly observe the progress and challenges of the programs on the ground.

The field visits had four main objectives:

• Identify challenges affecting the implementation of GF supported programs focused on HIV, TB, Malaria, RSSH (Resilient and Sustainable Systems for Health), and C19RM (COVID-19 Response Mechanism). The findings will help CCM/E make evidence-based decisions to improve performance.
• Get a clearer picture of how programs are functioning on the ground,  what’s working well, and where improvements are needed.
• provide guidance and orientation to Regional Health Bureaus (RHBs) on the Global fund grant management and CCM/E function.
• Ensure that the Year One budget under Grant Cycle 7 (GC7) is fully utilized and liquidated as planned, preventing delays and maximizing the funding’s impact

Sites Visited

• Regional Health Bureaus (RHBs): Met with leadership and program staff to discuss Program, grant management, coordination, and planning.
• Regional Public Health Institutes (RPHIs) / Laboratories: Reviewed laboratory services related to HIV, TB, and Malaria, including External Quality Assessment(EQA) and data systems.
• Regional PSS (Pharmaceutical Supply Service) Warehouses: Assessed how the medical supplies and commodities management and distribution system.
• Selected Woreda Health Offices: Evaluated local-level health program management,  planning, support, and follow-up at the lower level, as well as resource use.
• Health Centers and Primary Hospitals: Observed service delivery and patient care related to TB, HIV, and Malaria cases.
• Health Posts: Focused on how community-based services are reaching underserved populations.
• Regional NEP+ Offices: Engaged with organizations representing people living with HIV to gather feedback on the program’s impact.
• Community Representatives Affected by HIV: Collected direct input from affected individuals to understand their experiences and concerns.

The Method used: During the intensive five-day field visit, the teams engaged in in-depth discussions and document review focusing on critical aspects of the Global Fund grant programs, including program management, financial performance, and supply management and distribution system,  adherence to the Global Fund’s Code of Ethical Conduct, and safeguarding mechanisms for beneficiaries. The assessment includes the nine-month performance report covering July 2024 to March 2025, and briefing and debriefing were conducted for the regional Health Bureau management, program, and financial team. 

What the team has observed

The field visit highlighted good practices and areas of strength on the Global Fund implementation in each region. The teams successfully identified specific regional challenges and operational gaps that are impeding optimal grant implementation. These include, but are not limited to, issues Sub-optimal data quality and insufficient data analysis and intentional to use, under achievement of some of the program indicators, Low grant absorption, delayed disbursement, minimal allocation of domestic resources, Overstock and understock of supplies, in availability LLINs and larvicidal, human resource capacity, infrastructure limitations, and coordination challenges between different stakeholders( RHB, EPSS, Woreda and Health facilities).

Based on the finding , the teams formulated a set of actionable recommendations aimed at addressing identified challenges and leveraging existing strengths. These recommendations provide a clear way forward for improving grant performance and ensuring accountability.

A significant recommendation emerging from the visit emphasizes the need to strengthen domestic resource mobilization efforts for program management. This underscores the importance of sustainable financing mechanisms to complement Global Fund investments and ensure the long-term viability of health programs.

The insights gained from this field visit are instrumental in informing the CCM/E’s strategic decisions, fostering improved grant performance, and ultimately enhancing health outcomes for beneficiaries across Ethiopia.

Special thanks to the oversight field visit teams, and to the leadership and colleagues of all Regional Health Bureaus, health facilities, and communities at every level for their active engagement, collaboration, and commitment throughout the visit.