A central feature of the sector is the priority given to the health extension programme, which delivers costeffective basic services that enhance equity and provide care to millions of women, men and. Ethiopia is the second most populous country in subsaharan africa, with a population of over 94. The management, coordination, and distribution of technical support in each and every level is the responsibility of. Inequality, maternal and child health services, primary health care, ethiopia. Oct 06, 1988 the governments approach to health care is based on an emphasis on primary health care and expansion of rural health services, but the ministry of health is allocated only 3.
Mengesha admassu, md, executive director, international institute for primary health care ethiopia. Jan 15, 2018 ethiopia to launch new primary healthcare guidelines january 15, 2018 ethiopian ministry of health announced plans to implement a new primary healthcare guideline to ensure uniformity and quality of health service delivery in all health centers and places across ethiopia. Primary health care in ethiopia 85 lower female than male literacy rates, allocation of household resources including food and resources for health care 14 and second, negative attitudes of many males and the various ethiopian religious institutions toward fertility control. The almaata declaration of 1978 identified primary health care phc as the.
Now it must build on these efforts by improving the quality of these services and prioritizing the hardesttoreach, most marginalized, populations. Despite the fact that maternal health care utilization is essential for further improvement of maternal and child health, little is known about the current magnitude of use and factors influencing the use of these services in ethiopia. Pdf a patientcentered understanding of the referral. Sustaining improvements to public health in ethiopia center. Transformprimary health care unit phcu research funding. The ethiopian health extension program and variation in. Ethiopia remained a predominantly rural country and about 86% of its population lives in rural areas. Ethiopia health sector transformation plan 2015162019. However, the status of practice and associated fac tors were not studied in ethiopia. Since july 2002, woreda health offices have borne the primary responsibility for health service deliver y.
Ethiopias path towards universal health coverage through primary health care. During the past decade, ethiopia undertook an ambitious investment in primary health care known as the ethiopian health extension program that recorded impressive gains in several health outcomes. Hcf health care financing hep health extension package hew health extension workers hf health facility. Ethiopia is a democracy with a federal system of government comprising 9 regions and two administrative councils.
Ethiopia is one of the largest of the developing countries in africa and it has features in public health which are common to all the underdeveloped countriesprevalence of communicable diseases and malnutrition, limited economic resources, numerous peasant agricultural communities, a large child. The development of the health sector was made possible by strong political commitment, a. In brazil, where health is a constitutional right for all citizens, the decentralized health care system using innovative family health teams has made gains in improving access but suffers from stagnant government funding. In 1978, the world health organization who adopted the declaration of almaata 1 2. Right to health, which also contains entitlements to prevention, treatment and control of diseases. Primary health care in ethiopia under three political systems.
Since 1995 ethiopia has been decentralizing functions, resources, and authority to the local level. When 8monthold bora shewki of ethiopias hamer woreda. Ethiopia health sector transformation plan 201516201920. A facilitybased crosssectional study was undertaken in 10 primary health care units and 10 private medicine outlets. Generally, there is no clear evidence on the effect of health care financing reforms on access to essential medicines in ethiopia. The primary care level is established on the district level or woreda level in amharic and includes a primary hospital, local health centers, and rural health posts. This decentralized primary system functions due to the implementation of health extension workers cews that can refer patients to health centers or the primary. Ethiopias health extension countrylevel programmes 2014 3 indicator ethiopia average life expectancy at birth years2 63 physicians per 1,000 population2 0. The primary mandate of the institute will be to provide shortterm trainings on primary health care tailored to the needs of health workers, health managers, as well as policy makers from ethiopia, other african countries and from the rest of the. Communitybased care in ethiopia the fmoh has invested heavily in developing a model for communitybased primary care that is feasible and sustainable in lowresource settings.
Ethiopia is one of the countries in the world which has adopted phc as a national strategy since 1976. The international institute for primary health care ethiopia iifphc e is closely monitoring the evolving covid 19 pandemic and is dedicated to providing users with the most uptodate information on the virus and related resources to support leaders, frontline workers, and communities in their response. International institute for primary health care in ethiopia iifphce organizational mandate. Ethiopia public health training initiative through a landmark partnership between the carter center and the government of ethiopia, the nation has created a system to help address the devastating health challenges it faces by dramatically expanding access to health care, especially in rural areas. Transforming health care in ethiopia the lancet global. Ethiopia is country that is very susceptible to drought, and malnutrition and lack of food can become a major cause of poor health and mortality. Health care delivery is not just a problem in low and middleincome countries. Reviewing ethiopias health system development jmaj 524.
Progress towards mdgs health care in ethiopia health. Primary public healthcare is aimed at the way to provide quality and reliable health service. Health management information system nmis jan 2008 national wash coordination office tor 2009. There was only one physician for every 30,000 people in the east african nation struggling to recover from years of famine and civil war. Deployed as pairs, the hews are premised to provide basic, largely preventive, primary health services to rural villages and empower families to take charge of their own health. The doctor surge in ethiopia healthcare in america. Wamai1 table 1 shows the key countrys health related demographic and socioeconomic indicators. These nurses are graduates of private nursing institutes that are blamed to inadequately train their students. In order to sustain the progress, the ethiopian governmenturged on by its most important external donor partner, the.
Ethiopia chalks up its success to an equitybased primary health care. Community health extension program of ethiopia, 20032018. In the past two decades, the government of ethiopia has invested heavily in health system strengthening guided by its propoor policies and strategies resulting in significant gains in improving the health status of ethiopians. These are the essential health services designed to be provided to every community. Background primary health care services are fundamental to improving health and health equity, particularly in the context of low and middleincome settings where resources are scarce. Pdf primary health care in ethiopia under three political. Measuring eficiency of public health centers in ethiopia. Jan 12, 2010 dr gebreab barnabas, head of the regional health bureau in tigray province, talks to one about a primary health care programme in ethiopia. The impact of ethiopian health services extension program. Aug 18, 2016 the massive brain drain gutted ethiopias healthcare system because the country only had three medical schools graduating 120 doctors annually. Learn the important milestones in the health care evolution in ethiopia. A patientcentered understanding of the referral system in ethiopian primary health care units article pdf available in plos one 1010. Unofficial draft national protocol for hygiene and onsite sanitation, dec. It is the tenth largest country in africa, covering.
Health policy of ethiopia 1993 cmp cowash ethiopia. The development of the health sector was made possible by. In addition, health service delivery was inefficient and inequitable, and quality of health care was generally poor. The practice of essential nutrition actions in healthcare. Pdf community health extension program of ethiopia, 20032018. Mar 02, 2016 ethiopia has made rapid, impressive progress in rolling out basic health care to its 95 million citizens. The primary health care unit phcu comprises five satellite hps the lowestlevel. Health sector development program iv 201011 phe ethiopia.
Conceptual framework for the hepcaps health care finance projection model. In order to sustain the progress, the ethiopian governmenturged on by its most important external donor partner, the united statesmust. Ethiopia public health training initiative carter center. Kesete birhan admasu, md, mph, minister of health, ethiopia. To judge from recent news stories, 2015 has not been a good year for ethiopia. This could be because health care financing reforms, especially health insurance, are a new phenomenon for the countrys health care system. Sustaining improvements to public health in ethiopia. The health extension program of ethiopia harvard health. The declaration also defined eight essential components of primary health care, which helped outline a means of. Pdf ensuring health care equity in ethiopia researchgate. Of particular importance is the role that education plays in determining health outcomes in ethiopia. International institute for primary health care ethiopia.
And the government was widely criticised in june when the ruling peoples revolutionary democratic front party won an unlikely 100% of parliamentary seats in the general election. Access to essential medicines in primary health care units. Dr gebreab barnabas, head of the regional health bureau in tigray province, talks to one about a primary health care programme in ethiopia. The massive brain drain gutted ethiopias healthcare system because the country only had three medical schools graduating 120 doctors annually. Ethiopia is one of the largest of the developing countries in africa and it has features in public health which are common to all the underdeveloped countriesprevalence of communicable diseases and malnutrition, limited economic resources, numerous peasant agricultural communities, a large. Taking this fact into consideration, presently in ethiopia there are freeservice fs nurses, who are working in the health system without payment. Transforming ethiopias health care system from the ground up. The first wave of decentralization resulted in the fmoh, regional health bureaus rhbs, and woreda health offices sharing the decisionmaking about. The health care financing reform strategy, recognizing that health care should be financed through multiple mechanisms to ensure longrange sustainability, underscored the importance of promoting costsharing in the provision of health services.
Ethiopia has made rapid, impressive progress in rolling out basic health care to its 95 million citizens. Transforming ethiopias health care system from the ground. Primary health care in ethiopia under three political. The pre1991 period refers to the political structure where the power of decisionmaking completely remained in the hands of the central unitary government. International institute for primary health care in. The primary level of care includes primary hospitals, health centres hcs and health posts hps. Measuring eficiency of public health centers in ethiopia executive summary ethiopias health sector over the last 20 years has seen unprecedented expansion particularly for its primary health care phc system. Our findings suggest that socioeconomic characteristics of the individual are strongly correlated with health outcomes. This strategy focuses on fair access to health services by all people throughout the country, with special emphasis on prevention and the control of common diseases, selfreliance and community participation. Deployed as pairs, the hews are premised to provide basic, largely preventive, primary health services to rural villages and. Health in ethiopia has improved markedly since the early 2000s, with government leadership playing a key role in mobilizing resources and ensuring that they are used effectively. There was only one physician for every 30,000 people in the east african nation struggling to. Health information systems his is potentially very important for the development of the health sector in ethiopia. Health sector development programme iv of 201011201415 has been completed but is yet to be evaluated exhaustively.
Table 2 respondents for gavihss tracking study in ethiopia, june 2009. Gain a basic level of proficiency identifying ethiopians who have played a pivotal role in the evolution of ethiopian medical history. Gain an understanding of how hospitals, medical schools, public health, nursing, pharmacy and postgraduate training evolved. Thus, most primary schools are located in rural areas and moe 2012 reported that 81% of primary school students are rural. Health sector development program iv 201011 201415.
By design, the hep combines the overall capacity of the country with community. Primary health care in ethiopia 85 lower female than male literacy rates, allocation of household resources including food and resources for health care14 and second, negative attitudes of many males and the various ethiopian religious institutions toward fertility control. The 1st health legislation issued in 1930 ethiopian health care system history 10. Free medical care for the needy was introduced in 1977. In this section you will learn about the elements or functions of phc box 1. Aug 29, 2012 health care delivery is not just a problem in low and middleincome countries.
Michael klag, md, mph, dean, johns hopkins bloomberg school of. The comparative examination of the decentralized and democratized rebel health care systems in eritrea and tigray also brought into focus the primary health care in ethiopia 519 inconsistencies in the ethiopian system between sta ted policies and prevailing strategies and identified factors conducive to participatory primary care development. The impact of ethiopian health services extension program on. International institute for primary health care in ethiopia. It has seen the countrys worst drought since the dark days of 198485.
The governments approach to health care is based on an emphasis on primary health care and expansion of rural health services, but the ministry of health is allocated only 3. Important guidelines for printing and photocopying limited permission is granted free of charge to print or photocopy all pages of this publication for educational, notforprofit use by health care workers, students or faculty. Center, the ethiopia ministry of health, and the ethiopia ministry of education. The whos mental health gap action programme seeks to narrow the treatment gap for mental disorders by advocating integration of mental health into primary health care phc. This study aimed to assess the challenges and opportunities of this approach from the perspective of phc workers in a subsaharan african country. The secondary and tertiary levels are comprised of general and specialized hospitals, and the coverage of each extends to larger portions of the population. Thus, this study aimed to assess the practice of essential nutrition actions and factors associated with it in healthcare deliveries of she. Thus, there is a clear need for wellorganized research on the issue. Ethiopia to launch new primary healthcare guidelines. August 29, 2012 there are currently more ethiopian doctors working in chicago than in ethiopia, according to keseteberhan admassu, the countrys state minister of health. Over the past decade, ethiopia has achieved dramatic progress in improving the health outcomes of its population. Ethiopia has 3 medical schools at addis ababa, gondar, and the jimma institute of health sciences. Rather, it was articulated in the 1946 constitution of the world health organization. Speaking to an international group of experts assembled by harvard school of public health s hsph department of global health and population and yale global health leadership institute ghli, admassu described the.
Ethiopia public health training initiative through a landmark partnership between the carter center and the government of ethiopia, the nation has created a system to help address the devastating health challenges it faces by dramatically expanding access to. The graphic above depicts the threetier structure of the ethiopian health system. Ethiopia built a new hospital at gore and a 500bed hospital in harer was completed. Nha shows ethiopias health care financing reforms have yielded tremendous achievements. Utilization of maternal health care services in ethiopia. Challenges of maternal health services utilization and provision. A mobile clinic comes to the rural village in the video above to weigh all the children on a monthly basis.
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