Ethiopia, a country known for its rich history and cultural heritage, is also making significant strides in improving the health and well-being of its population. With over 110 million people, Ethiopia is the second-most populous nation in Africa and has one of the fastest-growing economies on the continent. This article delves into the structure, achievements, and ongoing challenges of the Ethiopian health system, making the information accessible and engaging for a broad audience.
Ethiopia’s landscape is as diverse as its population, ranging from towering mountains to deep river valleys. The country’s highest peak, Ras Dashen, stands at 4,620 meters, while the Danakil Depression dips to 148 meters below sea level. This geographical diversity is mirrored in the country’s demographic profile, where a predominantly young population resides mostly in rural areas. With a total fertility rate of 4.6 births per woman, Ethiopia’s population is projected to reach 122.3 million by 2030.
Remarkable Health Achievements
Over the past two decades, Ethiopia has made impressive progress in health outcomes:
- Increased Life Expectancy: Life expectancy has risen from 57 years in 2000 to 67 years in 2020.
- Reduced Maternal Mortality: Maternal mortality has decreased from 871 deaths per 100,000 live births in 2000 to 401 in 2019.
- Lower Under-5 Mortality: The under-5 mortality rate has fallen from 123 per 1,000 live births in 2005 to 59 in 2019.
These achievements reflect the country’s dedication to improving health services and outcomes for its citizens.
The Health System Structure
Ethiopia’s health system is organized into three tiers to ensure comprehensive care:
- Primary-level care: This includes health posts, health centers, and primary hospitals. Health posts focus on preventive care and minor treatments, referring more complex cases to health centers.
- Secondary-level care: General hospitals provide a wide range of services and act as referral centers for primary hospitals.
- Tertiary-level care: Specialized hospitals serve as referral centers for general hospitals, offering advanced medical care.
Strategic Health Plans
Ethiopia’s commitment to health is embodied in its strategic health plans, with the latest being the Health Sector Transformation Plan II (HSTP-II) for 2020–2025. The plan focuses on:
- Accelerating progress towards universal health coverage.
- Protecting people from health emergencies.
- Transforming districts (woredas).
- Improving the health system’s responsiveness.
Key strategic directions include quality and equity, an information revolution, a motivated health workforce, leadership, and health financing.
Human Resources in Health
Despite progress, the density of health professionals in Ethiopia remains below the Sustainable Development Goal (SDG) threshold, with only 1.23 doctors, health officers, nurses, and midwives per 1,000 population as of 2021–22. Efforts are ongoing to increase the number of health workers to meet the growing demands of the population.
Health Financing
Ethiopia has significantly increased its health expenditure, from USD 3.1 billion in 2016–17 to USD 3.62 billion in 2019–20. However, per capita health expenditure remains low at USD 36.3, compared to the World Health Organization’s (WHO) recommendation of USD 86 for essential health services. To address this, Ethiopia is expanding its community-based health insurance program to reduce out-of-pocket expenses for its citizens.
Expanding Health Infrastructure
To improve access to healthcare, especially at the primary care level, Ethiopia has invested heavily in expanding its health infrastructure. By 2021–22, the country had 17,534 health posts, 3,673 health centers, and 400 hospitals. This expansion aims to bring healthcare services closer to the population, particularly in rural areas.
Advancing Health Information Systems
Ethiopia has embraced modern health information systems, adopting the District Health Information System (DHIS2) as its national reporting platform. This has greatly improved data quality, usage, and governance, achieving over 90% reporting completeness.
Engaging the Community
Community engagement is a cornerstone of Ethiopia’s health strategy. The Health Extension Program and the Women’s Development Army (WDA) are key initiatives that promote health literacy and community involvement in health matters. These programs empower communities to take charge of their health, fostering a collaborative approach to healthcare.
Ethiopia’s health system has come a long way, achieving significant milestones in improving health outcomes and expanding healthcare services. However, challenges remain, particularly in increasing health workforce density and health financing. With its strategic health plans and community engagement initiatives, Ethiopia is well on its way to achieving universal health coverage and ensuring that no one is left behind. As the country continues to grow and develop, its health system will play a crucial role in shaping a healthier future for all Ethiopians.
For more detailed information, you can access the full report: Ethiopia Service Provision Assessment 2021–22 Final Report. or visit the Ethiopian Public Health Institute at EPHI Website
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