Other organizations that work in ethiopia include unicef, united nations, and other private charities. Ethiopia health sector transformation plan 201516201920. Key words hstp quality and equity universal health coverage. Strengthening human resources for health in ethiopia introduction the strengthening human resources for health hrh is a fiveyear 2012 2018 health systems strengthening project that is working to build local capacity for the development of systems to manage human resources for health, improve the. In accord with these principles and practices the federal ministry of health fmoh has integrated spm into its procedures and is reengineering the ministry itself using bpr methodology. Ethiopian health system health care in ethiopia health. As a result, ethiopia has done remarkably well in meeting most of the mdg targets. Fmoh bases its activities on the implementation framework of the health sector development program hsdp, which has had three successive strategic plans. 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. The reforms 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.
This paper explores the complementarity of two different reform processes in ethiopia that began in the 2000s. The process of decentralisation in ethiopia since 1991. Reviewing ethiopias health system development jmaj 524. Pdf strengthening health systems by health sector reforms. Freedom house has rated ethiopia as not free since 2011. However, health sector reform is not a concept that demands a single global definition 2, 3. Many programs and projects using the term health sector reform as a label do not meet these criteria. The cases of mexico, vietnam, and china all fall into this category. Aug 11, 2016 32 health sector transformation plan ethiopia is on track in achieving the mdg 6 target of universal access to treatment of hivaids by having 344,344 plwhiv were currently on art by the end of efy 2006 out of the target of 431,644 who need art, with achievement of 79. The cwgpa was a direct outcome of the fifth commonwealth ministers for public service. Health sector reform should refer to substantial strategic change efforts that are built on a strong evidence base and logical framework for health system change, i. By the end of 2002, a compulsory social health insurance programme targeting all poor households and selected.
Health and health care in south africa 20 years after mandela. Ethiopia health sector transformation plan global financing facility. In an effort to protect citizens from catastrophic effects of the clearly high share of outofpocket expenditure, the government is currently working to introduce health insurance. Health sector reform and sexual and reproductive health, publisher. Womens health project, school of public health, university of the witwatersrand, johannesburg. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Could different policy reforms have reinforcing impacts on gender equality. We are committed to improving health systems by strengthening human resources, expanding health financing options, and increasing health commodity and essential drug availability. Health sector reforms can be defined as sustained, purposeful changes to improve the efficiency, equity, and effectiveness of the health sector. Performance of the health sector development programme hsdp situational.
In ethiopia, the public sector remains a major recipient of health sector resources. Module 1 world health organization regional office for africa v foreword health systems in africa are undergoing considerable change, often in a context of ongoing health sec tor reforms. Ethiopia is a democracy with a federal system of government comprising 9 regions and two administrative councils. Exploring the potential of distribution services, identifies key challenges in ethiopias economy and proposes. The graphic above depicts the threetier structure of the ethiopian health system. Health sector reform international health systems program. Since the hivaids epidemic arrived in ethiopia, attitudes toward the disease as well as the opportunities for treatment and a healthy life have changed dramatically.
The health sector transformation plan hstp federal democratic republic of ethiopia, ministry of health. Ethiopia science and technology commission estc 1975 with the increasing number of training and research institutes, the effort in health research increased, both in volume and in the variety of fields. Building on the lessons learned in implementing the earlier plans and to be highly responsive to the current socioeconomic landscape, the government of ethiopia has developed health sector transformation plan hstp, which is part of the second growth and transformation plan gtp ii. Since 1990, the ethiopian government has allocated much funding to its health sector in order to reform its programs. The commonwealth key principles of public sector reform were recommended and endorsed by the commonwealth working group on public administration cwgpa, which met on 2728 november 2014 in london. Pdf critique of ethiopias pm abyis new homegrown policy. Ethiopian public health association epha, addis ababa, ethiopia. Based on the definition above, by fundamental change, the reform should be purposeful. The government of ethiopia has demonstrated its political committment to fight neglected tropical diseases. Health and health care in south africa 20 years after. Jul 18, 20 despite the contribution of the reform efforts in reshaping and restructuring the public sector for the better socioeconomic development of post dergue ethiopia, there have been a syndrome of on. Presenter moderator dr m a bashar dr tarundeep junior resident assistant professor 2. During this period, our country has made huge strides in improving access to health services and improvements in health outcomes.
Health facility governance in the ethiopian health system. The 2014 national health accounts nha report 20102011 indicates private providers forprofit and nonprofit are concentrated in urban areas where less than 20% of the population lives and receive only 16% of the total national expenditure on health. The infant mortality rate is almost twice that of the world. The health system in ethiopia has to be revaluated because of an upcoming shift in disease patterns in the epidemiological transition. National report of ethiopia sustainable development. Accelerate reform of the criminal justice system and the security sector to make them independent of political control and influence. In most countries, decentralization of health services is very central to these changes, and. Ethiopia among the least privileged nations in the world. Our study showed three general health system reforms across. Beyond the health care reform in ethiopia, there have been debates on implications. Available records indicate that no less than 5,000 health and health related publications and documents are issued in ethiopia. Especially after world war ii, tourism, banking, insurance, and transport began to. Health service delivery in ethiopia is characterized an inadequate number of welltrained health providers, limited health infrastructure and shortages of finance, equipment, and supplies. Health sector development program iv 201011 201415.
Apr 19, 2015 health sector reforms prersentation 1. Only major cities have hospitals with fulltime physicians, and most of the hospitals are in addis ababa. Ethiopia health sector transformation plan 2015162019. The current ethiopia health care financing strategy focus on financing of primary health care services in a sustainable manner. Health institutions and services the low life expectancy in ethiopia is the result of poor health, especially in infancy and childhood. A lowincome country, ethiopia has made impressive progress in improving health outcomes. Implementing health care reform journal of global health. It envisions reaching universal health coverage by 2035. Ethiopian hospital reform implementation guideline free. Enabling policy and legal environment that enhances the business processes in the health sector. According to the head of the world banks global hivaids program, in 2007 ethiopia had only 1 medical doctor per 100,000 people. Offices at different levels of the health sector, from the federal ministry of health fmoh to rhbs and woreda health offices, share decisionmaking processes, powers, and duties where fmoh and the rhbs focus more.
Especially after world war ii, tourism, banking, insurance, and transport began to contribute more to the. Ethiopia universal health coverage for inclusive and. In the ethiopian health system, some public health services have been provided to all citizens free of charge regardless of level. Dec 28, 2012 most of the health care system reforms in developing countries focus on demandside intervention, mainly realised by the introduction or extension of social health insurance. Strengthening health systems by health sector reforms.
This is but just a dream, however, for the typical ethiopian. Ethiopia ministry of health, and the ethiopia ministry of education. The prioritized initiatives are mobilizing adequate resources mainly from domestic sources, reducing outofpocket spending at the point of service use, enhancing. The findings confirmed that the hospitals gave free services for. Reforms o fundamental rather than an incremental change, which is sustained rather than one off, and also purposive cassels1997 19042015 249 3. One of the issues high on the agenda is health care financing. Ethiopian hospital reform implementation guideline pdf the federal ministry of heath has been leading a sector wide reform effort aimed. Training of dhmts in health management has been going on for some time. Ethiopia is a country of genuine strategic importance. Terry gakuruh this chapter provides an overview of the health system in kenya as a context in which to view the find. Ethiopia health insurance pacific prime international. Public sector, reforms, africa, new public management, public administration, donors i.
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. Conclusion s the ethiopian health care reform has laid the. Ethiopia has unveiled its sustainable and integrated development planning documents, the 5year growth and transformation plan and the climate resilient green economy strategy that shaped the content of this report. The latest economic update, the inescapable manufacturing services nexus. Better health is a key to individual happiness and a countrys development.
The secondary and tertiary levels are comprised of general and specialized hospitals, and the coverage of each extends to larger portions of the population. These reforms were usually embedded in a set of government reforms intended to improve the efficiency, equity of access, and quality of public services in general. Feb, 2014 the potential and actual impact of health sector reform on health systems has been highlighted in several studies 14. Ethiopia italian contribution to the health sector. Health extension workers in ethiopia provide family planning, maternal and child health, and nutrition services in communities across the country.
Health policy and systems research who world health. Home to more than 100 million people and with high population growth rates, it is projected to be among the worlds 10 most populous countries by 2050. Among the important features of the economic reform in ethiopia is empowering women through the. Ethiopias health care system includes primary health centres, clinics, and hospitals. The production and export of cash crops such as coffee were advanced, and importsubstituting manufactures such as textiles and footwear were established. Despite the contribution of the reform efforts in reshaping and restructuring the public sector for the better socioeconomic development of post dergue ethiopia, there have been a syndrome of on. This resulted in improvements in mortality rates and life expectancies. Addis ababa, june 11, 2018 in its latest economic update for ethiopia, the world bank group provides answers to several key questions what role can the services sector play in ethiopias economy. What reform priorities should ethiopia pursue in the service sector and how can they be achieved while maintaining a more sustainable economic growth rate. Federal ministry of health ethiopia population, health, and. Health sector transformation plan foreword by the minister of health ethiopia has implemented successive health sector development plans hsdps since 1997 in four phases.
Overview of the health system in kenya chapter 2 overview of the health system in kenya dr. 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. Therefore, this material should be regarded as an introduction to health economics rather than to economics. Introduction almost all african countries are carrying out some form of public sector reform. Ethiopia universal health coverage for inclusive and sustainable development. Like other developing countries in asia, outofpocket expenditure is the dominant source of health financing in vietnam. 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.
Beyond the health care reform in ethiopia, there have been debates. An event organized by an abt associatesled project in ethiopia and the countrys federal ministry of health jumpstarted a dialogue among a wide range of stakeholders on the issues of publicprivate partnerships ppps in health, health regulations, and financing in the health sector. Health infrastructure and the health extension program expanded significantly under the health sector. Health system reforms in five subsaharan african countries that. However, the world health organization in its 2006 world health report gives a figure of 1936 physicians for 2003, which is about 2. Ethiopian dialogue on supporting the private health sector. Wamai1 table 1 shows the key countrys health related demographic and socioeconomic indicators. Access to modern health care is very limited, and in many rural areas it is virtually nonexistent. The management, coordination, and distribution of technical support in each and every level is the responsibility of.
The police and courts have routinely been used to level spurious and politically motivated. Critique of ethiopias pm abyis new homegrown policy 2019. This means that, due to economic development, the burden of disease shifts away from communicable diseases like. Health economics as a course is meant to give medical, health officer and other paramedical students basic principles regarding economics and its application to the health sector. Hstp is also the first phase of the 20year health sector. Reconsidering civil service reform in ethiopia devex. Ethiopias economy depends heavily on the agricultural sector. More detailed information about the ethiopian health sector and how it is funded can be found in results and effectiveness paper on the various funding modalities in the ethiopian health sector january 20. Pdf background understanding the way health care reforms have. Under haile selassie i reigned 193074, ethiopias economy enjoyed a modicum of free enterprise. There were 119 hospitals 12 in addis ababa alone and 412 health. The process of decentralisation in ethiopia since 1991 7 southern ethiopian peoples democratic front sepdf, to a more cohesive political force in which the major regions are now governed by eprdfallied parties. As for the provider payment method, ffs is still widely used in practice.
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