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 mfi country scan final report page 2 of 41 preface the ethiopia country scan presents an overview of the current state of the ethiopian microfinance sector and will serve as the basis for shaping the future microfinance investment strategy in ethiopia under the auspices of microned. This is but just a dream, however, for the typical ethiopian. In ethiopia, the public sector remains a major recipient of health sector resources. Diaspora engagement projects in the health sector in africa.
Health facility governance in the ethiopian health system abstract health governance one of the pillars of a health system has received appreciable attention from the ethiopian health sector over the past decade. An ehand book for leaders and managers is not a product of, nor is it endorsed by, microsoft corporation. The health sector transformation plan hstp federal democratic republic of ethiopia, ministry of health. She helps to guide usaidethiopia s participation and technical contributions to the education sector. The ethiopian hospital services transformation guidelines ehstg build on and expand the ethiopian hospital reform implementation guidelines ehrig and are consistent with the health sector transformation plan hstp. However, the quality of care has been lagging behind. In mid2011, the government of ethiopia launched a pilot communitybased health insurance cbhi scheme in thirteen rural districts. There were 119 hospitals 12 in addis ababa alone and 412 health centers in ethiopia in 2005. Health sector reforms and district health systems unit 1 health policy, strategies and reform. The second growth and transformation plan gtpii of the wash sector, which is covering the period from mid2016 to mid2020, is thus designed to meet this national development objective. Healthcare industry is synonymously known as medical industry or health economy. The capacity development resource guides highlight the key technical areas of expertise needed to effectively influence health policy design, implementation, and monitoring and evaluation.
Urban water providers have been effectively capitalized in order to take on system improvements and capacity building initiatives. Moving towards universal health coverage in ethiopia. Esdp, the health sector development plan hsdp, industrial strategic plan, etc. The urban subsector ethiopias urban subsector has experienced the most benefit from the countrys concerted efforts to reform the wss sector. The overall purpose of the project is to contribute to the government of ethiopias and usaids.
Background the ethiopian health care system is under tremendous reform. The hapn office is currently comprised of four teams. Health facility governance in the ethiopian health system. 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. Challenges and opportunities by teresa curristine, zsuzsanna lonti and isabelle joumard this article examines key institutional drivers that may contribute to improving public sector efficiency and focuses on one of them in more. The health policy of the transitional government is the result of a critical examination of. Our study showed three general health system reforms across all five countries that. Ethiopias development plan entitled a plan for accelerated and sustained development to end poverty pasdep is a fiveyear 200506200910 strategic framework that guides overall development activities in. The study was designed as a facilitybased crosssectional survey of healthcare professionals and carried out in all public hospitals in. 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.
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. There are many reasons why women do not use health services in ethiopia. Ethiopia is the secondlargest refugeehosting country in africa. Pdf strengthening health systems by health sector reforms. Weakness of primary healthcare phc systems has represented a challenge to the achievement of the targets of disease control programmes dcps despite the availability of substantial development assistance for health, in resourcepoor settings.
In spite of some efforts to make the health care system integrated with information systems, it continues to be not welldeveloped in the nations health sector. The study concludes that decentralization in the health sector is likely to be more. In only a few cases, however, do countries appear to have received timely private sector development psd support for health or specific support toward health ppps. Ethiopian health system health care in ethiopia health. The banks role in the roads sector has been that of a lead donor with substantial influence at all levels of capacity and funding earmarked for specific capacity building activities. Aug 29, 2012 the objective was to provide the ethiopian delegation with the opportunity to learn from health leaders from other low and middleincome countries that have successfully managed primary care system reform efforts of their own. Ethiopia has made significant health gains in recent years, such as lowering infant mortality, but more work needs to. Recently, many wellfunded agricultural programs have been developed to improve nutrition. As part of this reform, health facilities throughout the country have been streamlining their. 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.
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. Stronger health systems are needed to promote health equity, deliver e. In education, aed has pioneered work on girls education and on educational reform. Since 2005, ethiopia has embraced a diagonal investment approach to strengthen its phc systems and concurrently scale up dcps. Among others, the aims of the scheme are to increase access to health care and to reduce household vulnerability to unexpected outofpocket health expenditure. Healthcare involves diagnosis, prevention, cure and rehabilitation of patients affected by one or more health disorders. This paper draws on results from nationally representative health facility studies conducted in ethiopia in 2008 and 2014. Other key documents that guide community health in ethiopia are the essential health services package for ethiopia, which defines hep services and where they should be delivered. Following the successful implementation of ethiopias first generation prspthe sdprp the government has prepared a successor development plan entitled a plan for accelerated and sustained development to end poverty pasdep. The usaid ethiopia office of health, aids, population and nutrition hapn is responsible for the design, implementation and oversight of all usaidfinanced health activities in support of the ethiopian health sector transformation plan hstp. The cwgpa was a direct outcome of the fifth commonwealth ministers for public service. Health sector transformation plan global financing facility. Publications on ethiopia available in pdf format include. Ministry of health, the regional health bureaus rhbs, and at the woreda level to achieve the results required in the child health and health sector reform project, known locally as the essential services for health in ethiopia eshe project.
The reform of ethiopias essential health services package, initially defined in 2005, is one of the most important steps towards the goal. A decade of progress providing safe abortion services in. Impact of ethiopias community based health insurance on. States not represented here run their own marketplaces.
This is being done through a combination of strategies and approaches, including. For 2017 health plan information for individuals and families, visit this page. Therefore, this study investigated the status of the quality of delivery services in northern ethiopia. Health institutions and services the low life expectancy in ethiopia is the result of poor health, especially in infancy and childhood. Effectiveness and sustainability of a diagonal investment. Today, ethiopia is home to 916,678 refugees primarily from eritrea, south sudan, somalia, and sudan. Wamai1 table 1 shows the key countrys health related demographic and socioeconomic indicators. In health and education sectors, by contrast, the bank has fitted its support into. In ethiopia, lack of proper management of medical equipment has limited the capacity of health institutions to deliver adequate health care. Ethiopias federal ministry of health fmoh has been leading a sectorwide reform effort aimed at significantly improving the quality and accessibility of services at all levels of the countrys decentralized health system. Health sector reform is a sustained process of fundamental change in policies and institutional arrangements of the health sector 1, usually guided by the government. It has maintained an opendoor policy toward refugees since the 1990s. The usaidethiopia office of health, aids, population and nutrition hapn is responsible for the design, implementation and oversight of all usaidfinanced health activities in support of the ethiopian health sector transformation plan hstp.
Enabling policy and legal environment that enhances the business processes in the health sector. Ethiopia health sector transformation plan 201516201920. Ethiopia health sector federal ministry of health case study page 3 of 22 this case study primarily focuses on the recalibration of the fmoh scorecard in 2009 provided by the bill and melinda gates foundation in 201120, the ministry of health began cascading the strategic scorecard throughout all levels of the health sector. She manages usg programs and coordinates policy development and implementation of sector strategies with the goven11nent, key donors, other usg agencies and civil society, as necessary. Reproductions supplied by edrs are the best that can be. Reviewing ethiopias health system development jmaj 524. Clement jafani nabare, a ghanaian health specialist residing in germany, demonstrates the use of. The most famous unknown people in the world stephen mansfield tedxnashville duration. While healthcare reform has been a central attention for local governments, its impact on job satisfaction is poorly understood. Hsdp implementation, the moh developed several policy documents such as the. The table below lists 2018 individual and family health plans available in states where the federal government is operating the marketplace.
Cse conservation strategy of ethiopia csrp civil service reform program csw commercial sex workers dag development assistance group dhs demographic health survey. Ethiopian hospital reform implementation guidelines. Hp health post hsdp health sector development programme. Ethiopia is a democracy with a federal system of government comprising 9 regions and two administrative councils. The centers activities focus on assisting the implementation of the health extension package hep in ethiopia, coordinating the efforts for achievement of the millennium development goals for ethiopia, coordinating the malaria quick impact initiative for africa, and coordinating the millennium villages project in ethiopia. Transforming ethiopias health care system from the ground up. Health sector transformation plan foreword by the minister of health ethiopia has implemented successive health sector development plans hsdps since 1997 in four phases.
Who in the african region ethiopia making people healthier. Beyond the health care reform in ethiopia, there have been debates on. In 2009, ethiopia partnered with the clinton health access initiative and the yale global health leadership institute to develop national guidelines for the management of hospitals. During this period, our country has made huge strides in improving access to health services and improvements in health outcomes. Almost 95% of children now enter primary school, and health service has expanded enormously through 38,000 health extension workers. Health systems in action management sciences for health. One of the issues high on the agenda is health care financing.
Ethiopia is party to international instruments upholding gender equality and the rights of women and. It is one of the fastest emerging industries of the globe involving. We are committed to improving health systems by strengthening human resources, expanding health financing options, and increasing health commodity and essential drug availability. Health system reforms in five subsaharan african countries that. Usaid ethiopia vacancy announcement sr pediatric advisor. A national system for monitoring the performance of hospitals. The district health management training modules have been developed to cover four major areas. At least two weeks should be set aside for module 4. The ehstg, which is consistent with the national focus on. Through the leadership of the federal ministry of health fmoh, the health sector has various coordinating mechanisms. It is estimated that only 72% of medical equipment found in addis ababa public hospitals are functional and in some hospitals in the regions functional equipment are near to 50%. Country development cooperation strategy 2011 2018. Putting the health of children and mothers first 4.
The reforms introduced include implementing revenue retention and use at health facility level, systematizing a feewaiver system for the poor, standardizing. Working with governments and the private sector aed has supported programs that saved millions of children from illness and malnutrition. The implementation of these reform initiatives was legalized through regional legislations and operationalized in line with. Kesetebirhan kesete admasu is a medical doctor and public health specialist who was the minister of health of ethiopia between november 2012 and 2016. The ethiopian government undertook a number of fundamental reform measures to address the main health problems and to meet the high unmet demand for health care in rural areas. This study documents the achievements and challenges of three major reforms in. Intrinsic motivations and the nonprofit health sector 2010 working paper. Various legal and regulatory reforms in all sectors have been implemented to. Federal democratic republic of ethiopia ministry of health health sector development program iv 201011 201415 final draft october 2010. Available records indicate that no less than 5,000 health and health related publications and documents are issued in ethiopia. The health sector transformation plan, in line with our countrys second growth and transformation plan gtpii, has set ambitious goals to improve equity, coverage and utilization of essential health services, improve quality of health care, and enhance the implementation capacity of the health sector at all levels of the system.
Ethiopian public health association epha, addis ababa, ethiopia. Policy and programmatic interventions prior to 2008, the health sector was the lead in tackling malnutrition in ethiopia, which joined the sun movement in 2010. Ethiopia is currently undertaking its development endeavour aiming to become a middleincome country level economy by the year 2025. The data come from three sources at two points in time. The role of icts in the health sector of developing countries a framework paper 31 may 2006 improving the health of individuals and communities, and strengthening health systems, disease detection and prevention are crucial to development and poverty reduction. Ethiopia health sector federal ministry of health case study. Improving quality and equity abstract ethiopia endorsed a health care financing strategy in 1998 that envisioned a wide range of reform initiatives. A facility based survey was conducted from december 2014 to february 2015 in. The hstp builds on the success of a series of health sector reforms in ethiopia since 1997. Despite the national efforts to change health system delivery, women in ethiopia still do not seem to seek access or use services, as depicted in the table below. Ethiopian health sector development programme hsdp iii.
These efforts translated into a rise in public spending on health from 0. This study aimed to determine the impact of healthcare reform on job satisfaction in the public healthcare sector in ethiopia. Business roundtable commissioned hewitt to prepare this report to evaluate health care reform through the lens of the private sector and to project the likely effect of proposed legislative changes on employer health care costs. It was reported that he left the government after declining a new nonhealth cabinet ministerial portfolio during a cabinet reshuffle in november 2016. After decades of institutional neglect of the health sector, recent efforts have been made to improve the health status of the population. Among the important features of the economic reform in ethiopia is empowering. The government of ethiopia endorsed the mps strategy which is aimed at strengthening the. Reform strategy to reach its goals in a system in which it lacked centralized budget control, ethiopias health ministry had to focus on guiding the countrys nine governing regions and two chartered citiesaddis ababa and dire dawa. As a result, ethiopia has done remarkably well in meeting most of the mdg targets. Health information systems his is potentially very important for the development of the health sector in ethiopia. The ehstg, which is consistent with the national focus on quality. In relation to sector reform, over recent years ethiopia has.
The pasdep adopted by the government in 200506 exploits the progress made during the implementation of sdprp. Health sector development program iv 201011 201415. Prepared for the office of the assistant secretary for planning and evaluation, united states department of health and human services. Implementing health care reform journal of global health. Health sector transformation plan hstp 201516201920. The studies covered topics including reform of provider payment, organization of social health insurance, selection of health benefits, drug regulation and pricing and the training and skill mix of health workers. A national system for monitoring the performance of. Quality of the delivery services in health facilities in. Globalization is said to affect the country, with many educated professionals leaving ethiopia for a better economic opportunity in betterdeveloped countries. Sector transformation plan hstp 20162020, which aligns to the countrys economic growth and development plans.
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