The double burden of tuberculosis tb and diabetes mellitus dm is a significant public health problem in low and middle income countries. In addition, health service delivery was inefficient and inequitable, and quality of health care was generally poor. Nha shows ethiopia s health care financing reforms have yielded tremendous achievements. Wamai1 table 1 shows the key countrys health related demographic and socioeconomic indicators.
Ehealth the costeffective and secure use of information and communications technologies in support of health and healthrelated field, including health care services, health surveillance, health literature, and health education, knowledge and research. Health economics and financing course ethiopia 2016. Primary health care gained the worlds attention after. Improving health care financing in ethiopia report dire international hotel, adama, ethiopia saturday, 07 june 2014 this report was prepared by technology transfer and research translation directorate, at the ethiopian public health institute this policy dialogue was informed by the following policy brief. A focus in quality and equity requires a shift in the status quo to drive improvements at national scale over the next five years. Often, as in ethiopia, this level of healthcare is free for people living in rural areas. Health service delivery in ethiopia is characterized an inadequate number of welltrained health providers, limited health infrastructure and shortages of finance, equipment, and supplies. Institute for health metrics and evaluation ihme 4,617 views 1.
There were 119 hospitals 12 in addis ababa alone and 412 health. The capacity development resource guides highlight the key technical areas of expertise needed to effectively influence health policy design, implementation, and monitoring and evaluation. Hsfrhfg, led by abt associates, has been the lead partner supporting ethiopias roll out and implementation of health care financing reforms at the national, regional, district or woreda and health facility levels. Ethiopia health sector federal ministry of health case study page 2 of 22 the decision back in ethiopia, minister tedros convinced the ministry leadership that a balanced scorecard was a higher priority for funding than competing initiatives. Public disclosure authorized program in ethiopia the. The course aims to share knowledge and policy experience on how health systems can improve equity in the financing and delivery of health care services for mother, newborn and children by exposing the participants to key theoretical and empirical knowledge in the field of health financing and equity. The reforms the health care financing reform strategy, recognizing that health care should be financed through. Background the ethiopian health care system is under tremendous reform. E health the costeffective and secure use of information and communications technologies in support of health and health related field, including health care services, health surveillance, health literature, and health education, knowledge and research. Progressivity of health care financing and incidence of. A broad spectrum of stakeholders met in addis ababa, ethiopia, from june 2024, 2011 to share the health policy projects hpp gap tool for financing family planning. Between 1986 and 1996, government financing grew from 23% to 43% of total health care financing in ethiopia. Health care financing continues to be a challenge in many developing countries.
Community health extension program of ethiopia, 20032018. In order to tackle these challenges, the government launched a propoor health policy and embarked on health care financing reform in 1998. The graphic above depicts the threetier structure of the ethiopian health system. A midterm evaluation of the health sector financing reform. Little is known about physicians role in financial protection of patients and families at the bedside in lowincome settings and how they perceive their roles and duties when treating patients in a health care system requiring high outofpocket. Elimination the reduction to zero incidence of a specified disease in a. Implementing a health insurance scheme was one of nine intervention strategies mentioned in this reform. The management, coordination, and distribution of technical support in each and every level is the responsibility of. 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.
Most of their work concentrated on infectious and parasitic diseases. Ehnri ethiopian health and nutrition research institute. Ethiopias health sector is heavily dependent on donor financing. Transforming ethiopias health care system from the ground. The researchers were mainly located in what was formerly northern ethiopia eritrea. Executive summary improving health care financing in ethiopia. A model projecting resource mobilization and costs executive summary executive summary this paper presents the results of modeling to project ethiopias future resources to finance primary health care and compare them with the likely costs of providing primary care according to current government plans. The ethiopian health care system is under tremendous reform. According to the head of the world banks global hivaids program, in 2007 ethiopia had only 1 medical doctor per 100,000 people.
In an effort to protect citizens from catastrophic effects of. Background outofpocket health expenditures can pose major financial risks, create accessbarriers and drive patients and families into poverty. Ethiopia endorsed a health care financing strategy in 1998 that envisioned a wide range of reform initiatives. We are committed to improving health systems by strengthening human resources, expanding health financing options, and increasing health commodity and essential drug availability. Implications on access to essential medicines eskinder eshetu ali, bpharm, msc department of pharmaceutics and social pharmacy, school of pharmacy, college of health sciences, addis ababa university, addis ababa, ethiopia abstract background.
The health system in ethiopia has to be revaluated because of an upcoming shift in disease patterns in the epidemiological transition. The health sector in ethiopia has shown remarkable progress involving a number of health, nutrition, and population indicators over the last decade figure 1. Although the health financing in ethiopia comes from a variety of sources, direct outofpocket. A national health care quality strategy will be developed to. We aimed to assess the successes and challenges of the hep over time, and develop a framework that may assist the implementation of the program toward universal primary healthcare services. Ethiopias second national health accounts report july 2003 prepared by. Ethiopian health system health care in ethiopia health. The expansion of health facilities continued through the era of emperor haile selassie and during the subsequent governments that took charge of the country. 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 children. The implementation of these reform initiatives was legalized through regional legislations and operationalized in line with prototype implementation frameworks that were modified and aligned within specific regional contexts. A step on the road to universal health coverage 3 for example, interviews with users revealed that improved availability of drugs and medical supplies has increased client satisfaction rosapep et al. 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. Iec hmis health care financing monitoring and evaluation.
Reviewing ethiopias health system development jmaj 524. Sep 05, 2014 institute for health metrics and evaluation ihme 4,617 views 1. Lia tadesse a woman committed to improving health care delivery system duration. It envisions reaching universal health coverage by 2035. This financing takes place via contributions to medical schemes, direct outofpocket expenditure and to a limited extent to other forms of private insurance. Mar 01, 2012 ethiopia endorsed a health care financing strategy in 1998 that envisioned a wide range of reform initiatives. Health care tier system until hsdp iii health facilities and the spec. In the absence of effective exemption mechanisms, poorer households suffer as a result of having to pay user fees which are a major component of oop payments.
Ethiopia health sector transformation plan 2015162019. Ethiopia health sector transformation plan 201516201920. 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. Health services in ethiopia study session 1 health services in ethiopia introduction.
The journal publishes analytical, descriptive and methodological articles, as well as original research, on public health problems, management of health services, health care needs and socioeconomic and political factors related to health and development. Ethiopia health sector federal ministry of health case study. 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. The secondary and tertiary levels are comprised of general and specialized hospitals, and the coverage of each extends to larger portions of the population. Health care financing in ethiopia implications on access to. As a result, ethiopia has done remarkably well in meeting most of the mdg targets. Health care financing in ethiopia implications on access. The tool represents the process of gathering, analyzing, and planning at the country level to project the contraceptive, service provision, and program support funding gaps. Although the health financing in ethiopia comes from a variety of sources, direct outofpocket spending accounts for a significant portion of health sector spending in the country. Ministers approved a comprehensive health care financing strategy fmoh 1998 in june 1998 to. Mar 01, 2012 health care financing continues to be a challenge in many developing countries. As a result of financial constraints for health, the ethiopian federal ministry of health began health care financing reform in 1998 to improve and diversify resource mobilization for health and secure financial protection for its citizens. The objective of this study was to explore health system challenges and opportunities for possible integration of dm and.
The ethiopian health sector transformation plan ii fmoh. In this first study session of the health management, ethics and research module you will be able to learn about the current healthcare delivery system within ethiopia, the historical development of primary health care phc and its application to the. Health care financing secretariat, ministry of health j federal democratic republic of ethiopia, ministry of health in collaboration with. Community based health insurance in ethiopia participedia. The second largest source of health finance is household spending. Assessment of health system challenges and opportunities. We have supported the government of ethiopia to train and deploy more than 38,000 health extension workers and 4,000 health officers, and is helping the government develop and deploy midwives, nurses, and anesthesiologists.
These include working with the ethiopian health insurance agency to implement and expand communitybased health. Ethiopia is a democracy with a federal system of government comprising 9 regions and two administrative councils. The prioritized initiatives are mobilizing adequate resources mainly from domestic sources, reducing outofpocket spending at the point of service use, enhancing efficiency and. Transforming ethiopias health care system from the ground up. A firstofitskind course gave unicefs ethiopia office health programme staff a crucial insight into the increasingly important role of health care financing in ethiopia and its implications for the countrys children. Jan 15, 2019 as a result of financial constraints for health, the ethiopian federal ministry of health began health care financing reform in 1998 to improve and diversify resource mobilization for health and secure financial protection for its citizens. The current ethiopia health care financing strategy focus on financing of primary health care services in a sustainable manner. Ethiopia has been implementing a community health extension program hep since 2003. This means that, due to economic development, the burden of disease shifts away from communicable diseases like. In an effort to protect citizens from catastrophic effects of the clearly high share of.
Community based health insurance schemes partially fulfill the ethiopian governments long term goal of improving healthcare by mobilizing domestic resources, improving access to healthcare services, and increasing the quality of services provided. Ethiopia national expanded programme on immunization comprehensive multiyear plan 2011 2015 federal ministry of health. One of the issues high on the agenda is health care financing. Edhs ethiopia demographic health survey ehaq ethiopian hospitals alliance for quality ehrig ethiopian hospital reform implementation guideline emr electronic medical record eos enhanced outreach strategy epi expanded program on immunization etb ethiopian birr eu european union fmhaca food, medicine and healthcare administration and control. Health finance, health insurance cbhi, shi, publications resource type. However, despite the known synergy between the two disease conditions, services for tb and dm have separately been provided. Willingness to pay for social health insurance and its. 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. Poor health care financing is one of the major challenges for the health system of ethiopia fmoh 2010.
The term primary health care phc is the name given to the essential healthcare that is universally accessible to individuals and is acceptable to them at a cost that the country and community can afford. Government also provides a tax benefit those who purchase private health care cover through medical schemes. The country achieved the targets of the millennium development goal on child health well ahead of time 1. Mar 10, 2020 health management, ethics and research module. In ghana, outofpocket oop payments accounted for 45% of total health care financing in 20056 akazili et al. United states agency for international development. We also support the development of much needed human resources and health financing schemes.
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