Health Systems Profile
2%
55%
43%
User Fees
International and National Donors*
Government Funding
*International and national donors include grant loans from bilateral and multilateral donors and international NGO's and private donors
The Ethiopian healthcare system is divided into three main categories of tertiary, secondary, and primary care facilities. Tertiary care facilities treat 3-5 million people and provide specialized care. The secondary care facilities treat 1-1.5 million people and provide general health care. Primary care facilities are further divided into three sub-categories, primary hospitals, health centers, and, health posts. The primary hospitals treat up to 60,000-100,000 people and provide general health care needs for issues such as communicable diseases. The health centers treat 15,000 - 25,000 people percenters and provide care for primary health issues such as immunizations and nutritional requirements. Each health center is then connected to 5 health posts that treat up to 3,000 - 5,000 people each. They are connected to the health centers through a referral system that is categorized within each woreda/district.
One of the major issues with the Ethiopian health system is the centralization of healthcare in the capital city and the lack of adequate facilities in rural areas. In the past 20 years, there has been a 73.2% decrease of health workers in rural areas as they migrate to urban areas for better opportunities. The majority of the healthcare workers that remain in rural areas tend to have an altruistic perspective on healthcare. With this in mind, one of the big issues in Ethiopia is maternal mortality. Although declaring the reduction of maternal mortality a goal for the millennium development plan has reduced its rates, its progress has plateaued in comparison to the other millennium development goals.
Many of the organizations listed in table 2.2 have initiated different programs that tackle the issue of the weak healthcare infrastructure in rural areas. However, there are still many cultural influences that impact maternal health, one of these influences are child marriages. In many parts of Ethiopia young girls are forced into marriage by the age of 15 and are expected to become pregnant within a year. This causes many health issues such as postpartum hemorrhaging, anemia, eclampsia, obstructed labor, and promotes unsafe abortions. This also can negatively impact the mental health of these women. These issues serve to highlight gender inequality within the country. Consistently, in these community's village elders, who are typically male, make definitive decisions dictated by cultural influences. Therefore, women and girls in these communities give birth to the presence of a traditional birth attendant rather than a trained professional as dictated in their culture.
Health Ratios in Ethiopia
As of 2010
Challenges of the Ethiopian health system
As of 2010
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Ethiopian health system suffers from very poor infrastructure.
There are many challenges that affect the health care system in Ethiopia. One of the major challenges in reducing maternal mortality is the poor infrastructure in rural healthcare facilities. Many of these facilities don’t have access to potable water and suffer from electrical shortages. Additionally, these healthcare facilities are spread far and wide as only 42% of the rural population are within walking distance to a health facility. As there is no emergency transport system, the primary method of travel is walking. With this in mind, some of the families that live in these areas have to walk up to 6 hours in order to reach the nearest healthcare facility. As previously stated there is a large percentage of health workers that migrate to more urban areas in search of more lucrative opportunities. Therefore, the healthcare workers that remain in these facilities are often undertrained and overwhelmed by the number of patients. Another health care issue that has a large effect on the system is the lack of education. This impacts the health system as it causes a lack of awareness and misconceptions with reproductive care. Lack of education also causes social and gender inequalities that can lead to child marriage.
Given that the healthcare system of Ethiopia has a weak infrastructure, the government and other organizations have funded and began multiple programs to help improve the healthcare in Ethiopia. The Ethiopian government had made it a millennium goal for the country to improve its health care system through the Health sector development plan (HSDP). This initiative plans to improve the health sector by benchmarking new practices, construction of new facilities as well as upgrading and equipping previous facilities. There has been substantial growth in the health system since the implementation of HSDP, one of the many successes are that it has reached 88.7% and 84% of the target number of health posts and health centers, respectively, open to the public. In addition, with this expansion, the ministry of health is working to send two female health workers to health posts to train the staff per woreda to increase the quality of healthcare. Other initiatives such as the Community Based Health Insurance will help drastically improve the overall health of the population. This initiative is focused on providing affordable health care to more than 83.6% of Ethiopians and plans to cover 50% of the population by 2015. This new reform and outreach will increase the number of health facilities in rural areas making it much easier for women there to access the health care that they need to be able to have a safe pregnancy. Moreover, the increased exposure to these facilities will raise awareness and help promote educational programs to be implemented in the communities that are in need of it most. With the implementation of this program and the increased access to health care, this better the chances of reducing maternal mortality in Ethiopia. It helps increases the chances of mothers going to the clinics as one of the main reasons for maternal mortality was the distance from hospitals. Additionally, many women in rural areas prefer to deliver their children with a traditional midwife at home. With the expansion of the HSDP, it will enable health care workers to integrate themselves with the community and develop a better relationship with the mothers. This will, in turn, make the women feel more comfortable going to healthcare facilities during their deliveries thus, possibly reduce maternal mortality.