Ethiopia is the second largest country in Africa with a population of over 90 million people.  Primarily an agrarian society, nearly 85% of the population relies on agriculture for livelihood, which contributes to almost 50% of the total GDP.  Approximately 40% of GDP comes from service sector and the remaining 10% is from the industrial sector.     

Quickly changing its demographics, Ethiopia has one of the fastest urbanization rates (4.89%) in the world, placing significant infrastructural stress on services such as public health facilities, schools, and roads.  Ethiopia’s government is struggling to keep up with the infrastructural demands of a growing urban population while trying to reach the still predominantly rural people.

Ethiopia has ambitiously set economic goals to become a middle-income country by 2025. Through the Growth and Transformation Plan (the country’s key strategic document), Ethiopia’s long-term vision is anchored on sustained, rapid, and broad-based economic growth. In order to attain its stated goals, Ethiopia must continue to maintain its double-digit GDP annual growth through equitable and increasingly democratic ways.  Government officials, including Ethiopian Foreign Minister Tedros Adhanom, have referenced studies, which show a positive correlation between economic growth and continued investment in women and children’s health.

According to the Ethiopia Service Provision Assessment conducted by the Ethiopian Public Health Institute, outpatient curative care for sick children is available in 95% of all facilities. Growth monitoring (73%) and child vaccination (72%) are less widely available. Overall, only six out of ten health facilities offer the entire range of child health services.

There are still several obstacles for caregivers to seek and receive care. Some of these obstructions include demand barriers, such as:

  • Knowledge/beliefs about childhood illness

  • Lack of awareness of services

  • Preference for home-based or traditional care

  • Distance and lack of transportation

  • Cost of care-seeking

  • The need to obtain husband’s permission to seek care

  • The opposition of traditional or religious based leaders.

There are also supply barriers that include:

  • The inconsistent availability of services at health posts
  • Drug stock outs

The research shows Ethiopia’s ability to provide services at the community level, through it’s community health system and it’s partnerships with civil society organizations. However, the research indicates demand barriers as still remaining a challenge. Many of the demand barriers could be alleviated through mass information programs. These programs would correct the lack of availability of services at the health posts.

 

Recommendations 

Mr. Tedros Adhanom, Minister of Foreign Affairs and former Health Minister, was extraordinarily adept at leveraging multilateral, disease specific funding flows for this robust health system strengthening. His visionary strategy decentralized community health services by increasing access to treatment at health posts. This has been a clear success of Ethiopia’s child health interventions in the public health infrastructure. Rolling out the Health Extension Workers throughout the country has been highly successful in ensuring all Ethiopians have access to commodities and services.   The country’s focus on the health centers and the health posts have paid off in terms of dramatic reductions in under-5 mortality.  Yet, there is still a long way to go.

International partners have expressed the need for a highlighting of the “Ethiopian Health Success Story” on national and international stage as a key to unlock this further investment. More of this multilateral, bilateral and domestic investment is needed.  Telling the story of Ethiopia’s success thus far would be key. 

Ethiopia has an ambitious development strategy that strives to become a middle -income country by 2025. Therefore most investments and government spending has been through the perspective of economic opportunity. Therefore, Speak Up Africa sees an opportunity to craft economic messages for the government and international community to create a case for child health investment in order to catalyze political will and resources. Studies have already shown the positive correlation on the investment of women and children’s health with economic impact.

Beyond leveraging additional resources, Ethiopia is lacking critical communications designed for the caregivers. Speak Up Africa believes that there is nothing more powerful than an informed mother. Designing comprehensive communication materials designed to reach the primary caregivers, mothers, is an important step in mitigating the impacts of preventable diseases.

 

Resources: Read more about pneumonia in Ethiopia

Clinton Health Access Initiative: Oxygen Access to treat severe cases of pneumonia

 

To learn more, please read the Ethiopia Landscape Assessment or contact Roxanne O'Connell at roxanne.oconnell@speakupafrica.org.