The second most populous country in Africa
Ethiopia is the second most populous country in Africa with estimated population of about 120 million people with diverse languages, religions, and other cultural features. The country has one of the fastest population growth rates that is on a decrease since the beginning of the new millennium. Until recently Ethiopia was considered to be one of the fast-growing economies in Africa with a vision to reach a middle-income status by 2035. Needless to say, this prospect is being challenged by cyclic political instability and recurrent droughts with their own direct and indirect impact on the projected strides in the development of the health sector.
Health indicators
The 2019 Ethiopian mini demographic and health survey (EMDHS) showed that 37 % of children under the age of five were stunted, whereas 12% suffered the severe form of it. The country experiences one of the unacceptably high maternal mortality ratios in the world. In 2017, Ethiopia reported the death of 401 women per 100,000 population from pregnancy and childbirth-related complications. It declined from 1,030 in 2000. Based on the country’s goal to reduce the ratio to 199 per 100,000 population by 2020, one can judge that the achievement was not impressive though encouraging. The country is demonstrating remarkable improvement in reducing infant and child mortality rates. The under-5 mortality rate for example has declined from 123 per 1000 live births in 2005 to 59 in 2019. Similarly, infant and neonatal mortality rates have dropped from 77 and 39 in 2005 to 47 and 33 in 2019 respectively. This is a massive improvement but has not spared the country from being one of the worst with respect to these specific indicators. Nevertheless, the achievement indicates that success is within reach if we work towards it in concert.
Triple burden of diseases
Ethiopia is one of the countries with a very high morbidity and mortality from triple burden av diseases consisting of Group I diseases: Communicable, maternal, neonatal and nutritional diseases; Group II Diseases: Noncommunicable diseases (NCDs), mental, neurological and substance use disorders; and Group III conditions: Injuries.
Non communicable diseases
NCDs and Injuries (NCDI) comprise a large burden of disease in Ethiopia largely because of the epidemiologic transition a significant proportion of the society is undergoing. According to 2016 estimates, noncommunicable diseases and injuries represented 46% of the total disease burden in Ethiopia, which is expected to rise rapidly in the coming decades along with economic development, urbanization and lifestyle changes. The magnitude of the problem calls for a multi-sectoral mechanism and a considerable increase in the effort to control and avert these conditions. NCDI services and their utilization are limited in Ethiopia. Only 54% of all health facilities (combined public and private) are ready to provide general NCD health services. Availability is even lower for specific NCD conditions, including diabetes, cardiovascular diseases, chronic respiratory disease, and cervical cancer. Readiness of trained staff and guidelines are extremely scarce, and the availability of essential diagnostics and medications are also major limitations.
Major hurdles and bottlenecks
The major hiccups to Ethiopia’s health service include a massive shortage of human power. The challenge entails shortage, urban/rural and regional disparities, poor motivation, retention, and performance. The huge disparity of wages and benefits between public and private sectors and an amorphous public-private partnership exacerbate the human resource problems. The overall financial constraint in the sector contributes to limited access to appropriate technology in the field as well as acquiring and retaining technical skills to use the barely available biomedical facilities.
The need for public education & multisectorial collaboration
Alongside actions directed towards changing social, environmental and economic conditions that impact health, mobilizing and educating the public is critically important. A multisectoral collaboration by stakeholders including the health sector, other sectors and partners is needed to curtail the formidable health challenge the country is facing.
ENHPA’s vision
It is our sincere hope that the Ethio Nordic Health professionals association (ENHPA) will contribute it’s share in capacity building and improvement of healthcare in Ethiopia by mobilizing expertise and resources.