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. Pdf background understanding the way health care reforms have. Strengthening health systems by health sector reforms. Health policy and systems research who world health. Offices at different levels of the health sector, from the federal ministry of health fmoh to rhbs and woreda health offices, share decisionmaking processes, powers, and duties where fmoh and the rhbs focus more. The secondary and tertiary levels are comprised of general and specialized hospitals, and the coverage of each extends to larger portions of the population. Beyond the health care reform in ethiopia, there have been debates. Especially after world war ii, tourism, banking, insurance, and transport began to contribute more to the. Conclusion s the ethiopian health care reform has laid the. During this period, our country has made huge strides in improving access to health services and improvements in health outcomes. Ethiopian health system health care in ethiopia health. The process of decentralisation in ethiopia since 1991 7 southern ethiopian peoples democratic front sepdf, to a more cohesive political force in which the major regions are now governed by eprdfallied parties. In the ethiopian health system, some public health services have been provided to all citizens free of charge regardless of level. The cases of mexico, vietnam, and china all fall into this category.
This is but just a dream, however, for the typical ethiopian. Under haile selassie i reigned 193074, ethiopias economy enjoyed a modicum of free enterprise. Better health is a key to individual happiness and a countrys development. Ethiopian hospital reform implementation guideline free. Health infrastructure and the health extension program expanded significantly under the health sector. Overview of the health system in kenya chapter 2 overview of the health system in kenya dr. Like other developing countries in asia, outofpocket expenditure is the dominant source of health financing in vietnam. Ethiopia italian contribution to the health sector. Ethiopia is a country of genuine strategic importance. The ethiopian health care system is under tremendous reform. These reforms were usually embedded in a set of government reforms intended to improve the efficiency, equity of access, and quality of public services in general. Public sector, reforms, africa, new public management, public administration, donors i. The prioritized initiatives are mobilizing adequate resources mainly from domestic sources, reducing outofpocket spending at the point of service use, enhancing.
The police and courts have routinely been used to level spurious and politically motivated. Exploring the potential of distribution services, identifies key challenges in ethiopias economy and proposes. The cwgpa was a direct outcome of the fifth commonwealth ministers for public service. Despite the contribution of the reform efforts in reshaping and restructuring the public sector for the better socioeconomic development of post dergue ethiopia, there have been a syndrome of on. In most countries, decentralization of health services is very central to these changes, and. One of the issues high on the agenda is health care financing. Ethiopian dialogue on supporting the private health sector. Ethiopia universal health coverage for inclusive and. The latest economic update, the inescapable manufacturing services nexus. Hstp is also the first phase of the 20year health sector. Federal ministry of health ethiopia population, health, and. Wamai1 table 1 shows the key countrys health related demographic and socioeconomic indicators. According to the head of the world banks global hivaids program, in 2007 ethiopia had only 1 medical doctor per 100,000 people.
Terry gakuruh this chapter provides an overview of the health system in kenya as a context in which to view the find. Health institutions and services the low life expectancy in ethiopia is the result of poor health, especially in infancy and childhood. 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. Our study showed three general health system reforms across.
Dec 28, 2012 most of the health care system reforms in developing countries focus on demandside intervention, mainly realised by the introduction or extension of social health insurance. Pdf strengthening health systems by health sector reforms. Performance of the health sector development programme hsdp situational. Training of dhmts in health management has been going on for some time. Since the hivaids epidemic arrived in ethiopia, attitudes toward the disease as well as the opportunities for treatment and a healthy life have changed dramatically. Ethiopia health sector transformation plan 2015162019. This paper explores the complementarity of two different reform processes in ethiopia that began in the 2000s. The findings confirmed that the hospitals gave free services for. However, health sector reform is not a concept that demands a single global definition 2, 3. However, the world health organization in its 2006 world health report gives a figure of 1936 physicians for 2003, which is about 2. Introduction almost all african countries are carrying out some form of public sector reform. This resulted in improvements in mortality rates and life expectancies. Especially after world war ii, tourism, banking, insurance, and transport began to.
Health economics as a course is meant to give medical, health officer and other paramedical students basic principles regarding economics and its application to the health sector. Reconsidering civil service reform in ethiopia devex. The management, coordination, and distribution of technical support in each and every level is the responsibility of. Health sector development program iv 201011 201415. Ethiopia has unveiled its sustainable and integrated development planning documents, the 5year growth and transformation plan and the climate resilient green economy strategy that shaped the content of this report. Apr 19, 2015 health sector reforms prersentation 1. The health system in ethiopia has to be revaluated because of an upcoming shift in disease patterns in the epidemiological transition. Health sector reform should refer to substantial strategic change efforts that are built on a strong evidence base and logical framework for health system change, i. Strengthening human resources for health in ethiopia introduction the strengthening human resources for health hrh is a fiveyear 2012 2018 health systems strengthening project that is working to build local capacity for the development of systems to manage human resources for health, improve the. Since 1990, the ethiopian government has allocated much funding to its health sector in order to reform its programs. Health sector reform international health systems program. Accelerate reform of the criminal justice system and the security sector to make them independent of political control and influence. 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.
Health sector reform and sexual and reproductive health, publisher. Health care system, thus enhancing the publicprivate ngo partnerships in the delivery of health care services in the country. Health system reforms in five subsaharan african countries that. The production and export of cash crops such as coffee were advanced, and importsubstituting manufactures such as textiles and footwear were established.
Been implementing the ethiopian reform implementation guidelines since. Addis ababa, june 11, 2018 in its latest economic update for ethiopia, the world bank group provides answers to several key questions what role can the services sector play in ethiopias economy. Critique of ethiopias pm abyis new homegrown policy 2019. Ethiopia universal health coverage for inclusive and sustainable development.
National report of ethiopia sustainable development. Access to modern health care is very limited, and in many rural areas it is virtually nonexistent. An event organized by an abt associatesled project in ethiopia and the countrys federal ministry of health jumpstarted a dialogue among a wide range of stakeholders on the issues of publicprivate partnerships ppps in health, health regulations, and financing in the health sector. Health extension workers in ethiopia provide family planning, maternal and child health, and nutrition services in communities across the country. Feb, 2014 the potential and actual impact of health sector reform on health systems has been highlighted in several studies 14. The health sector transformation plan hstp federal democratic republic of ethiopia, ministry of health.
As for the provider payment method, ffs is still widely used in practice. Health facility governance in the ethiopian health system. The current ethiopia health care financing strategy focus on financing of primary health care services in a sustainable manner. Enabling policy and legal environment that enhances the business processes in the health sector. Ethiopia among the least privileged nations in the world. Health and health care in south africa 20 years after mandela. Womens health project, school of public health, university of the witwatersrand, johannesburg. By the end of 2002, a compulsory social health insurance programme targeting all poor households and selected. Freedom house has rated ethiopia as not free since 2011.
The graphic above depicts the threetier structure of the ethiopian health system. In ethiopia, the public sector remains a major recipient of health sector resources. 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. Ethiopias economy depends heavily on the agricultural sector. Among the important features of the economic reform in ethiopia is empowering women through the. Other organizations that work in ethiopia include unicef, united nations, and other private charities. In accord with these principles and practices the federal ministry of health fmoh has integrated spm into its procedures and is reengineering the ministry itself using bpr methodology. The process of decentralisation in ethiopia since 1991. Health sector transformation plan foreword by the minister of health ethiopia has implemented successive health sector development plans hsdps since 1997 in four phases.
Health sector reforms prersentation linkedin slideshare. More detailed information about the ethiopian health sector and how it is funded can be found in results and effectiveness paper on the various funding modalities in the ethiopian health sector january 20. What reform priorities should ethiopia pursue in the service sector and how can they be achieved while maintaining a more sustainable economic growth rate. Beyond the health care reform in ethiopia, there have been debates on implications. Presenter moderator dr m a bashar dr tarundeep junior resident assistant professor 2. Aug 11, 2016 32 health sector transformation plan ethiopia is on track in achieving the mdg 6 target of universal access to treatment of hivaids by having 344,344 plwhiv were currently on art by the end of efy 2006 out of the target of 431,644 who need art, with achievement of 79. Demographic and health surveys dhs 2000, 2005, 2011. Ethiopia health sector transformation plan global financing facility. There were 119 hospitals 12 in addis ababa alone and 412 health. Ethiopia health insurance pacific prime international. Ethiopia ministry of health, and the ethiopia ministry of education. A lowincome country, ethiopia has made impressive progress in improving health outcomes. Only major cities have hospitals with fulltime physicians, and most of the hospitals are in addis ababa. Subnational governments at the subnational level, concerns about ethiopias dominantparty state are therefore replicated.
Ethiopias health care system includes primary health centres, clinics, and hospitals. Information quality and use remain weak within the health sector, particularly at the peripheral levels of woreda and facility, which have primary responsibility for operational management under the woreda decentralization process begun in 2002 gc. Home to more than 100 million people and with high population growth rates, it is projected to be among the worlds 10 most populous countries by 2050. Health service delivery in ethiopia is characterized an inadequate number of welltrained health providers, limited health infrastructure and shortages of finance, equipment, and supplies. Jul 18, 20 despite the contribution of the reform efforts in reshaping and restructuring the public sector for the better socioeconomic development of post dergue ethiopia, there have been a syndrome of on. 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. Implementing health care reform journal of global health. 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. It envisions reaching universal health coverage by 2035. This means that, due to economic development, the burden of disease shifts away from communicable diseases like. Ethiopia is a democracy with a federal system of government comprising 9 regions and two administrative councils. The infant mortality rate is almost twice that of the world.
As a result, ethiopia has done remarkably well in meeting most of the mdg targets. Health sector reforms can be defined as sustained, purposeful changes to improve the efficiency, equity, and effectiveness of the health sector. Could different policy reforms have reinforcing impacts on gender equality. 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. Therefore, this material should be regarded as an introduction to health economics rather than to economics. The government of ethiopia has demonstrated its political committment to fight neglected tropical diseases. Many programs and projects using the term health sector reform as a label do not meet these criteria. Module 1 world health organization regional office for africa v foreword health systems in africa are undergoing considerable change, often in a context of ongoing health sec tor reforms. Ethiopian public health association epha, addis ababa, ethiopia. Pdf critique of ethiopias pm abyis new homegrown policy. 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. Reviewing ethiopias health system development jmaj 524. Fmoh bases its activities on the implementation framework of the health sector development program hsdp, which has had three successive strategic plans. Health and health care in south africa 20 years after.
Available records indicate that no less than 5,000 health and health related publications and documents are issued in ethiopia. Among the important features of the economic reform in ethiopia. We are committed to improving health systems by strengthening human resources, expanding health financing options, and increasing health commodity and essential drug availability. Ethiopian hospital reform implementation guideline pdf the federal ministry of heath has been leading a sector wide reform effort aimed. 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. Building on the lessons learned in implementing the earlier plans and to be highly responsive to the current socioeconomic landscape, the government of ethiopia has developed health sector transformation plan hstp, which is part of the second growth and transformation plan gtp ii. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Based on the definition above, by fundamental change, the reform should be purposeful.
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