Ethiopia - Healthcare Ethiopia - Healthcare
The Government of Ethiopia (GOE) is working to strengthen the healthcare system to align it with the Millennium Development Goals. Ethiopia has a large, predominantly rural and subsistence agriculture population with poor access to safe water, housing, sanitation, food and health service. The government has made significant investments in the public health sector that have led to improvements in health outcomes. Nevertheless, communicable diseases like HIV/AIDS, TB, malaria, respiratory infection, and diarrhea remain a serious challenge in Ethiopia. High fertility rates, and low contraceptive prevalence continue to drive a rapidly increasing population in Ethiopia. With a growing middle class, the GOE is facing an increase in non-infectious diseases such as cancer, diabetes, heart diseases, hepatitis B&C and high blood pressure. Mental health and eye problems are also becoming major issues in Ethiopia.
Under the second Growth and Transformation Plan (GTP II) and Health System Transformation Plan, the Ministry of Health (MOH) is implementing changes to various aspects of the healthcare system. For better management, the government has increasingly decentralized management of its public health system to the Regional Health Bureau levels. The MOH is also committed to reforming agencies such as Ethiopian Food and Drug Administration (EFDA) and the Pharmaceutical Supply Agency (PSA).
EFDA is being strengthened to provide increased regulatory oversight for the registration, importation and quality of medicines, supplies and equipment into the Ethiopian Market. EFDA has a mandate to regulate practices, facilities, professionals and products in the health sector. This agency is responsible for promoting and protecting public health by ensuring the safety and quality of products and health services through registration, licensing and inspection of health professionals, pharmaceuticals and health institutions, as well as the provision of up-to-date regulatory information. The GOE is implementing a plan to transform EFDA to make its operations more efficient with the aim of ensuring 100% availability of vital and essential drugs at all levels of the healthcare delivery system without stock shortages. Currently, EFDA is implementing a “zero backlogs” strategy for medicine registration and licensing activities. EFDA has digitized the importation and registration of health commodities to Ethiopia using the below listed programs:
- i-Register: is used by importers for application of market authorization and product registration (new products, request registration exceptions and renew existing registrations).
- i-Import: is an online application uses for importers to apply for and receive permits to import all health commodities. PSA also has access to this application as they are participating in procurement activities.
- Vitas: A platform designed to support logistics management information and warehouse management and inventory control. It starts functioning at the central warehouse and 18 regional hubs throughout Ethiopia.
- Dagu: A platform designed to support logistics management information and inventory control at service delivery points by using systematic record keeping. This application provides service at more than 700 sites all over the country.
- mBranaA platform integrated with Vitas and other programs in PSA that it uses to manage inventory from beginning to end.
The following list is the 2020 impact-level targets for the Health System Transformation Plan (HSTP):
• Reduce infant and neonatal mortality rates.
• Decrease HIV contraction and achieve zero new infections among children.
• Lessen the number of TB deaths and incidence.
• Diminish malaria case incidence and mortality rate.
It has also set targets to stabilize and reduce deaths and injuries from road traffic accidents, which are significantly high in Ethiopia.
The GOE encourages private sector participation in the area of quality of care and quality of service. The government is also working with the private sector to build advanced tertiary care hospitals to meet domestic demand that would otherwise be met through outbound medical tourism, and ultimately to attract medical tourism to Ethiopia. The Ethio-American Hospital, which began construction in April 2017, plans to begin operations by December 2019, is an example of the government’s commitment to developing major new healthcare facilities. This project also demonstrates the government’s commitment to encouraging foreign investment in the sector through public private partnership (PPP) arrangements. A guideline to implement PPP in the healthcare sector in Ethiopia has been drafted and sent to the Ministry of Finance for comments. Standardization and expansion of hospitals located in different regions is also the main focus under health infrastructure development in the country.
Currently the below list of health care facilities are available in Ethiopia:
Health Posts: 17,154 available and 438 under construction
Health Centers: 4,063 available and 68 under construction
Hospitals: 338 available and 218 under construction
Private Clinics: 3867
Private Hospitals: 43
In addition to working on the number of healthcare facilities in the country, MOH is working on improving services to reduce health related burdens. Cancer is one of the fastest growing healthcare challenges in Ethiopia. The MOH is working to establish cancer diagnosis centers at six hospitals. To address this huge burden, MOH has continued to work on radiation therapy expansion programs and access to chemotherapy services. Cancer chemotherapy services were provided only in four health centers. Currently MOH has decentralized the service into 12 hospitals in different regions of the country.
Some of the upcoming priorities in the health care sector are:
- Implement the use of drone technology for the delivery of vaccines, blood and other health related commodities in the rural areas.
- Improve the management of human and infrastructural resources.
- Improve resource mobilization.
- Improve research and evidence-based decisions and enhance the use of technology and innovation by supplementing with the deployment of appropriate information systems. The MOH has developed a national “Information Revolution Roadmap” that contains actionable and measurable interventions. The Ministry aims to focus on enhancing data usage to positively impact the healthcare sector by maximizing availability and accessibility of high-quality data at all levels in the healthcare system.
- Facilitate the procurement of drugs, supplies and equipment and create availability of essential drugs at the health centers.
- Increase patient satisfaction and address good governance
- Work on an early warning system, risk assessment and multi-sectorial coordination mechanisms that can improve response time for epidemics.
- Procurement of medical equipment from quality providing companies and considering after sales maintenance service as part of contract package.
MOH, in partnership with EthioTelecom, is working to roll out a Healthnet program to improve IT infrastructure and connectivity of healthcare facilities through the country. Through this program MOH seeks to collect data to deliver national level reports on healthcare needs and service delivery.
Telemedicine is a priority for the MOH. Telemedicine is being carried out with respect to some specialty care services through multiple telemedicine technologies. Currently, preparatory work for the implementation of telemedicine services is underway.
The GOE’s seeks to address high out of pocket costs for health services through the introduction of community-based health insurance (CBHI) and social health insurance (SHI) for the informal and formal segments of society, respectively. The Ethiopian Health Insurance Agency (EHIA) has already been established and is undertaking the necessary steps. Currently 522 woredas in Ethiopia have started implementing CBHI.
Challenges in the healthcare sector in Ethiopia include:
• Lack of transparent and accountable pharmaceutical and logistics management system.
• Shortage of foreign currency hindering timely procurement of equipment, supplies and pharmaceuticals. Foreign exchange shortages also result in payment delays.
• Delays in the bidding process.
• Poor data management and reporting for proper decision making.
• Lack of capacity.
|Unit: USD ‘000||2017||2018||2019 (estimated)||2020 (estimated)|
|Total Market Size||122,982||86,130||99,050||113,907|
|Total Local Production|| |
|Total Imports||93,846|| 57,130 ||65,700||75,554|
|Imports from the United States|| |
| 347 ||399||459|
(total market size = (total local production + imports) - exports)
- Equipment and services to new hospitals and health centers
- Construction of modern hospitals, blood banks, warehouse for pharmaceuticals and health care facilities
- Pharmaceuticals and supplies
- IT support
- Cold storage facilities
- Knowledge and skill transfers
The GOE is keen to acquire service, equipment, supplies, information management systems, and knowledge and skill transfers to improve the quality of the healthcare system. This is an opportunity for U.S. companies that are providing equipment and supplies, hospital furniture, ambulances for emergency, pharmaceuticals, vaccinations and other services.
Ministry of Health
Ethiopian Food and Drag Authority (EFDA)
Ethiopian Pharmaceutical Supply Agency (EPSA)