6 April 2017

Ethiopia: Urban Health Extension Gathering Momentum

The World Bank indicates that 54 per cent of the world's population lives in urban areas. Africa is the least urbanized continent, though it is showing an average urban growth rate (3%). Ethiopia, which is the second most populous nation in Africa, is characterized by low proportion of urban population but rapid rate of urbanization in the world (4.8% annually). By 2050, Ethiopia will be the 5th among the nine global urban population contributors. The rural to urban migration has been increasing in an incredible rate every year.

Nowadays, Ethiopian cities and towns are being overpopulated by people who migrated from rural areas. The people leave their rural home for search of job and education. If the rapid urbanization rate continues like this, 30 per cent of Ethiopians would be expected to live in urban centers of the country by 2028. Having noticed the ever increasing urban population, the Ethiopian government has been launching basic services, which could address the health and social challenges of the society.

Speaking at the National Conference on Urban Health held from April 3-4, 2017 in the capital, State Minister of Health Dr. Kebede Worku said that Ethiopia has been implementing Urban Health Extension Program (UHEP) since 2009. The program has been improving the health situation of the urban community through active participation and mobilization services. The Primary Health Care Unit (PHCU) which was launched in three Addis Ababa sub-cities, to be rippled across in other parts of the country, could be one of the success stories of the program.

According to him, the UHEP has been providing 15 packages. The services are categorized into the following major themes: hygiene and environmental sanitation, family health care, prevention and control of communicable and non-communicable disease, and injury prevention, control, first aid, referral and linkage. Urban health extension workers are nurses with special training. They are deployed in urban areas to provide support to the most at-risk populations in the community. They are required to spend 50 per cent their time conducting house-to-house activities in the community. Based on this, 5,000 health extension workers were deployed in all urban centers of the country since 2009.

The State Minister added that the government has been implementing the Health Sector Transformation Plan (HSTP) all over the country in the five year Growth and Transformation Plan (GTP) to enhance the health and life standard of Ethiopians. He stated that infant mortality rate has been scaled down by 67 per cent since 1991 and the life expectancy of Ethiopians has been elongated from 45 to 64 years.

Dr. Kebede pointed out that the reduction of HIV and AIDS risk impact and vulnerability rate by 90 per cent over the last 12 years and the mortality rate by 50 per cent indicate that Ethiopia has been successfully implementing its health policies and strategies.The prevalence of health problems related to sanitation and hygiene is hugely decreased in both rural and urban areas of the country.

He underlined that his ministry has deployed more than 43,000 health extension workers both in urban and rural areas to provide training and supervision which could elevate the awareness of the public. Ethiopia would increase its efforts in addressing the health and sanitation challenges that could result from urbanization and lifestyle change of the society.

"Urbanization is a good phenomena but it has numerous challenges.Though Ethiopia is still characterized by low proportion of urban population in the world, it has rapid urbanization development rate. Non-communicable diseases like hypertension, diabetes and heart attack are increasing in urban areas. We have to beef up our prevention mechanisms to overcome such health burdens," the State Minister emphasized. The State Minister urged governmental sectors and other concerned bodies to step up their efforts in sharing knowledge, experiences and skills to alleviate health problems in urban areas.

Addis Ababa City Council Speaker, Tabor Gebremedhin on his part said that the city administration has been vigorously working aspirant of making the African capital clean, green, healthy and hospitable.

Regarding enhancing the health sector of the city, Tabor insisted that the city administration has been working to provide modern, reachable and affordable health service to all its residents.

"The health extension package we have launched ten years ago has become our great accomplishment. But we need to speed up our pace with the ever growing population," the Speaker noted.

According to him, although many activities remain to be undertaken, more than 75 health centers and several hospitals have been built and renovated in the capital so far.

The U.S Agency for International Development (USAID) and its partner John Snow Inc (JSI), in collaboration with the Ethiopian government, have been implementing Urban Health Extension Program (UHEP) since 2010.The program has benefited approximately 2.6 million Ethiopians living in 19 cities and towns in the Amhara, Oromo, SNNPR and Tigray states. The program has been translated in to action to improve the health status of the urban population in Ethiopia by reducing HIV/tuberculosis related and maternal, newborn, and child mortality and morbidity, and by decreasing the impact of communicable and non-communicable diseases.

USAID, Chief of Health, Population and Nutrition, BethAnne Moskov for her part said, over the past 25 years, Ethiopia has brought significant improvements in the health sector especially in reducing infant, under-five and maternal mortality. To sustain the gains in the health sector, Moskov has called for concerted efforts to address the challenges of congestion, pollution and rapid urbanization.

"Working with the Ministry of Health, state health bureaus and other stakeholders through the urban health extension program, the program has built the capacity of urban health extension workers. We have to step up our support to alleviate the problems in hygiene and sanitation."

Ethiopia has launched the five year Growth and Transformation Plan (GTP) and it has realized many success stories so far. By 2025, the country has planned to ensure the middle income status with industry and manufacturing as its main economic backbone.

Its young demographic base could be huge asset for its future development. Almost half of the young population would be expected to live in urban centers in the coming decades. The Ethiopian government has been designing plausible policies and strategies to address the challenges associated with urbanization and overpopulation. Moreover, it has been striving to improve living standards of the rural community to combat the rural-to -urban migration. The industry parks which has been constructed in various states of the country would create job opportunities for millions of people dwelling in rural areas .

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