7 June 2018

Africa: Ethiopia's Health System As Example to Other African Countries

Ethiopia has achieved a significant improvement in the health sector. Citizens' health status in the meantime has also improved. The country successfully reduced infant and maternal mortality rate before the Millennium Development Goals deadline.

Ethiopia is a leader in Africa in reducing maternal and under-5 mortality; and one of the few countries in Africa that have achieved the Millennium Development Goals (MDGs) for child and maternal health.

Recently, health professionals from Burkina Faso came here to learn from the best practices and experience of Ethiopian health policy, and from the successes of the country's health extension program.

This indicates that Ethiopian primary, secondary and tertiary health system successed, and the country's track of preventing, controlling and managing of various health problems is becoming an example and benchmark for other African countries to emulate.

But, most notably, innovative strategies to improve household behaviors and coverage of basic health care services contributed to Ethiopia's achievements, and the Health Extension Program (HEP) remains the core of such innovations and provides a model for countries struggling to improve health outcomes in a resource-constrained setting.

The health extension program is serving as the primary vehicle for implementing essential community-based health care packages, and as an effective referral system from the grass-roots level to widen access to ownership of health extension and scale-up the success of the best practices.

The country's resilient health system and effective leadership hugely improved the primary health care system highly by expanding the health extension workers (HEWs) services at community level. Accelerated Expansion of Primary Health Care Coverage and Health Extension Program were designed to expand of essential health services, particularly in rural areas.

Since the beginning of the health extension program, trained and graduated model households started to vaccinate children, use toilets, and sleep under mosquito nets. Currently, there are critical masses of nearly three million model households that have graduated over the years by fulfilling the model family criteria.

Another of the country's innovative health care initiative, the Health Development Army (HDA) has been serving as a massive program engaging women's groups to disseminate health information and facilitate uptake of critical health services. This solidarity movement, which consists the organization of groups of 30 households, consists of three million HDAVs who are from model families from each village, and aims to improve the engagement and leadership of community members in improving their own health.

HDA enables them to promote healthy behaviors as well as to strengthen and sustain community engagement and ownership. However, their focus is not only on health, but on other aspects of women's development as part of a wide national social and political agenda.

The health information system at the health post is based on a number assigned to each family in a survey. Two HEWs are based at a village health post serve 5,000 people, and there is one HDAV who serves every five to ten families. Every family is registered at health post.

Every health center is responsible for supporting and monitoring the activities of the HEWs and HDAVs working there. This network of HDAVs, HEWs, five health posts, and a health center forms a primary health care unit is important to prevent diseases and share best practices and experiences.

These efforts have led to a stronger health system to be delivered at hospitals and primary health centers, while disease control programs and community-based primary health care services are readily accessible to all.

Communities, service providers and professional associations have played a great contribution in improving Ethiopia's health system priorities and implem entations. More resilient health system has been creating with community's engagement and professional standards.

Since 2003, Ethiopia has been making progress by putting the national health system on the right track, and in the process has become a more resilient health system. It has made major efforts to implement integrated community management of childhood illness. The country has also invested heavily in strengthening health system in human resource development, the health information system, supply chain management, infrastructure, health care financing, and governance of the health system.

The establishment of a strong community-based workforce of HEWs and HDAVs has had many advantages in connecting health system to every household in the country.

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