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. Hospital management in the context of health sector reform. 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 national health policy of 1983 and the national health policy of 2002 have served well in guiding the approach for the health sector in the fiveyear plans. Ayenew haileselassie, communications advisor, hsfrhfg the usaidfunded health sector financing reform health finance and governance project hsfrhfg is working with the government of ethiopia to improve financing and governance of health insurance and health services so that citizens can have access to quality health care and. Ethiopia health sector federal ministry of health case study page 3 of 22 this case study primarily focuses on the recalibration of the fmoh scorecard in 2009 provided by the bill and melinda gates foundation in 201120, the ministry of health began cascading the strategic scorecard throughout all levels of the health sector. Abstract this brief discusses the progress made in the ethiopia health sector development program. In the context of the health sector reform and decentralization in ethiopia, generating health information and intelligence that is standardized, integrated and well linked at all levels is well recognized to monitor the health services and health status of the population. Performance of the health sector development programme hsdp situational. Health sector reform is a sustained process of fundamental change in policies and institutional arrangements of the health sector1, usually guided by the government.
American influence on ethiopia s homegrown reform process will be limited, but there are a number of opportunities for positive engagement. At this time, if you have time, can you ask around and check how ethiopia is. During this period, our country has made huge strides in improving access to health services and improvements in health outcomes. The process lays down a set of policy measures covering the four main core functions of the. Globalization is said to affect the country, with many educated professionals leaving ethiopia for a better economic opportunity in betterdeveloped countries. Ayenew haileselassie, communications advisor, hsfrhfg the usaidfunded health sector financing reformhealth finance and governance project hsfrhfg is working with the government of ethiopia to improve financing and governance of health insurance and health services so that citizens can have access to quality health care and. Health sector development program iv 201011 201415. Health sector reform and sexual and reproductive health, publisher. 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.
View enhanced pdf access article on wiley online library html view download pdf for offline viewing. Ethiopia health sector transformation plan 2015162019. Jul 18, 20 reconsidering civil service reform in ethiopia. Aid, ownership, and coordination in the health sector in.
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. Pdf strengthening health systems by health sector reforms. The reforms introduced include implementing revenue retention and use at health facility level, systematizing a feewaiver system for the poor, standardizing. In the second growth and transformation plan of ethiopia 2015 2020, it is envisaged that necessary incentive packages such as tax exemption for heavy machines and some medical equipment, as well as importing of vehicles for ambulance service, will be made available to the private sector working on health and healthcarerelated services. We are committed to improving health systems by strengthening human resources, expanding health financing options, and increasing health commodity and essential drug availability. Health policy and systems research who world health. Law teaching material ethiopia join owit international president at the apec public a summary of international public sector accounting standards international public financial management reform. The health sector transformation plan hstp federal democratic republic of ethiopia, ministry of health. Ethiopian national ehealth strategic world health organization. The centers activities focus on assisting the implementation of the health extension package hep in ethiopia, coordinating the efforts for achievement of the millennium development goals for ethiopia, coordinating the malaria quick impact initiative for africa, and coordinating the millennium villages project in ethiopia. The report highlighted that the absence of good governance is prevalent in all sectors and regions without any variation. Planning and implementation of district health services. A step on the road to universal health coverage 3 for example, interviews with users revealed that improved availability of drugs and medical supplies has increased client satisfaction rosapep et al.
The programs aims were to develop a health system that provides comprehensive and integrated primary care services, primarily based at community health level facilities. Tools, opportunities and challenges january 2014 empowered lives. The health sector in ethiopia has had successive leadership at the top that demonstrated professional capability and political commitment to lead in the drivers seat. In an effort to protect citizens from catastrophic effects of the clearly high share of outofpocket expenditure, the government is currently working to. Business process reengineering in ethiopia berihu assefamay 2009 i prepared a short note on business process reengineering bpr in ethiopia as per the request of prof. Better health is a key to individual happiness and a countrys development.
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. To create standardized, integrated and harmonized eheath environment to improve health service delivery. His request in one of his emails to me reads as follows. Our study showed three general health system reforms across all five countries that could explain. At least two weeks should be set aside for module 4. As a result, ethiopia has done remarkably well in meeting most of the mdg targets. Health service delivery in ethiopia is characterized an inadequate number of welltrained health providers, limited health infrastructure and shortages of finance, equipment, and supplies. With an estimated population of more than 85,000,000, ethiopia is africas second most populous country. Enabling policy and legal environment that enhances the business processes in the health sector. Among the important features of the economic reform in ethiopia. Federal ministry of health ethiopia population, health, and. Access to modern health care is very limited, and in many rural areas it is virtually nonexistent. Ethiopias health care system includes primary health centres, clinics, and hospitals. As part of the new health sector financing reform hsfr initiatives, in june 2011 the ethiopian government launched a pilot cbhi scheme in districts across the four main regions tigray, amhara, oromiya.
Health sector reform is a sustained process of fundamental changes in national health policy, institutional arrangements, etc. Findings and implications from a civil service survey and qualitative analysis english abstract this report identifies key challenges facing the ethiopian civil service today and suggests avenuesfor further reforms. Health facility governance in the ethiopian health system. Health sector transformation plan foreword by the minister of health ethiopia has implemented successive health sector development plans hsdps since 1997 in four phases.
Addis abeba, january 022019 the ministry of foreign affairs said a joint forum led by ambassador girma biru, macroeconomic advisor to prime minister abiy ahmed, was established with a specific task of tackling challenges of attracting foreign direct investment fdi in ethiopia. By closing this message, you are consenting to our use of cookies. We thank dr tedros, dr kebede and dr nejmudinthe of the ministry of health, and the government of ethiopia. Health sector reforms and district health systems unit 1 health policy, strategies and reform. This started with former minister dr tedros adhanom, who introduced, in the eyes of our respondents, significant changes. The epub format uses ebook readers, which have several ease of reading. This package was published with the intention to have public sector facilities provide a minimum standard of care that fosters an integrated service delivery approach essential for advancing the health of the.
Good governance is a dismal performance in the ethiopian public sector. Introduction in recent years, economic pressures on the government and specifically on the health sector have forced the governments of developing countries to initiate health sector reforms. The health service system in ethiopia is federally. Health sector transformation plan global financing facility. Convened by ghanas ministry of health, the national health insurance authority, the world health organization. This is but just a dream, however, for the typical ethiopian.
Womens health project, school of public health, university of the. To adopt appropriate ehealth environment in the health sector of ethiopia, to improve the health outcome by bridging the equity gap and enhancing the effectiveness and efficiency of the health service delivery. The following sections trace debates in ethiopia on health financing from the 1990s up to the adoption and roll out of the health insurance schemes, before analysing this empirical material in light of the theoretical framework. While healthcare reform has been a central attention for local governments, its impact on job satisfaction is poorly understood. Various legal and regulatory reforms in all sectors have been implemented to. In mid2011, the government of ethiopia launched a pilot communitybased health insurance cbhi scheme in thirteen rural districts. The implementation of these reform initiatives was legalized through regional legislations and operationalized in. Impact of ethiopias community based health insurance on. Health institutions and services the low life expectancy in ethiopia is the result of poor health, especially in infancy and childhood. The ehstg, which is consistent with the national focus on.
Federal democratic republic of ethiopia ministry of health health sector development program iv 201011 201415 final draft october 2010. Despite the national efforts to change health system delivery, women in ethiopia still do not seem to seek access or use services, as depicted in the table below. Ethiopia health sector transformation plan 201516201920. There were 119 hospitals 12 in addis ababa alone and 412 health centers in ethiopia in 2005. It appears that bpr is quite popular in ethiopia for. The government of ethiopia published its essential health services package for ethiopia in 2005 federal ministry of health 2005. African strategies for health the african strategies for health project and management sciences for health participated in the financial protection and access to care workshop, held in accra, ghana from february 1519, 2016. The quest for good governance in the ethiopian public sector. In spite of some efforts to make the health care system integrated with information systems, it continues to be not welldeveloped in the nations health sector. Development of national minimum standards for healthcare facilities in ethiopia vi in ethiopia, government and development partners are investing a huge amount of resources to improve the quality of health services and ensure their sustainability. Development of the national minimum standards for healthcare. The study was designed as a facilitybased crosssectional survey of healthcare professionals and carried out in all public hospitals in. The district health management training modules have been developed to cover four major areas. The health sector shoulders the greatest responsibility in bringing a continued reduction in the spread of hiv as well as the care and treatment of those infected and affected.
Summary report1 world bank 1this report was completed with the nancial support of the bill and melinda gates foundation and norad. There are many reasons why women do not use health services in ethiopia. Therefore, this material should be regarded as an introduction to health economics rather than to economics. Very recently, there was a live broadcast on ethiopian television focused on a study report on good governance in the ethiopian public sector. This is an american idea but most donors seem to use it. The ethiopian hospital services transformation guidelines ehstg build on and expand the ethiopian hospital reform implementation guidelines ehrig and are consistent with the health sector transformation plan hstp. The health sector, the education sector and the community are the three priority focus areas for capacity building. Ethiopia health sector federal ministry of health case study. Community health information system data recording and. 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. If we change only health financing its not health sector reform william hsiao 8.
The study concludes that decentralization in the health sector is likely to be more. Conclusion s the ethiopian health care reform has laid the groundwork for health system improvement, but progress. Beyond the health care reform in ethiopia, there have been debates on. Available records indicate that no less than 5,000 health and health related publications and documents are issued in ethiopia. The implementation of these reform initiatives was legalized through regional legislations and operationalized in line with. Ethiopian public health association epha, addis ababa, ethiopia. In the early 1990s, ethiopia was recovering from a prolonged civil war. Health system reforms in five subsaharan african countries that. 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.
Ethiopia country report ethiopia is a landlocked country located in east africa, and is bordered by eritrea, djibouti, somalia, kenya and sudan. The oromo moved north through the southern highlands, bypasssing the sidama on the west, and into the central highlands, where they settled in the center and west on land, some. Health information systems his is potentially very important for the development of the health sector in ethiopia. In addition the new health policy derives guidance directly from the national health sector reform programme and the national poverty eradication programme, which was the cornerstone of president musevenis last election manifesto. Fmoh bases its activities on the implementation framework of the health sector development program hsdp, which has had three successive strategic plans. Health care financing african strategies for health. Over the last decade, ethiopias macroeconomic performance has been impressive, with an average economic growth rate. Training of dhmts in health management has been going on for some time. Through health sector reform in developing countries, ministries of health have sought to enhance health care through greater community governance and improved management effectiveness. Now 14 years after the last health policy, the context has changed in four major ways.
Overview ethiopia is the second most populous country in africa, with an estimated population of 90 million in 201445 percent of whom are under the age of 15. This study aimed to determine the impact of healthcare reform on job satisfaction in the public healthcare sector in ethiopia. Among others, the aims of the scheme are to increase access to health care and to reduce household vulnerability to unexpected outofpocket health expenditure. Federal democratic republic of ethiopia, addis ababa. Although ethiopias official language is amharic, there are a. Ethiopian health system health care in ethiopia health. Improving quality and equity abstract ethiopia endorsed a health care financing strategy in 1998 that envisioned a wide range of reform initiatives. Moving further on civil service reforms in ethiopia. Key words hstp quality and equity universal health coverage. The ethiopian health care system is under tremendous reform. Only major cities have hospitals with fulltime physicians, and most of the hospitals are in addis ababa. Health facility governance in the ethiopian health system abstract.
However, there is shortage of evidence on the effect of the health care financing reforms on access to essential medicines in the. One of the issues high on the agenda is health care financing. Library of congress federal research division country profile. Reconsidering civil service reform in ethiopia devex. The addis ababa health bureau has been implementing the health care.
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