The State of Health and Medicare in Ethiopia

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The State of Health and Medicare in Ethiopia

• Abraham Endeshaw(MD)
• Medical Services Directorate
• FMOH

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Outline of presentation

• Introduction and back ground
• Hospital distribution
• Teaching hospitals
• Capacity and capability in relation to
  international standards
• Access to medicines and resources
• Health professionals and population ratios
• conclusion

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Area - 1.125 million square km Population 79.8
Million(2010) Political Regions 9 and 2 City
Administrations Primary Health Service coverage
89.6 MMR590/100,000 IMR77/1000 Hospital Beds
15,111
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Urban Rural
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Distribution of Main Hospitals With Major Roads
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Main Hospitals
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Distribution of Hospitals by ownership
MOH Other governmental Private for profit NGO TOTAL
Specialized 15
regional 34
District 56
Total 105 30 49 11 195
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Distribution of hospitals by region
Region Number of hospitals
Tigray 18
Afar 3
Amhara 23
Oromiya 31
Somali 8
Benishangul 4
SNNP 45
Gambella 1
Harari 6
Addis Ababa 41
Diredawa 5
Central 10
TOTAL 195
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Specialized Hospitals

• Examples include
• MCH Gandhi Memorial hospital
• Ethio Swedish pediatric hospital under AAUMF
• Fistula Hamlin Addis Ababa Fistula hospital
• TBs St Peter Tb specialized hospital
• Psychiatric Amanuel specialized mental hospital
• Many Private hospitals providing -MCH, Cardiac,
  etc services

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Hospital capacity and capability

• No accreditation hence difficult to talk about
  international standard
• National regulatory standard under preparation
• Few high tech equipment such MRI,CT available
• In response to this
• Procurement of high tech equipment underway such
  as MRI,CT,ICU and OR equipment for major teaching
  hospitals
• Efforts underway to equip all hospitals as per
  national standard

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• National patient referral system

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Teaching hospitals

• MD Teaching Universities and Hospitals

Teaching university /hospital type output
AAUMF Gov 86
ST Paul Millennium college Gov 2nd batch
Gondar University Gov 65
Mekelle University Gov 65
Hawassa University Gov 37
Adama University Gov 2nd batch
Bahir Dar University Gov 3rd batch
Arba minch University Gov 2nd batch
Hayat Hospital Private
Bethel teaching hospital Private
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Health professionals

• Doctors to Patients- 136,158
• Nurses to patients- 13869
• Mid wives-156,427
• Health extension workers-12301

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Health professionals
Name of Specialty Public Public Private Private Total
Name of Specialty Number Number Total
General Practitioner 1,008 87.6 143 12.4 1,151
Internist 72 58.4 52 41.6 124
general Surgeon 91 65 49 35 140
Pediatrician 47 51.1 45 48.9 92
Gyneacologist 83 53.5 72 46.5 155
Ophthalmologist 50 72.9 19 27.1 69
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Name of Specialty Public Public Private Private Total
Name of Specialty Total
Orthopedist 14 70 6 30 20
ENT Specialist 9 36 16 64 25
Anesthesiologist 33 73.5 13 26.5 46
Dentist 23 62.8 17 37.2 40
Radiologist 43 52.9 40 47.1 83
Neurologist 7 63.6 4 36.4 11
Dermatology 8 44.4 10 55.6 18
Psychiatrist 21 88.5 4 11.5 25
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Resources and Drugs

• Unavailability,
• un affordability,
• poor storage
• irrational use
• Governments response includes
• Establishment of PFSA
• Design of the LMIS
• Implementing pharmacy services reform addressing
  supply and service

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conclusion

• There are fewer hospitals in number and type than
  required
• Maximizing the use of existing hospitals
  resources both in public and private sectors is
  required
• Unprecedented priority by the government to the
  quality of services by hospitals lately
• The need for equitable distribution of hospitals
• Need for achieving local standards and striving
  to achieve international standards

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• THANK YOU