Ethiopia

Health statistics:

Life expectancy at birth (2016): 63/67 (male/female)

Probability of dying between 15 and 60 years: 253/2197 (per 1000 population, 2016)

Total expenditure on health per capita (2013): $74

Number of doctors per 1000 population (2014): 0.025

Nursing and midwifery personnel density (per 1000 population, 2013): 0.252

Neonatal mortality rate (per 1000 live births, 2016): 27.6 [21.7-35.2]

Maternal mortality ratio (per 100.000 live births, 2015): 353 [247-567]

Births attended by skilled health personnel (2008): 27.7%

Top 10 causes of death (2012):

Lower respiratory infections: 103.4 thousand people / 15% of total

HIV/AIDS: 50.1 / 7.3%

Diarrhoeal diseases: 41.3 / 6%

Birth asphyxia and birth trauma: 29.7 / 4.3%

Protein-energy malnutrition: 28.6 / 4.1%

Stroke: 28.3 / 4.1%

Preterm birth complications: 27.2 / 3.9%

Neonatal sepsis and infections: 16.1 / 2.3%

Tuberculosis: 15.9 / 2.3%

Meningitis: 15.1 / 2.2%

Distribution of causes of deaths in children under 5 (2008):

Other causes: 18% of total

Acute respiratory infections: 18%

Birth asphyxia: 15%

Prematurity: 12%

Diarrhoea: 9%

Neonatal sepsis: 8%

Injuries: 7%

Congenital anomalies: 5%

Malaria: 3%

HIV/AIDS: 2%

Measles: 2%

Healthcare system

Public healthcare in Ethiopia is structured in a decentralised three-tier system consisting of primary, secondary and tertiary care. With the decentralised structure, decision-making takes place at the regional and district levels.

The lowest level of the referral system is the primary health care unit, which consists of rural health posts, health centres and a primary hospital. Health posts provide preventive, promotive and basic curative services, as well as training and outreach services. “Health extension workers” at the health posts can refer patients to health centres or the primary hospital for more serious issues. Health centres coordinate 5 health posts each and offer a slightly higher level of care. Around 20 professionals work at the centres, which provide preventive, curative, inpatient and ambulatory services, as well as treatment for common psychiatric disorders and dental services. Primary hospitals function as referral centres for health centres and training centres for nurses and paramedical professionals. They are staffed with approximately 53 health workers and provide preventive, curative, inpatient, ambulatory and emergency surgical services. Primary hospitals can refer patients to General Hospital, which are at the secondary level. These have approximately 234 staff and they provide inpatient and ambulatory services. They also function as training centres for health officers, nurses, physicians and surgeons. Specialised hospitals at the tertiary level provide inpatient services and function as referral centres for general hospitals. These hospitals are staffed with around 440 professionals, and provides the highest level of care and most advanced facilities.

The health sector in Ethiopia provides some services free of charge, such as immunisation, counselling, testing and treatment of tuberculosis and HIV/AIDS and prevention of mother-to-child transmission. This is meant to improve the health status of particularly vulnerable citizens. The greatest barriers to medical treatment are difficulties accessing care (in terms of distance, transport means and treatment costs), particularly in rural areas. Many citizens also mention concerns about availability of health workers and scarcity of medical supplies.