During this period, our country has made huge strides in improving access to health services and improvements in health outcomes. Offices at different levels of the health sector, from the. Britain in comparative perspective article pdf available in the international journal of human resource management 115. The study concludes that decentralization in the health sector is likely to be more. 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. From an analysis of health sector reform in the region and elsewhere, it is seen that there is no consistently applied, universal package of measures that constitutes health sector reform. Hospital management in the context of health sector reform. 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. Our study showed three general health system reforms across all five. The role of icts in the health sector of developing countries a framework paper 31 may 2006 improving the health of individuals and communities, and strengthening health systems, disease detection and prevention are crucial to development and poverty reduction. Health sector transformation plan foreword by the minister of health ethiopia has implemented successive health sector development plans hsdps since 1997 in four phases. Health care system, thus enhancing the publicprivate ngo partnerships in the delivery of health care services in the country. As the country still stands at the beginning of structural transformation, tapping into the potential of the service sector, such as telecom, utilities and finance, could help ethiopia to reach its industrial goals.
Health sector reform is a sustained process of fundamental change in policies and institutional arrangements of the health sector1, usually guided by the government. What are the main objectives of national health policy. Fetp graduates lead a variety of initiatives such as training local health sector staff. Despite the contribution of the reform efforts in reshaping and restructuring the public sector for the better socioeconomic development of post dergue ethiopia, there have been a. 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. Through health sector reform in developing countries, ministries of health have sought to enhance health care through greater community governance and improved management effectiveness in their publi. Measuring eficiency of public health centers in ethiopia executive summary ethiopias health sector over the last 20 years has seen unprecedented expansion particularly for its primary health care phc system. 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. Ethiopia health sector transformation plan 201516201920. In general the trend is to move away form a dominant public sector towards a financial structure where the role of the private sector. Various legal and regulatory reforms in all sectors have been implemented to.
Ethiopia is a democracy with a federal system of government comprising 9 regions and two administrative councils. 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. Federal ministry of health fmoh to rhbs and woreda health offices, share decisionmaking processes. It has also stated the importance of targeting the most. In ethiopia the low level of socioeconomic development resulting in one of the low standard of living, poor environmental conditions and low level of social services has been the major causes for a poor health status of the people 12. Ethiopia health sector federal ministry of health case study. For more than a decade, ethiopia has been implementing health sector reform which is now in its fourth phase of strategic planning but studies revealed that the ability of any institution attract. The ethiopian health care system is under tremendous reform. Ethiopian health care system pdf ethiopia public health. Assessment of clients satisfaction with health service. Implementing health care reform journal of global health.
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. Beyond the health care reform in ethiopia, there have been debates on implications. Some lessons within the last decade, the concept of health sector reform for middle and lower income countries has gone from being a new idea to becoming an overused buzz word that is attached to any and all efforts to improve health systems. Health sector reform international health systems program. Health sector reform and sexual and reproductive health, publisher. The analysis explores the sustainability of ethiopias economic model based on domestic demand, especially public investment. 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.
Health sector reform is a sustained process of fundamental changes in national health policy, institutional arrangements, etc. Ethiopia s federal ministry of health fmoh has been leading a sector wide reform effort aimed at significantly improving the quality and accessibility of services at all levels of the countrys decentralized health system. Through health sector reform in developing countries, ministries of health have sought to enhance health care through greater community governance and improved management effectiveness in their public hospitals. Better health is a key to individual happiness and a countrys development. Health in ethiopia has improved markedly since the early 2000s, with government leadership playing a key role in mobilizing resources and ensuring that they are used effectively.
The derg borrowed its ideology from competing marxist parties, all of which arose from the student movement. These health financing reforms are generating remarkable change in the ethiopian health system. We are committed to improving health systems by strengthening human resources, expanding health financing options, and increasing health commodity and essential drug availability. Health sector reform should refer to substantial strategic change efforts that are built on a strong evidence base and logical framework for health system change, i. The latest economic update, the inescapable manufacturing services nexus. Reconsidering civil service reform in ethiopia devex. Transforming ethiopias health care system from the ground. While considering health sector reform, new forms of relationships among the components. 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. This is but just a dream, however, for the typical ethiopian. 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.
Kenya and botswana, ethiopia, mali, nigeria and senegal. Improving quality and equity abstract ethiopia endorsed a health care financing strategy in 1998 that envisioned a wide range of reform initiatives. Health service delivery in ethiopia is characterized an inadequate number of welltrained health providers, limited health infrastructure and shortages of finance, equipment, and supplies. As part of this reform, health facilities throughout the country have been streamlining their. Health infrastructure and the health extension program expanded significantly under the health sector. The graphic above depicts the threetier structure of the ethiopian health system. Ethiopian health care system is augmented by the rapid expansion of the private. Moving further on civil service reforms in ethiopia.
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. Beyond the health care reform in ethiopia, there have been debates on. Health sector reforms and district health systems unit 1 health policy, strategies and reform. Health sector reform in ethiopia is an undergoing process as a comprehensive. The implementation of these reform initiatives was legalized through regional legislations and operationalized in line with.
Essay on the impact of globalization on health sector the main. Lancet published several articles about ethiopia, saying ethiopia has been widely lauded for introducing health reforms that have transformed primary health. Comoros, congo drc, cote divoire, equatorial guinea, eritrea, ethiopia, gabon, kenya. Ethiopian hospital reform implementation guidelines. Now, as the country embarks on a 20year plan to improve primary care delivery, the countrys federal ministry of health has enlisted the help of hsph and ghli, with funding from the bill.
The cwgpa was a direct outcome of the fifth commonwealth ministers for public service. One of the issues high on the agenda is health care financing. Health sector reform and human resource management. Ethiopia economy growth was higher than its neighbors countries such as kenya and uganda. This chapter provides a brief overview of the health system in egypt as it relates to health facilities and outpatient services. The secondary and tertiary levels are comprised of general and specialized hospitals, and the coverage of each extends to larger portions of the population. 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. Business roundtable commissioned hewitt to prepare this report to evaluate health care reform through the lens of the private sector and to project the likely effect of proposed legislative changes on employer health care costs. The ehstg, which is consistent with the national focus on quality. The national health policy2002 aims at reviving and emerging the ailing health system and increasing the primary health sector outlay to ensure a more equitable access to health services across the social and geographical expanse of the country. Many programs and projects using the term health sector reform as a label do not meet these criteria. Federal democratic republic of ethiopia ministry of health health sector development program iv 201011 201415 final draft october 2010. The most famous unknown people in the world stephen mansfield tedxnashville duration. The structure and performance of ethiopias financial.
Womens health project, school of public health, university of the witwatersrand, johannesburg. There are many reasons why women do not use health services in ethiopia. Jul 18, 20 despite the contribution of the reform efforts in reshaping and restructuring the public sector for the better socioeconomic development of post dergue ethiopia, there have been a syndrome of on. The report begins by looking at the global context in which social security schemes are now operating and the relevance of social security to the goal of decent work. Pdf strengthening health systems by health sector reforms. This indicts that the recent ethiopia economic growth in ethiopia was stronger than nigeria and south africa. In ethiopia, more than 650 fellows have graduated as of december 2018. Ethiopia among the least privileged nations in the world.
Through the leadership of the federal ministry of health fmoh, the health sector has various coordinating mechanisms. Ethiopian health system health care in ethiopia health. Exploring the potential of distribution services, identifies key challenges in ethiopia s economy and proposes. Health institutions and services the low life expectancy in ethiopia is the result of poor health, especially in infancy and childhood.
The development of the health sector was made possible by strong political commitment, a. Reviewing ethiopias health system development jmaj 524. 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. 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 process of reform is also proceeding rapidly in many countries. The chapter provides a context in which to view the findings of the egypt service provision assessment espa survey. Offices at different levels of the health sector, from the federal ministry of health fmoh to rhbs and woreda health offices, share decisionmaking processes, powers, and duties where fmoh and the rhbs focus more. Strengthening human resources for health in ethiopia introduction the strengthening human resources for health hrh is a fiveyear 2012 2018 health systems strengthening project that is working to build local capacity for the development of systems to manage human resources for health, improve the. According to claire schaffnitchatterjee 20, ethiopia has averaged 8. Overview of the health system in egypt chapter 2 overview of the health system in egypt. Many people lost their jobs, had no access to healthcare and education because.
A midterm evaluation of the health sector financing reform hsfr. Health sector development program iv 201011 201415. Challenges and opportunities by teresa curristine, zsuzsanna lonti and isabelle joumard this article examines key institutional drivers that may contribute to improving public sector efficiency and focuses on one of them in more detail. Ethiopia health sector transformation plan 2015162019. One of them, the ethiopian peoples revolutionary party eprp, believed so strongly in civilian rule that it undertook urban guerrilla war against the military rulers, and anarchy ensued in the following years. Health facility governance in the ethiopian health system abstract health governance one of the pillars of a health system has received appreciable attention from the ethiopian health sector over the past decade. Key words hstp quality and equity universal health coverage. Sustainable development and poverty reduction program. The process lays down a set of policy measures covering the four main core functions of the.
Information quality and use remain weak within the health sector, particularly at the peripheral levels of woreda and facility, which have primary responsibility for operational management under the woreda decentralization process begun in 2002 gc. Health sector transformation plan global financing facility. Fmoh bases its activities on the implementation framework of the health sector development program hsdp, which has had three successive strategic plans. Abstract through health sector reform in developing countries. Ethiopian national ehealth strategic world health organization. The health sector transformation plan hstp federal democratic republic of ethiopia, ministry of health. Available records indicate that no less than 5,000 health and health related publications and documents are issued in ethiopia. Measuring eficiency of public health centers in ethiopia. Ethiopia s economy depends heavily on the agricultural sector. Ethiopian public health association epha, addis ababa, ethiopia. Ethiopia has made significant health gains in recent years, such as lowering infant mortality, but more work needs to be doneparticularly in rural areas.
The management, coordination, and distribution of technical support in each and every level is the responsibility of. In phase i, the effectiveness of the bpr health care. Ethiopian health care system pdf 1 health service delivery quality of care in hsdp iii. The structure and performance of ethiopias financial sector 5 clearly there is evolving structural shift when deposit is observed by institutions. Health system reforms in five subsaharan african countries that. Health facility governance in the ethiopian health system. Health information systems his is potentially very important for the development of the health sector in ethiopia.
Services at all levels of the ethiopian health care system. Information is presented with respect to general organization of the health system. Among the important features of the economic reform in ethiopia is empowering. As a result, ethiopia has done remarkably well in meeting most of the mdg targets.
Apr 19, 2015 if we change only health financing its not health sector reform william hsiao 8. 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. Yale school of public health, new haven, connecticut, usa. At least two weeks should be set aside for module 4. The health sector, the education sector and the community are the three priority focus areas for capacity building. A decade of health sector reform in developing countries. The district health management training modules have been developed to cover four major areas.
Increase efficiency in the use of available resources. 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. The commonwealth key principles of public sector reform were recommended and endorsed by the commonwealth working group on public administration cwgpa, which met on 2728 november 2014 in london. Pdf health sector reform and human resource management. Enabling policy and legal environment that enhances the business processes in the health sector. A central feature of the sector is the priority given to the health extension programme, which delivers costeffective basic services that enhance equity and provide.
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