Center for National Health Development in Ethiopia to boost government capacity

In the summer of 2004 Professor Awash Teklehaimanot, a health expert with the Earth Institute at Columbia University and member of the Center for Global Health and Economic Development, launched the Center for National Health Development in Ethiopia, a project of the Earth Institute in support of accelerated expansion of primary health care facilities in Ethiopia.

The government of Ethiopia has committed to train up to 25,000 health workers over five years to provide basic promotive and preventive health services throughout Ethiopia. After a one year training, the graduates will be placed in 15,000 villages (average population 5,000 each). In addition to the training and placement of these health workers, the government plans to build and upgrade nearly 3000 new primary health care centers and construct thousands of basic care facilities called health posts. The estimated total investment required to implement this plan, which will provide health services to 85 percent of the population, is $1.6 billion. "The government of Ethiopia's health care plan is very ambitious, as the government realizes that improved health is essential for growing other areas of the economy," says Teklehaimanot.

The Center for National Health Development in Ethiopia will provide a critical boost to the capacity of Ethiopia?s Ministry of Health, helping it to succeed in its bold plan. The center, which started its work in August 2004, is staffed by Ethiopian professionals with extensive experience and training in planning and health systems development, epidemiology, vector biology, and prevention and control of infectious diseases, The Center?s staff have a special focus on malaria and HIV/AIDS, data management and program evaluation.

Ethiopia's health care system is among the least developed in Sub-Saharan Africa. The present government has recognized that ill health of a fast growing population, now over 70 million, is an impediment to social and economic development. The government has chosen to strengthen primary health care as a strategic approach, to address the lack of physical access to even basic health care facilities in rural areas.

Widespread poverty, poor nutritional status, low education levels, and poor access to health services have contributed to the high burden of ill health in the country. Life expectancy at birth is currently about 54 years and is expected to decline to 46 years if the present HIV infection rates are maintained. Malaria is the primary health problem in the country; it is the leading cause of outpatient visits and is responsible for 8 to 10 million annual clinical cases and a significant number of deaths. In total, as much as 90 percent of the health problems in Ethiopia are due to preventable communicable and nutritional diseases.

Professor Teklehaimanot?s long history of working on health issues in Ethiopia, particularly on malaria, has given him an opportunity to work closely with the Ethiopian government in designing this program and assessing what outside support is needed. Providing this support will be the mission of the Center for National Health Development in Ethiopia. The center will assist Ethiopia?s Ministry of Health in resource mobilization, and will provide technology for evaluation, data management, and analysis that will contribute to operations management and quality control. The center will also provide technical support to facilitate work with civil society, the private sector, UN agencies, and the donor community toward the accelerated expansion of primary health services in Ethiopia.

The Ministry of Health in collaboration with the Ministry of Education initiated the program by selecting 85 trainers; the training of the trainers took place in 2003. The one-year training of the first 2,800 women destined to become rural extension health workers is being undertaken this year in fourteen Technical and Vocational Education Training Centers. The government?s plan is that all extension health workers in rural Ethiopia will be women, as it is thought that female health workers will be able to gain the confidence of women in rural households to pass along important knowledge throughout the population.

The Earth Institute at Columbia University is among the world?s leading academic centers for the integrated study of Earth, its environment, and society. The Earth Institute builds upon excellence in the core disciplines?earth sciences, biological sciences, engineering sciences, social sciences and health sciences?and stresses cross-disciplinary approaches to complex problems. Through its research, training and global partnerships, it mobilizes science and technology to advance sustainable development, while placing special emphasis on the needs of the world?s poor.

Contact: Jennifer Freeman
jbfreem@aol.com
917-496-8131
The Earth Institute at Columbia University