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Fact Sheet- Ethiopia 2020
Demography
In 2013 EFY, the total population of Ethiopia is projected to be 102.9 million. By 2024, the population is projected to reach 109.5 million (Central Statistics Agency, July 2013). The total fertility rate is 4.6 births per woman (2.3 in urban areas and 5.2 in rural areas) and a corresponding crude birth rate of 32 per 1000 (EDHS 2016). The crude death rate is 6.3 per 1000 population (CSA projection). The average household size is 4.6.
State of Health
Life expectancy at birth increased from 58 years in 2007 to 65.5 years in 2017, with an annual rate of increase ranging from 1.98% in 2007 to 0.7% in 2017.
Ethiopia is currently facing triple burden of diseases (communicable and non-communicable
Diseases/NCDs, mental health, and injuries) that affects all age groups, with a disproportionately higher burden among children and women in their reproductive age. In 2019, 58% of disability adjusted life years (DALYs) were due to maternal and neonatal conditions, communicable diseases, and malnutrition; 35% of the total DALYs was due to NCDs and 7% by injuries. Over the past two decades, the share of NCDs has increased from 17% to 35%.
Ethiopia has documented notable results in improving the health of women and children for the past two decades. Maternal mortality ratio has decreased from 871 maternal deaths per 100,000 live births in 2000 to 401/100,000 in 2017. Under-5 mortality rate has decreased from 166/1000 live births in 2000 to 59/1,000 live births in 2019. Neonatal mortality has also decreased from 49/1000 live births in 2000 to 33/1000 live births in 2019.
Regarding prevention and control of communicable diseases, Ethiopia has achieved significant results in prevention and control of HIV/AIDS, Tuberculosis and malaria. HIV incidence has decreased from 3 per 10,000 in 2007 EFY to 1.6 per 10,000 at the end of 2012 EFY. Tuberculosis incidence rate has consistently decreased to reach to 140 per 100,000 population in 2019. Incidence of malaria has decreased to 28/1000 population at risk at the end of 2012 EFY. Mortality due to malaria has also decreased to less than 0.3 deaths per 100,000 population at the end of 2012 EFY.
Health Service Coverage
The first Health Sector Transformation Plan (HSTP-I) was implemented from 2015 to 2020). Currently, the second health sector Transformation Plan (HSTP-II), a five-year strategic plan that spans from 2020/21 to 2024/25 is developed and implementation is currently underway. The goal of HSTP-II is to improve the health status of the population, through accelerating progress towards Universal Health Coverage (UHC), protecting people from health emergencies, transforming Woredas and improving health service responsiveness.
The primary health coverage has potentially increased from 50.7% in 2000 to more than 90% in 2019, but the UHC service coverage index is only 43%. During HSTP-I period, outpatient attendance per capita has increased from 0.48 to 1.02 per capita per year in 2020.
Health Infrastructure
During the HSTP-I period, remarkable progress was documented in terms of expansion of health infrastructure that can improve access to health services to the population. In 2020, 353 functional hospitals, 3,735 health centers and 17,550 health posts were providing health services to the population. This expansion has improved access to health services to the population
Health Service Utilization
Health service utilization has remarkable improved over the past few years.
Reproductive and Maternal Health services: In 2012 EFY, 69% women in the reproductive age group have received a modern contraceptive method. Moreover, 69% pregnant women have had at least 4 ANC visits, 63% pregnant women were attended by skilled delivery attendants, and 83% women received early postnatal care.
Child Health Services: In the past few years, notable achievements were registered in improving the routine immunization program coverage. The proportion of under 1 children that received measles and all basic vaccines has increased from 90% and 86% in 2007 EFY to 95% and 90% in 12 EFY, respectively.
Prevention and control of Communicable diseases: By the end of 2012 EFY, 78.7 % of People living with HIV (PLHIVs) know their status, 90% of PLHIVs who know their status were on ART and 95% of PLHIVs on ART had suppressed viral load. Regarding Tuberculosis, detection rate was 69% and 95% of Tb patients successfully completed their treatment
Human Resource for Health:
Human resource is one of the building blocks of the health systems. Efforts have been made to improve the number and mix of the health workforce over the past few years. By the end of 2012 EFY, 273,601 heath workforces were working public health facilities, among which 181,872 (66.5%) are health professionals and the remaining 91,723 (33.5%) are administrative/supportive staff. Regarding health professional to population ratio, one physician was serving for 9,979 population, one nurse for 1705 and 1 midwife for 5491 people. More than 40,000 health extension workers are also providing community health services in more than 17,000 health posts.
Health Financing
In order to protect the public from financial risks, the health sector has developed and implemented health care financing reform and different health financing strategies. In order to mobilize adequate financial resources, health care financing reforms such as revenue retention and use by health facilities, provision of exempted services and fee waiver systems, outsourcing of services, establishment of private wings and other reforms shave been implemented in the health sector. Moreover, Community based health insurance system implementation is also in progress.
According to the latest NHA study findings (NHA 2017), the per capita health expenditure in Ethiopia is 33.2 USD. From the total health expenditure, 32% is covered by the government, 31% is from out of pocket expenditure and 35% is from development partners.
At the end of 2013 EFY, more than 834 Woredas have started implementing Community based health insurance (CBHI), from which more than 60% of the eligible households are registered CBHI members.