Health Policy, Plans and Strategies
The government of Ethiopia issued its health policy in 1993, which emphasizes the importance of achieving access to a basic package of quality primary health care services by all segments of the population, using the decentralized state of governance. The health policy stipulates that the health services should include preventive, promotive and curative components.
In order to achieve the goals of the health policy, a twenty-year health sector development strategy has been formulated, which is being implemented through a series of five-year plans. The implementation of the first health sector development program (HSDP) was launched in 1997, and now the second HSDP is under way. The main trust of the HSDP implementation is based on sector-wide approach, encompassing the following eight components:
• Service delivery and quality of care
• Health facility rehabilitation and expansion
• Human resource development
• Pharmaceutical services
• Information, education and communication
• Health sector management and management of information systems
• Monitoring and evaluation
• Health care financing
The HSDP has introduced a four-tier health service system which comprises: a primary health care unit, (a network of a health center and five health posts), the hospital, regional hospital and specialized referral hospital.
A health post is now being staffed by two health extension workers. These new cadres are trained for one year and their training emphasizes disease prevention measures with focus on the following programs:
A health center is at the highest level of a primary health care unit. It includes services such as in-patient and out-patient services inluding surgery, and with laboratory services.
A health station used to give services that a health center does, but at a smaller scale. Health Station is now being phased out. According to the new health sector development program (HSDP), a primary health care unit comprises of 5 health posts and a health center serving as a referral point. Therefore, when the HSDP is fully implemented, a health center will serve 25,000 people.
The aspect of health management and support within the health system is operated in accordance with the decentralized administrative structures. At present, the decentralization process has expanded to district level and has devolved primary responsibility for service delivery and management from regional health bureaus to district health offices, enabling them to management and coordination primary health care delivey in the their respective areas.
Supportive and educational supervision is undertaken at all levels, from the Federal Ministry of Health to district health offices. In addition, responsibility for logistical support is shared among the Federal Ministry of Health, the regional health bureaus, and district health offices.