posted 06/07/05

As Ethiopia's Health Program Moves Forward, Experts Prepare to Measure Impact

Foziya Jemal (left), a sanitarian from Arsi Negele Health Center in Ethiopia, interviews a villager during a pretest of health survey questions. The national health survey will establish a baseline of health information that eventually will measure the project's success. Photo credit: Yesim Tozan

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A vigorous outreach program in Ethiopia to train, pay and deploy 25,000 young female health care workers is under way. By 2009, the program and its trainees will provide services to 85 percent of rural Ethiopians, most of whom have no access to health care.

The Ethiopian government began the effort in 2004 and has allocated significant resources. Villagers across the country are donating labor and local materials for construction of health posts and for buildings to house the health workers.

How much impact will this program have in a country where life expectancy is 48 years?

Going door-to-door to rural dwellings, experts are conducting a comprehensive survey that may provide the answer.

This spring, experts at The Center for National Health Development in Ethiopia, part of The Earth Institute, will visit 7,300 households in all parts of Ethiopia to try to establish a baseline of health information that eventually will measure the project's success.

Baseline data will include information about child morbidity and nutrition, vaccination coverage, malaria prevention and control, knowledge and behavior related to HIV/AIDS, use of contraception, and access to safe drinking water.

As much as 90 percent of the health problems in Ethiopia are due to preventable communicable and nutritional diseases. They’re attributable to AIDS, malaria, tuberculosis, food and water borne illnesses, all compounded by malnutrition.

The outreach program, known as the Health Extension Program, has already placed 2,612 health workers, and another 7,100 are being trained this year for placement to various villages in early 2006. Their focus is on health promotion and disease prevention among the country’s rural residents.

A second survey will be conducted in a few years to compare with the baseline survey and provide a measure of the program's success.

Though the Health Extension Program is moving forward on schedule, Awash Teklehaimanot, director of the Center for National Health Development in Ethiopia, said future funding is required for this $1.6 billion initiative.

"The rate of progress and commitment of the [Ethiopian] government to execute the Health Extension Program is admirable," said Teklehaimanot. "Already the construction of health posts is going ahead of plan, and the rate of progress for health centers is going at reasonable pace.

"However, I think a concentrated effort on the part of development partners [which include the Gates Foundation, the US Agency for International Development (USAID), and the World Bank] will be required to provide essential equipment and drugs to the health centers."

The World Bank has provided $10 million to equip 248 health centers with refrigeration for vaccine storage and other supplies.

Still, thousands of other centers need the same equipment.

The Federal Ministry of Health also plans to fortify other health services in support of the health workers. The Ethiopian government recently built 532 health centers, which is 23% of the total health centers the government has planned to construct.

USAID has pledged to contribute $2 million to train 2,000 clinical officers in 20 hospitals. These officers will work at health centers to treat patients referred by the health workers stationed in the villages.

Teklehaimanot, an Ethiopian and a malaria expert, is coordinating the survey effort, which will take about a month to complete.

Related Links:

Earth Institute Supports Training Women to Battle Disease in Ethiopia
Earth Institute Supports Accelerated Expansion of Health System for Ethiopia
Information on the Health System in Ethiopia
The Center for National Health Development in Ethiopia

About The Earth Institute

The Earth Institute at Columbia University is the world's leading academic center 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 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. For more information, visit