The average proportion of monthly household healthcare expenditure increased from 3. Health care financing, efficiency, and equity nber working. Standardization and expansion of hospitals located in different regions is also a focus of health infrastructure development in the country. The infant mortality rate is almost twice that of the world. A guideline to implement publicprivate partnerships in the healthcare sector in ethiopia has been drafted and sent to the ministry of finance for comments. A model projecting resource mobilization and costs executive summary executive summary this paper presents the results of modeling to project ethiopias future resources to finance primary health care and compare them with the likely costs of providing primary care according to current government plans.
Wamai1 table 1 shows the key countrys health related demographic and socioeconomic indicators. Everything you need to know about finance and investing in under an hour big think duration. Fundamentals of health care financial management a practical guide to fiscal issues and activities third edition steven berger dd dd iii 1102607 1. Hospitals and health centers in the three big regions started to retain revenue in 20052006, and now it is being rolled out to all regions as a national program. 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. A guideline to implement ppp in the healthcare sector in ethiopia has been drafted and sent to the ministry of finance for comments. Healthcare finance provides timely and indepth coverage of the challenges faced by healthcare providers and payers in light of skyrocketing healthcare costs, regulatory developments and diminishing reimbursements. Improving quality and equity abstract ethiopia endorsed a health care financing strategy in 1998 that envisioned a wide range of reform initiatives. Sources of healthcare finance in south africa south africa currently spends 8. Ethiopias real gross domestic product gdp growth decelerated to 7.
Executive summary improving health care financing in ethiopia. Ethiopias health care system includes primary health centres, clinics, and hospitals. Healthcare system in singapore columbia university. Access to modern health care is very limited, and in many rural areas it is virtually nonexistent. Ethiopia is a democracy with a federal system of government comprising 9 regions and two administrative councils. H42,h51,i18 abstract this paper examines the efficiency and equity implications of alternative health care system financing. Implications on access to essential medicines background the ethiopian health care system is under tremendous reform. We are committed to improving health systems by strengthening human resources, expanding health financing options, and increasing health commodity and essential drug availability. The implementation of these reform initiatives was legalized through regional legislations and operationalized in line with. Health finance, health insurance cbhi, shi, publications resource type. We also support the development of much needed human resources and health financing schemes. In the early 1990s, ethiopia was recovering from a prolonged civil war. The tplfeprdf has long sought to secure popular support through rapid and broadbased development, including healthcare provision.
There were 119 hospitals 12 in addis ababa alone and 412 health. As indicated in table 8, the healthcare cpi was 101. Care is a povertyfighting organization that has helped establish more than 150,000 microfinancing organizations in 26 countries. Level of macroeconomics pdf huntsburg ohio haynes 3239 cocepts of physics dhcp server geauga county. Background owing to lack of adequate healthcare financing, access to at least the basic health services is still a problem in ethiopia.
Community based health insurance schemes partially fulfill the ethiopian governments long term goal of improving healthcare by mobilizing domestic resources, improving access to healthcare services, and increasing the quality of services provided. Community based health insurance in ethiopia participedia. Only major cities have hospitals with fulltime physicians, and most of the hospitals are in addis ababa. Although outofpocket payments are still one of the barriers to accessing healthcare in the country, in 1998 ethiopia started some decentralising reforms aimed at improving the healthfinancing. The health infrastructure had seriously deteriorated, and health service delivery was inefficient and inequitable. Health care financing reforms in ethiopia began in 1998, when the federal ministry of health fmoh developed a health care financing strategy to improve and diversify resource mobilization for health, ensure equitable and efficient resource allocation and use, and secure financial protection for its citizens. Combined by authors with data from the ministry of finance and economic cooperation mofec for comparison. Although the health financing in ethiopia comes from a variety of sources, direct outofpocket spending accounts for a significant portion of health sector spending in the country. The shortage of medicines, deficiency of water and electricity supply to.
According to the head of the world banks global hivaids program, in 2007 ethiopia had only 1 medical doctor per 100,000 people. One intervention might rank higher on one or both metrics than another, which shows how intervention choicethe selection of a. It is developing guidelines and programs designed to increase the production of crops and facilitate ease of access, not only to clinics, but to safe water supplies and schools too. For a government seeking to expand health access, there are two main options. Our approach incorporates financial risk protection into the economic evaluation of health interventions and therefore provides information about the efficiency of attainment of both major objectives of a health system. Define healthcare management and the role of the healthcare manager. Health care financing reform has allowed health facilities to retain and use their revenue for health service quality improvements.
Ethiopias economy experienced strong, broadbased growth averaging 9. The healthcare sector consists of companies that provide medical services, manufacture medical equipment or drugs, provide medical insurance, or otherwise facilitate the. Reviewing ethiopias health system development jmaj 524. Addis ababa, oromia and dire dawa world bank, 2014c. Improving health care financing in ethiopia report dire international hotel, adama, ethiopia saturday, 07 june 2014 this report was prepared by technology transfer and research translation directorate, at the ethiopian public health institute this policy dialogue was informed by the following policy brief. Thus, health expenditure reported through the audited government accounts of the ministry of finance and economic cooperation mofec. Other, more traditional challenges wastestudies indicate that the u. Among the notable achievements include achievement of mdg4 with a 67 percent drop in underfive mortality from the 1990 estimate, that contributed to an increase in average life expectancy at birth from 45 in 1990 to 64 in 2014. Helmed by an experienced team of independent editors and journalists, we deliver news, analysis, educational content to an audience of senior healthcare financial managers and.
Alebachew a, hatt l, kukla m, nakhimovsky s 2014 universal health coverage measurement in a lowincome context. With the intention of raising funds and ensuring universal. Interministerial dialogue between the ministries of finance and health will need to be embedded within the process of developing a health financing strategy that is based on evidence and takes into account. 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. Although the health financing in ethiopia comes from a variety of sources, direct outofpocket. Health gains and financial risk protection afforded by. These four budgeting methods each have their own advantages and challenges, which will be discussed in more detail in this guide. About 85% of the healthcare provision is provided by public healthcare facilities, while the remaining 15% is provided by the private healthcare 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 care to millions of women, men and children. Ethiopia investment climate from the perspective of regions. However, there are clear inequalities in the extent to which different sections of the south african population is able to access healthcare services. Ethiopia made remarkable progress in access to water and sanitation between 1990 and 2010 xix figure 0. However, the world health organization in its 2006 world health report gives a figure of 1936 physicians for 2003, which is about 2. Health service delivery in ethiopia is characterized an inadequate number of welltrained health providers, limited health infrastructure and shortages of finance, equipment, and supplies.
Health care financing, efficiency, and equity sherry a. The centers for disease control and prevention cdc office in ethiopia was established in 2001 and works closely with the ministry of health and other partners to maintain strong programs in training, treatment, counseling and testing, and laboratory capacity building. This is relatively high by international standards. Ethiopia skills for competitiveness and growth in the manufacturing sector world bank, 2014b. Differentiate between the functions, roles, and responsibilities of healthcare. Poor health care financing is one of the major challenges for the health system of ethiopia fmoh 2010.
As a result, ethiopia has done remarkably well in meeting most of the mdg targets. The government is currently looking for ways to help solve the problems related to poor access to healthcare and medical facilities in ethiopia. Alebachew a, hatt l, kukla m 2014 monitoring and evaluating progress towards. Shanks 1 learning objectives by the end of this chapter, the student will be able to. We have supported the government of ethiopia to train and deploy more than 38,000 health extension workers and 4,000 health officers, and is helping the government develop and deploy midwives, nurses, and anesthesiologists. Ethiopia endorsed a health care financing strategy in 1998 that envisioned a wide range of reform initiatives. Using 2009 as the base year, the healthcare inflation was kept below the general inflation. Improving health care financing in ethi opia report dire international hotel, adama, ethiopia saturday, 07 june 2014 this report was prepared by technology transfer and research translation directorate, at the ethiopian public health institute this policy dialogue was informed by the following policy brief. There are four common types of budgets that companies use. Underfive mortality rates in ethiopia and subsaharan africa ethiopia has demonstrated that lowincome countries can achieve improvements in health. The implementation of these reform initiatives was legalized through regional legislations and operationalized in. Ethiopia aims to reach lowermiddleincome status by 2025. Primary healthcare in ethiopia is provided by facilities including health centers and health posts. Ethiopia health insurance healthcare system globalsurance.
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