Trend of Expenditure in The Health Sector
The finding from Ethiopia’s fourth National Health Accounts (NHA, 2010) showed that national health expenditure has grown significantly from the 2004/05 level of 4.5 Billion Birr (USD522 million) to Birr 11.1 billion (USD 1.2 billion) in 2007/08.In terms of per capita health expenditure, the increase has been from the 2004/05 level of USD7.14 to USD16.09 in 2007/08. The report also provided the proportion of health expenditure by each source of financing in the order of 40% by the rest of the world followed by 37% by household out-of-pocket expenditure, the Government (both central and regional) 21% and the remaining being covered by a combination of employers based insurance schemes and other private sources. Official government reports monitoring health expenditure showed that over the years the share of government health budget allocation as a total government budget during the PASDEP period has shown some sign of improvement. For example, health budget allocation as a proportion of received regional public block grant from federal government accounted for 10.1% in 2008/09. However, health care funding still remain a continued challenge for the health care system of Ethiopia prompting to an inward and outward looking for the mobilization of additional health resources such as community and social insurance schemes, enhancing in the user fees revenues and increased mobilization of funding from external sources-global and health development partners.
Figure 2.11: Trends of Health Expenditure in USD/Capita Pastoralist Health Service Pastoralist population in Ethiopia constitutes about 10% of the total population of the country. Yet, there is Lack of appropriate health service delivery package to address the health care needs of the communities in the Pastoralist regions. This has prompted to establish two core objectives under HSDP-II regarding the Pastoralist health services and systems. These were to establish an appropriate health service delivery for the pastoralist population and to increase coverage and utilization of health services in pastoralist population. In this regard, a concept paper, "Health Service Delivery to Pastoralists", was developed by FMOH and the 16 HEP packages were tailored to pastoralists needs and have been translated into local languages. In addition, as part of government’s effort to give technical assistance to the emerging regions, a board composed of members form six ministries was established under the Ministry of Federal Affairs including a technical committee for the integration of support to the Newly Emerging Regions.
Following the redesign and implementation of CSRP and the BPR, one of the major organizational transformations in the FMoH was the establishment of Pastoralist Health Promotion and Disease Prevention Directorate to focus and draw attention to this pastoralist population. 2.2.8. Operational Research Operational research in health is very crucial to identify priority health and operational problems by producing evidences for planning and decision making for improving health services. Although it is a critical part of M&E, operational research has not been conducted in a coordinated manner during the HSDP I and II periods. Research and Technology Transfer is one of the core processes redesigned as part of the BPR. There have been a surge in the number of operational researches during HSDP III covering wide areas such as on the causes of maternal mortality (Maternal death audit), prevalence of cervical cancer, coverage of child and TT immunization, coverage and impact of the expanded program of immunization, EPI coverage survey, effect of Misoprostol, choice of family planning, nutritional surveillance, traditional medicine, HIV/AIDS, TB, and malaria, surveillance of major public health problems and health commodity tracking. Operational researches were also conducted on the EOS coverage validation survey, national nutrition baseline survey, effectiveness of Coartem, effectiveness of residual DDT spray, and cost of health services.
- Cross cutting issues
- Gender
Gender is among the cross cutting issues and has remained a crucial concern that has prompted the setting of clear objective for gender mainstreaming at all levels of the health system. In this regard, the government has completed the preparation of a training manual on physical violence and analytic framework on gender and health, compilation and analysis of data on female workers to be used for advocacy purposes. The final version of this document will be published and distributed to stakeholders..There has been also a rapid assessment aimed at prevention of physical abuse on women and on the provision of adequate health services for the victims of abuse. Based on the results of the assessment and the identified gaps, a draft training manual has been developed for use by health workers. This training manual has been further refined through a consultative workshop attended by all concerned stakeholders
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