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The Ministry of Health held a briefing on its six month performance on Thursday January 30th. Minister of Health Dr. Kestebirhan Admasu who presented the performance report stated that the Ministry has seen much progress in healthcare.
Skilled medical professionals
One concern remains the lack of doctors. Currently there are 26 government medical schools which have 11,000 medical students. Doctors make up about 3,946 of that number.
The ratio of doctors to patents is currently 1 to 21,000. According to the World Health Organization target, that number should be 1 to 10,000.
“We believe we will be able to meet that standard by the end of the Growth and Transformation Plan period. We are also working extensively to increase the number of midwives,” stated the minister.
According to the report, currently, there are about 6,500 midwifes working in government medical centers. The government is also training 2,000 to 3,000 currently and plans to train 10,000 midwifes by the end of the GTP period.
The Medhanit Akrebot fund agency that was established five years ago is the main provider of those labeled essential medicine. The agency that went operational with a capital of 25 million birr currently moves 10 billion birr worth of medicine. Just in the last six months, it purchased medicine and medical equipment worth five billion birr.
Although the WHO says the agency is doing a commendable job, there are still instances where hospitals and health centers do not receive medicine they need due to logistical problems.
“We are putting in a lot of work in overcoming this challenge by establishing more medicine storage facilities. We have now 17 storage facilities that are almost finished and we expect them to become functional in the next two months. We are also working out a system that gets the medicine from the storage facilities to the door steps of health centers and hospitals,” the minister stated.
After the 17 storage facilities go operational, it means there will be one storage facility in every 200km radius of a medical center.
The report also states that there are a lot of challenges regarding special types of medicine for illnesses that affects a small number of people. Pharmaceutical companies are not interested in supplying this type of medicine because there isn’t a lot of need for it.
“To solve this problem we have organized a task force which I myself visit every two weeks, and we are working on designing a plan that will allow us to provide these types of medicine to hospitals and health centers and to keep them in stock so that there will never be a shortage,” the minister said.
The Ministry has also ordered medical equipment for big hospitals worth USD 12 million. These include MRIs, Cat Scans as well as dialysis machines.
“Once we get all the equipment we ordered, we will be able to provide more services such as kidney transplants. I believe we will begin that specific service after three months,” he stated. He also said that experts have already traveled to the University of Michigan in the US to get some exposure in the organ transplant area.
The universal health insurance that was supposed to be effective by the Ethiopian Health Insurance Agency by January this year has been delayed until July.
“There are two types of health insurance. One is the community based insurance which has already been piloted in 13 Woredas but we will soon be expanding the insurance to 161 of them. The other, the universal health insurance scheme, we believe will be effective by July this year,” he said. People will pay a small premium and the Woreda administration, the state government and the federal government subsidizes the rest.
According to the ministry, the delay in introducing the universal health insurance is due to several processes. “The Ethiopian Health Insurance Agency has established 26 branches. Organizing those branches and hiring the work force needed takes a long time,” the minister said.
It is also stated that getting contractual agreements with medical facilities as well as pharmacies had its own lengthy process contributing to the delay.
Reducing maternal mortality
Maternal Mortality has been reduced by 44 percent and the efforts of the Ministry have been acknowledged by the WHO.
“The main target here is to cut down maternal mortality by 75 percent. We work with different stake holders to make this happen. For a long time it has been that mothers in the rural area gave birth in their home for many reasons. One is because of the lack of health centers, but now that has improved significantly,” Kestebirhan said.
There are over 3,200 functional health centers currently. This means that there is one health care center in every 7km radius.
“Ambulance service was also something that was given in big cities, but now we have managed to have one ambulance per Woreda, even two in some cases. This took a significant amount of investment from the government,” he added. It is expected that by the end of the GTP period, 61 percent of mothers in the country will give birth in health centers, that number currently is 26 percent.
Cross border diseases
“Unless the conflict in Somalia is resolved and children are vaccinated, the danger of the Polio virus is always going to be there,” he said.
Currently, in Somalia’s southern part, there are well over 300,000 children who have never received vaccination for anything. Because of the high mobility in the border area, children who may be carrying the virus are bound to cross over.
“The Dolo zone previously known as the Warder zone is especially at risk. We have mobilized a significant number of health workers to work there. WHO’s Stop Polio Campaign experts are also in the area. We also have 26 teams referred to as mobile health teams that provide medical services and vaccinations,” he said.
The minister also mentioned that currently there are 56 vaccination posts alongside the border of Ethiopia and Somalia.
Capacities of medical professionals
The minister noted that there have been several instances that have put the capabilities of medical professionals in question.
“One of the milestones in this area is that we drafted a regulation that will be used to monitor the performance of medical professionals. Hospitals are also in the process of establishing a medical ethics committee that will be in charge of looking at cases of misconduct and reviewing complaints,” Kestebirhan said.
A monitoring body is also being established in all teaching hospitals. Starting next year, students graduating from medical school to become doctors, nurses and other types of health professionals will need to take a separate national competency examination that is similar to the COC examination.For those who have already graduated and are already in the system, to be able to renew their medical licenses, they will need to go through a continuous professional development courses that are mandatory