Category: "Health"

At 88 Dr. Catherine Hamlin is still serving Ethiopia

September 7th, 2012

At 88, this Aussie doc is still serving Africa

AT THE age of 88, Sydney-born Catherine Hamlin still walks from her mudbrick home on the banks of an African river to perform surgery at the hospital she founded nearly 40 years ago.
Dr Hamlin, who is in Australia to raise funds for the hospital in Addis Ababa, has devoted much of her life to helping Ethiopian women who suffer debilitating injuries during childbirth.
She arrived in Ethiopia in 1959 with her husband, the late Dr Reginald Hamlin, on a three-year contract and has been there ever since.

She plans to be buried there beside her partner.

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Ethiopia: Dictators spurn their nations' health care

September 2nd, 2012

Ethiopians from a community of people with disabilities arrive Aug. 25 to pay their respects in Addis Ababa at the coffin of Prime Minister Meles Zenawi, who died days earlier at a hospital in Belgium. Though their citizens are stuck with their nations' meager health services, dictators often travel abroad for better care. Photo: Rebecca Blackwell, Associated Press SF

Ethiopia: Dictators spurn their nations' health care

Foreign Matters
By Joel Brinkley

Meles Zenawi, Ethiopia's dictator, died last month - in a Brussels hospital.
Why didn't he get medical care at home? Look at the state of his people's health, and you'll understand.
The government provides vaccinations for only 5 percent of the children. Fewer still receive antibiotics when they contract pneumonia. Only 20 percent of teenage girls are educated about AIDS. Is it any wonder that Ethiopia's average life expectancy is 56 - among the world's lowest?
Eleven years ago, 53 African nations signed a pledge to spend at least 15 percent of their national budgets on health care. Almost no nation has lived up to that. Right now, Ethiopia dedicates 3.6 percent of its budget to health. So no one was surprised when the president went abroad for care.

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ETHIOPIA: Surge of doctors to strengthen health system

August 16th, 2012

ETHIOPIA: Surge of doctors to strengthen health system

Source: IRIN

ADDIS ABABA, 14 August 2012 (IRIN)
- Ethiopia is preparing for a flood of medical doctors within "three to four years", an influx meant to save a public health system that has been losing doctors and specialists to internal and external migration.

"We are now implementing strategies that intend to increase the current below-World Health Organization [WHO] standard number of medical doctors and retaining them in public hospitals," Tedros Adhanom, Ethiopia's minister of health, told IRIN.

"We have now reached an enrolment rate of more than 3,100," he said. The rate of enrolment in the country's medical schools has increased tenfold from 2005, when it was below 300.

"In the next two, three years, it could go to six and eight thousand," said the minister, adding that once these students start to graduate, the problem regarding shortage of physicians in the country "will [have] considerably stabilized".

While WHO recommends countries have a minimum of one doctor per 10,000 people, Ethiopia has fewer than a fifth of that ratio, compared to a regional average of 2.2 physicians per 10,000 people.

"We have not [supplied] enough doctors despite the high demand," Tedros told IRIN.

A draft of the country's Human Resource for Health Strategic Plan shows an intended increase in the number of physicians to 1 per 5,000 people by 2020. The plan seems on course, with a report presented to parliament in May revealing 2,628 students had been enrolled in 22 universities over the previous nine months. Currently fewer than 200 doctors graduate annually.

But once the new students start to graduate, "We can succeed in easing the problem significantly within three to four years," the minister said. "Afterwards, we can also have more doctors that specialize in several sub-health fields."

Questions over quality

With the strong emphasis on health personnel numbers, experts have expressed concerns about the quality of medical education available.

"Of course, whenever emphasis is given to numbers, quality is compromised," said Milliard Derebew, a medical professor at Addis Ababa University. "Due attention should be given to quality as well," he said.

Tedros also admitted quality is a concern. "We go [for] high speed and high volume, and keeping the quality could be a problem", though it is one that "should be addressed soon". He said the country would look to others for support in terms of funding and experience.

Through the Medical Education Partnership Initiative (MEPI), the US is supporting Ethiopia's efforts to improve the quality of medical training.

Milliard said medical teachers at Addis Ababa University receive incentives to they take additional classes. The initiative has improved the medical school's ratio of books-to-students, from one book per 24 students to one per three.

"Besides [this], we are networking with known US universities through video conferencing so that the students learn from experience of others," he said.

Focus on retention

Challenges also remain in retaining doctors prone to migration. In 2006-2007, 37 percent of the country's public-sector physicians worked in Addis Ababa, which was only home to less than 4 percent of the population.

"The remaining available physicians to the public sector serve the rest of the regions but [are] largely working in major cities," says the government's draft Human Resource for Health Strategic Plan.

One study found that the country faces "a mass exodus of physicians," caused by low salary, insufficient supply of drugs, lack of professional resources and poor management. "Low quality of life in Ethiopia and political repression were found to be the most significant exogenous push factors of migration," the study said.

Ethiopia has been able to increase the number of lower-level healthcare staff, such as health extension workers, helping to bridge the human resource gap at the village level. But in the long run, the ministry said, the present flooding strategy could be the way to boost the public health system.
"If you can train in big numbers," said Tedros, the minister of health, "even if you lose some through brain drain, it may not be that significant. That's why we believe brain-drain is not the source. It's the mismatch between the demand and supply which is the source of the problem. On the other hand, you should also do something to retain the people that we train.

"But whatever you use to retain should [be] based on what you can offer," Tedros continued. "For instance, you can't compete with developed countries in paying high the salaries. You can't compete with them by using the same approach," he said.

Medical training is expensive, estimated to cost the country an average US$22,745 per student. Doctors are required to serve in public hospitals for some time before going into private practice in different countries.

"Right now we are introducing financial and non-financial incentives to keep them," Tedros continued. "Apart from various incentives that regional governments give, the retention strategy includes lowering the fixed number of years that doctors should serve in rural health facilities and installing private wings in public hospitals," he said.

Accordingly, the government expects graduate medical doctors to serve in rural public hospitals for a minimum of one year, while the service period in public hospitals in major and regional cities might reach up to five years. While in those hospitals, doctors can receive additional financial benefits from private wings set up in public hospitals.

"We have private wing, for instance, that started in Ethiopia [where doctors can] work off-hours and weekends, and they get additional financial benefits," said the minister. "I don't think they would go anywhere because [the income is] not really as high as they would get if they migrate but it's good enough to sustain their life here, and they prefer to stay here with the additional funding they already generating themselves."

Ethiopia currently has no alternative but to train physicians in large numbers, a strategy that has been applied in parts of Asia, said Kebba Omar Jaiteh, a senior WHO expert. "We have seen this trend in India and other Asian countries. When they start training at the beginning, people start moving, but they reach a saturation point whereby…people no longer want to go because the country has improved economic-wise and social-wise. Until that time comes, we need to keep on training in order to serve the people."

In Ethiopia, more HIV-positive mothers deliver babies free of the virus

August 1st, 2012

In Ethiopia, more HIV-positive mothers deliver babies free of the virus

By Indrias Getachew

, 1 August 2012 – Adanech* rushed to the Saris Health Centre in Addis Ababa when her labour pains started.

Like every mother in the world, she hoped to deliver a healthy baby. But Adanech is HIV positive, and without appropriate care, she could pass on the virus to her baby.

“I want my child to be free [of HIV],” said she said. “I don’t want my child to share my fate. That’s what I wish for.”

Because of an effective mother-to-child transmission (PMTCT) programme at the health centre, supported by UNICEF and its partners, Adanech has an excellent chance of having her wish come true.

Supporting mothers living with HIV

Rahel Wondafrash, the nurse in the delivery room, handed Adanech a dose of prophylactic medicine. This is part of a regimen of medicines for mothers and babies to help prevent HIV transmission.

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Ethiopia: Speech By Ethiopia's Minister of Health At the London Summit On Family Planning

July 12th, 2012

Ethiopia: Speech By Ethiopia's Minister of Health At the London Summit On Family Planning

Washington, DC — Following is the text of the address by Ethiopia's Minister of Health Dr. Tedros Adhanom Ghebreyesus to delegates at the London Summit on Family Planning:

Excellencies, Distinguished Guests, Ladies and Gentlemen: It is a great pleasure and honour to take part in this landmark event. On behalf of the Government and people of Ethiopia, let me start by thanking the Government of the United Kingdom, the Bill and Melinda Gates Foundation, and all those involved in the organization of this momentous Summit.

Secretary Mitchell and Mrs Gates - your personal commitment to advancing the health and rights of women and men throughout the developing world is an inspiration to all of us. We salute you for all your dedicated efforts and leadership.

Ladies & Gentlemen: Today, we have before us a unique opportunity to transform the lives of millions of women and men around the world, by resolving to accelerate access to family planning.

Timing is of the essence. And I say this because I truly believe that the key conditions for achieving real and unprecedented impact are now aligned like never before. I want to highlight three key ingredients in particular.

First, the progress already achieved in building up health systems and improving health outcomes over the last two decades provides us with a stronger footing for scaling up access to family planning. Reinforced by the 2015 MDGs, countries have achieved tremendous progress particularly on the first two parts of the 4-point ICPD action plan set 20 years ago in Cairo: universal access to education; and reducing child mortality. In fact, emboldened by the substantial global progress on child health, last month, in Washington DC, we launched a new global call to action on child survival. We all came away from that meeting greatly energized. Of course, we know that improved child survival has a significant impact in increasing demand for family planning.

Importantly, we agreed that stronger emphasis will be needed on advancing a continuum of care for maternal, newborn and child health.

Second, family planning - which has proven to be a highly politicized issue over the years, is now starting to be seen in a different light by many. Providing access to family planning is about social justice. It is about upholding the rights of women and men to choose. It is about empowering them to take control of their own lives.

However, our progress in the latter two ICPD objectives - reducing maternal mortality and broadening access to reproductive health services and family planning has been relatively slower. Why? I believe largely because all the key conditions for success, had not been adequately aligned - strong political will, real country ownership and a commitment to understand and work together with communities to address socio-cultural and economic barriers to accessing health services, as well as the investments needed in building national capacities to deliver the services at scale. This summit, I believe, will be a real opportunity to turn things around.

Thirdly, today we have studies that have shown that voluntary contraceptive use can avert more than half of all maternal deaths in the developing world . This result lays bare our moral obligation to ensure universal access to family planning. Inaction is no longer an option.

Also, In order to really impact maternal health, we must continue to push on all the other key factors, including ensuring girl's education, access to skilled birth attendance, and overall improvements in living conditions.

*** Let me now turn to the encouraging progress my own country Ethiopia is already making on family planning.

Our Government is committed to enabling women and men to choose whether, when and how many children they have through the use of proven family planning methods. We are building a women-centered health system and family planning is part of our efforts to improve the health of women and girls. We now have in place a strong primary health care service.

Health extension workers in every village across our country are reaching women with vital reproductive health and family planning information.

As a result, we have seen an unprecedented upsurge of real voluntary demand for contraceptive. The broader range of free modern contraceptive options we offer has also been key to fuelling demand.

And we have made significant progress in meeting this demand. The unmet need for family planning in Ethiopia has declined, and the contraceptive prevalence rate has doubled in 5 years. Based on the current trends, contraceptive prevalence rates will reach 65% by 2015 by reaching additional 6.2 million women and adolescent girls.

This is a very ambitious goal. But our Government's commitment to realizing it is steadfast. The current demographic transition of falling birth and death rates, presents us with a unique window of opportunity to sustain economic growth and secure Ethiopia's place as a middle income country by 2020/22. It is an opportunity that we cannot afford to miss. We are determined to close the family planning gap and accelerate our efforts on maternal and child survival and health. This is why we are now focusing on three key challenges:

First, recognizing that early childbearing is a major contributor to maternal mortality, we are now targeting our efforts on adolescent girls (15 to 19 years) who have the highest unmet need for family planning.

Second, we must do more on ensuring commodity security by both strengthening the supply chain and expanding the contraceptive methods we offer.

Third, although we are increasing our national budgetary allocations to family planning each year, we still have a 50% funding gap for commodities.

These challenges amount to a five point action plan for Ethiopia:

We will make family planning a cross-sectoral development issue by securing family planning commitments across all stakeholders and all leadership levels.
We will make more domestic funding available for family planning.
We will focus more efforts on adolescent girls, by expanding youth friendly services.
We will scale up delivery of services to hard to reach groups 5. We will monitor the availability of contraceptives by using innovative approaches

Ethiopia is committed to take a very bold action and will never shy away. We will fight because it's a cause worth fighting for.

We also count on the continued support of all our partners. We have very high hopes that this landmark initiative will help us mobilize the resources and ensure affordable market to make a lasting difference in the lives of millions.

In closing, let me just add that it is not what we promise here today but what we will do when we go back home that matters. Let's seize this opportunity today to give millions of people the choice of how they will live their lives tomorrow. If united anything is possible. I wish us a successful summit.

Thank you.