When we observe his 4th death commemoration it is appropriate to have an overview of the changes that took effect through his sagacious leadership. So in this piece let us see envisaged plans and achievements gained in the health sector over the years.
For 26 years or since 1940 E.C, the then Ministry of Health had been making an effort to contain and ward off communicable disease. Making researches and collecting information pertaining to the transmission of various types of diseases were also the core objective of the ministry.
The then government did try to dot the nation with health centers. In so doing till 1966E.C. the government did manage to establish 93 health stations and 679 clinics. In general, there were 84 hospitals having 9,167 beds.
Regarding health professionals, the number of medical doctors was not exceeding 375, nurses not more than 934 and health officers not more than 376.
Community nurses were 286 and health supervisors were not more than 270. Despite all such efforts the health service provisions was restricted only to major towns. Due to this, the poor segment of the society had not a chance to get health services.
Between the year 1966 to 1983 E.C, 72 hospitals, 153 health stations and 2,229 clinics were built. Pertaining to manpower development, were not more than 1,200 medical doctors,3,575 nurses, 24 health officers, 389 health supervisors, 377 pharmacists and 9,945 health assistants.
But this figure includes the former Ethiopia state -Eritrea too. Though Derg had accepted lamata convention to expand health services for all, due to the system's shortcomings no better success was registered.
During the war mongering, as the health service coverage was not exceeding above 35 per cent, community health problem was not addressed well.
Following the toppling of the Derg regime in 1983 E.C, some health institutions slackened out and health service provisions were weakening in the remaining ones.
The transformation period kicked off with rehabilitation and strengthening tasks of health institutions. Parallel to this, designing a health policy that solve community health problem in an accelerated fashion was made a point.
The core elements of the policy are democratization and decentralization of the health care system, development of the preventive, pro-motive and curative components of health care, assurance of accessibility of health care for all segments of the population and the promotion of the private sector and NGOs' participation in the health sector.
Besides, the health policy places focus on providing health promotion and disease prevention, curative and rehabilitative services, public health emergency preparedness and response to enable the population to see to its own health.
Based on the policy, the government has prepared a twenty- year Health Sector Development Plan(HSDP). It has been revisited . The plan eyes at ensuring community ownership and empowerment through effective social mobilization,enhanced and sustained awareness creation. Also creating conducive environment and supporting community based organizations are in its goals.
The plan serves as a primary vehicle for prevention, health promotion, behavioral change communication and basic curative care through effective implementation of the 16 packages. The plan was evaluated to beef up the health sector's capacity,improve work systems and organizational structure. The sustainability of the tasks was ensured.
As put above, the health policy focuses on disease prevention. Simultaneously, the government provides special emphasis to the expansion of health facilities.
Blending both preventive and curative tasks, it is possible to put in place basic health service structures and thereby ensure effective and decentralized health system. To improve health service accessibility, in1996, the health extension program did play the main role for the betterment of basic health services.
Nationwide, the government did deploy close to 40,000 health extension workers both in urban and rural areas. They and others who joined them are playing important role to meet the vision of materializing productive and healthy citizens.
In 1983, there were only 153 health stations but in recent years the number has soared to 3500. Extrapolating the trend, it is possible to hit the target set to provide health service to 25,000 people at a given station.
These days at least one health post is found in every kebele.Nowadays, the number of total health posts is over 16225. In 1983, there were only 72 hospitals nationwide, by now the figure has shot up to 311 hospitals,precluding hospitals built by private and non government institutions.
In addition, expansion and capacity upgrading tasks have been carried out in the existing hospitals. By adding 55 health stations in the capital, it is possible to raise the number to 75. Based on this, national health service coverage has reached 100 per cent from where it was 38 per cent in 1983 .
Nationally, there has been an effort to hit the target set in a short span of time by creating health access to 100,000 people with in a primary hospital, to 1.5 million people with in a given general hospital and to 5 million people in given referral hospital. Besides expanding health institutions, it is possible to set up a system that ensures public ownership and participation in health institutions.
On the other hand, to make the nation a destination of medical tourists, in addition to the modern hospitals which have been constructed by the government, there is an effort to take on board investors, who have interest to engage in the sector.
To foster the participation of investors in building various health institutions, over 40,000 private health institutions are now providing health services in various health hierarchy. Of the 1,500 private health institutions found at the capital, 32 are hospitals.
Regarding manpower training and deployment, presently, over 40,000 health extension workers and 46,000 nurses, (1 to 2109 ratio) exist in the country.
Reports indicate that things are getting above the standard set by world health organization. It is heartening to note the presence of over 6000 health officers, 8500midwivers, 5,000 medical doctors and 10,870 health professionals.
In general over 150,000 of them are working in government run health institutions. In 1983, professionals working in the health sector were not more than 16,550.This indicates that the government has been doing its level best to produce numerous health professionals and to effect transformation making a great difference.
Presently, health institutions' intake capacity has passed the 23,000 mark. Of which, some 3,560 are studying to be medical doctors.Based on this, over 16,000 health professionals have been graduating every year and joining the sector.
Ten years back, the number of medical doctors graduating and engaging in the health sector was below 150.This year alone, over 2,700 medical doctors had graduated. In 1983, there were only three health training institutions and universities, but now, the number has mounted to 30.
Besides, medicine and medical equipment supplies are improving. Tasks such as health and health related input supervisions,ensuring sector transformation and research that can solve health and health related problems of the community have been enjoying focal attention by the incumbent.
In addressing good governance problems in the health sector and improving service provision and thereby addressing concerns and requests raised by the community, the incumbent has prepared a good governance strategy and no effort has been spared to implement it at all levels.
It has been made possible to build a health sector development army linked to the ministry office and to the society found at the grass root level in a bid to implement and attain target set in the sector.
In general, by the concerted,multifaceted and an all out effort of the govern ment,stakeholders in the health sector, the public , better results are recorded. The death caused by HIV and AIDS has declined by 90 per cent. Similarly,the death toll by malaria has declined by over 60 per cent.
The death caused by tuberculosis too has made a nosedive by over 80 per cent. Ethiopia had achieved the millennium development goals- 4 by reducing under five child mortality rate ahead of time. The target set to scale down maternal mortality by 75 per cent is effected.
National health coverage has also reached 100 per cent. Improvement in the health sector has been contributing a lot in improving life expectancy of citizens--on the average from 45-64 ages.
Down the road, the ministry of health envisions bringing into play and implementing health sector development programme and Growth and Transformation Plan II. The set goal in the coming years is ensuring equity and quality of health service to the community.
Minister of Health Dr. Kesetebirhan Admasu has recently told to the Ethiopian Herald that, "While we improve access to health service,there is always a question of quality.
Balancing quantity and quality is mandatory. So, in the next five years, the focus will be improving quality of health care starting from the community level, from health posts up to tertiary hospitals.
So we will have key performance indicators that would show whether the service we are providing to the public is of acceptable quality of standard quality," he added.
The bottom line is when we remember Meles let us reaffirm commitment to hold high the torch of change he rekindled through his sagacious leadership.
The author is Editor of the Ethiopian Press Agency
.jpeg?itok=vCj6bCRe)
