There are many barriers to residents obtaining proper health care in Ethiopia. It is estimated that 76 percent of Ethiopian women live in rural areas and do not have access to health care due to long traveling distances with lack of transportation.
Why Better Health Care in Ethiopia is Necessary
There are 1,949 health stations and 141 health centers in Ethiopia. Many of these facilities do not have a physician present to provide care. Therefore, many people, particularly women, do not want to travel long distances to a facility that may not have a proper physician to provide care. This is especially true for women that must travel alone because of the high rate of rapes and abductions that take place in Ethiopia.
There is a great need for proper health care in Ethiopia when disease is responsible for 74 percent of deaths. The conditions that are most responsible for deaths include malaria, acute respiratory infections, nutritional deficiencies, diarrhea and HIV/AIDS. In 2009, there were 1.7 million cases of malaria reported and 1.1 million cases of HIV/AIDS. Ethiopia is ranked third in all of Africa and eighth in the entire world for the most cases of tuberculosis.
The lack of health care in Ethiopia has resulted in a high rate of infant and maternal deaths. There are an estimated 59 deaths for every 1,000 live births and 88 deaths for every thousand children under the age of five. 34 percent of children are born underweight and 50 percent are stunted due to nutritional deficiencies by the age of five.
Understanding Issues in Ethiopia’s Current System
Ethiopia’s government has been largely focused on battling famine which is why the health care system has suffered. However, in 2012, the government built 13 new medical schools and increased the enrollment in the already established schools. The government has proposed that with the estimate of 85 percent of the rural population not having access to health care in Ethiopia, a large barrier is the lack of physicians available in the public sector.
A study in 2009 that surveyed how many physicians were working in Ethiopia showed that there were 2,152 physicians in the public sector (about one physician for every 42,000 patients). The same survey showed that 73 percent of physicians that graduated from a residency program in Ethiopia either left the public sector to work privately or immigrated overseas for more income. The government has made efforts to increase the number of residency programs to train more doctors and surgeons. However, the increase in students is not enough to support the population.
The deficit of surgeons is even greater than general physicians. Until 1980, all surgeons were trained outside the country and there were roughly three surgeons to every 1,000,000 patients. This improved when the Tikur Anbessa Hospital established the first surgical residency program in 1980 and has since continued to improve.
Since 2005, there have been seven more surgical residency programs added that have incorporated subspecialty training such as neurosurgery, urology, cardiothoracic surgery, plastics and reconstructive surgery. This program accepts only 25 new residents a year and each student will rotate between six different hospitals around the city of Addis Ababa.
How the Government is Battling the Issue
The local government has decided that increasing the number of students and graduates will decrease the physician shortage which is currently the worst barrier of proper health care in Ethiopia, but the increase in student enrollment has compromised the quality of physician training. One factor that contributes to lowering the quality of training is the limitation of resources; there are on average 30 students to one cadaver.
Another damaging factor to the quality of medical training due to the increase of enrollment is the lack of instructors. There are not many incentives in teaching students, therefore recent graduates with little clinical experience are asked to instruct the new students.
There is a desperate need to develop health care in Ethiopia. The lack of attention to the health care system is due to the great efforts to end famine in the country. However, the country’s government is making small efforts to improve citizens’ access to health care in Ethiopia.
– Kristen Hibbett