This document discusses existing and emerging health issues in Ethiopia. It notes that while Ethiopia has made improvements in health indicators, challenges remain like neonatal mortality, under-5 deaths, and maternal mortality. Emerging issues like COVID-19 also impact health. The building blocks of the health system are described, including health service delivery, workforce, information systems, access to medicines, financing, and leadership. National health policy in Ethiopia focuses on decentralization and developing preventive care. Strategies under the Health Sector Transformation Plan aim to improve quality, equity, and universal health coverage. Reforms introduced revenue retention and exemptions to improve access.

1. Submitted to : Mr. Besha G.
Submission Date: 09/12/2022
INSTITUTE OF HEALTH SCIENCE SCHOOL OF PHAR
HEALTH SERVICE MANAGEMENT GROUP
ASSIGNMENT
JIMMA
UNIVERSITY

2. GROUP 5
1. Rediet Teshome RU0150/12
2. Ruhiya Workineh RU1991/12
3. Samuel Garada RU1374/12
4. Sarah Foni RU5163/12
5. Seifa Demise RU1284/12
6. Shambal Getachew RU1460/12
7. Simera Keno RU0197/12
8. Wandimu Alemu RU1432/12
9. Yohannes Getaye RU5135/12

3. Existing and emerging health
issues and trends

4. Existing and emerging health issues
and trends
 Existing issues can be described as issues that
happened before the last ten years and persist until
now.
 Over the last decades, Ethiopia has made great
improvements in many health indicators through
the Health Extension Program and Expansion of
PHC units.

5. existing and emerging….
Despite considerable improvements, Ethiopia needs
to show better results in the following areas:
 Neonatal mortality
 Under age 5 deaths
 Maternal mortality
 Mortalities due to HIV, malaria and TB
 Malnutrition Health care referral system etc.

6.  These shortcomings endanger the health and lives of all
patients, add additional costs to the health care system,
and reduce productivity.
 To achieve necessary improvements in health care
quality, there is a need to improve management skills of
senior leaders at different levels.
existing and emerging….

7. existing and emerging….
The situations are aggravated by challenging situations like
 inefficient and ineffective utilization of financial
resources,
 shifting burden of disease (epidemiologic transition),
 decentralization and devolution,

8. existing and emerging….
 Emerging health issues like COVID-19 is disease
affecting people of any age, climate sex, social groups
and race.
 These group not only affected but also transmit the
virus to others. It has also great health impacts of the
globe.

9. existing and emerging….
 Increased rate of illness is expected to put pressure to
the quality of health care in Ethiopia with potential
service saturations and severe limitations for poorer
households in terms of affordability and accessibility as
well.

10. existing and emerging….
 Health systems are evolving and have to continuously
respond to the changing demographic and
epidemiologic profiles of populations;
 rapid changes in medical technology;
 increasing influence of globalization; and
 the desire to rapidly expand services and achieve
universal health coverage.

11. existing and emerging….
A well-functioning health information system is one that
ensures the;
 production,
 analysis,
 dissemination and
 use of reliable and timely information on health
determinants, health system performance and health
status.

12. existing and emerging….
 If the system is not functioning well to produce
evidences on occurrences of diseases could have
resulted in worst outcomes in the lives of the people
served by the health sector
 The leaders and managers are expected to establish
clear goals and standards, and for which they are
hold accountable to.

13. existing and emerging….
 These trends and diseases burden needs also a
proactive leadership to respond promptly and safe
lives.
 It is also important to indicate that several competing
priorities should arise that need the attention of
everyone in the sector.

14. Building blocks of health system

15. The building blocks of health system

16. 1. HEALTH SYSTEM
DELIVERY
 Increased inputs should lead to improved service
delivery and enhanced access to services.
 Ensuring availability of health services that meet a
minimum quality standard and securing access to
them are key functions of a health system.

17. Key characteristics of good service delivery
 Comprehensiveness
 Accessibility
 Coverage
 Continuity
 Quality
 Person centeredness
 Coordination
 Accountability and efficiency

18. 2. Health workforce
 The health workforce can be defined as “all people
engaged in actions whose primary intent is to enhance
health”.
 These human resources include clinical staff, such as
physicians, nurses, pharmacists and dentists, as well as
management and support staff, i.e. those who do not
deliver services directly but are essential to the
performance of health systems

19. Health workforce continued…..
 The ability of a country to meet its health goals
depends largely on the knowledge, skills, motivation
and deployment of the people responsible for
organizing and delivering health services.
 Inorder to streangthen the health system the workfoce
of the health system must be a health information
system with a strong human resources component can
help build the evidence base to plan

20. 3. Health information systems
 Sound and reliable information is the foundation of
decision-making across all health system building
blocks.

 It is essential for health system policy development and
implementation, governance and regulation, health
research, human resources development, health
education and training, service delivery and financing.

21. health information system ….
 The health information system provides the
underpinnings for decision-making and has four key
functions:
(i) data generation
(ii) compilation
(iii) analysis and synthesis, and
(iv) communication and use.

22. 4. Access to essential medicines
 Access has been defined as “having medicine
continuously available and affordable at public or
private health facilities or medicine outlets that are
within one hour’s walk of the population”

23. 5. Health systems financing
Health financing refers to the “function of a health
system concerned with the mobilization,
accumulation and allocation of money to cover the
health needs of the people, individually and
collectively, in the health system.

24. health systems financing cont….
 These objectives can be achieved more easily if the
available funds are used efficiently, highlighting the
need for a third objective, that of efficiency in resource
utilization.
 As a result, the financing system is often divided
conceptually into three inter-related functions
(i) revenue collection,
(ii) fund pooling, and
(iii) purchasing/provision of services.

25. 6. Leadership and governance
 Leadership and governance in building a health system
involve ensuring that strategic policy frameworks exist
and are combined with effective oversight, coalition
building, regulation, attention to system design and
accountability.
 Accountability is therefore an intrinsic aspect of
governance.

26. Systemic thinking Vs Program
focused approach

27.  “Systems thinking” is an approach to problem
solving that views "problem" as part of the wider,
dynamic system (WHO, 2009). It involves more
than a reaction to present outcomes or events.
 “System-level interventions” target one or multiple
system building blocks directly or generically,
rather than a health problem specifically.

28. Table 1 Skills of systems thinking versus the usual program
focused approach

29. National health policy, Objectives,
strategies and reform in Ethiopia

30. Content of national health policy
1)Health system strengthening
System thinking approach in leading and strengthening
health system
 System
A system is a set of interacting or interdependent
components forming an integrated whole.
 Health System
The sum of the organizations, institutions, and
resources whose shared primary purpose is to improve
health.

31. Content….
2) System thinking versus program focused
approach
 views "problem" as part of the wider,
dynamic system .
 Involves more than a reaction to present
outcomes or events.

32. The objectives of national health policy
1) Democratization and Decentralization of the health
service system
2) Development of the preventive and promotive
components of health care
3) Development of an equitable and acceptable standard
of health service system that will reach all segments of
the population within the limits of resources

33. Strategies of the national health
policy of Ethiopia
The Health Sector Development Program strategies
 drafted in 1993/94 and
 designed for a period of 20 years, with a rolling five-
year program period.
• The programs are as follows

34. strategies..........

35. strategies....
HSTP (Health Sector Transformation
Program)
 builds upon the successes and challenges of the
successive HSDPs implemented over the last 20 years.
The Health Sector Transformation Plan I
(HSTP)
 The next five-year national health sector strategic plan
 Has three key features:
These are: quality, equity and Universal health coverage.

36. The reforms in Ethiopia
In Ethiopia the reforms introduced were
 Implementing revenue retention and use at health
facility level
 Systematizing a fee waiver system for the poor
 Standardizing exemption services
 Setting and revising user fees
 Introducing a private wing in public Hospitals