Publication: The Health Workforce in Ethiopia :
Addressing the Remaining Challenges
Loading...
Published
2012-01-12
ISSN
Date
2012-03-19
Author(s)
Editor(s)
Abstract
Health indicators in Ethiopia, particularly on child health and malaria, have improved significantly in recent years, with the next challenge now focused on improving maternal health indicators. Improvements in child health and malaria in particular can be attributed to strong government commitment towards health results, reflected in a number of notable policies and programs related to Human Resources for Health (HRH), in particular the health extension worker program. However, indicators related to maternal health remain problematic. Ethiopia has one of the lowest levels of assisted deliveries in the region. Although increases in the number of health workers particularly in rural areas may have contributed to improving access to some health services, it is in the government's interest to further improve the stock, distribution, and performance of relevant health workers in Ethiopia, particularly to bring about improvement in access to maternal health services for the poor. This document reviews the current HRH situation in Ethiopia, summarizes the evidence on population use of select health services, and offers relevant policy options to assist the government finalize its new human resources strategy and address remaining health challenges.
Link to Data Set
Citation
“Feysia, Berhanu; Herbst, Christopher H.; Lemma, Wuleta; Soucat, Agnes. 2012. The Health Workforce in Ethiopia :
Addressing the Remaining Challenges. World Bank Study. © World Bank. http://hdl.handle.net/10986/2226 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication "...and then she died" : Indonesia Maternal Health Assessment(World Bank, 2010-02-01)Maternal health remains one of the top priorities of the Government of Indonesia (GoI) and the Ministry of Health (MoH) because reductions in maternal mortality have been slows. The current Maternal Mortality Ratio (MMR) for Indonesia is 228 but with existing programs and interventions the government does not believe it will be able to achieve its stated millennium development goal of 102 maternal deaths per 100,000 live births by 2015. There are positive trends in an increased use of skilled birth attendants, almost universal access to some level of antenatal care and continued use of family planning but these are not enough to stem the tide of maternal death. Interventions by the skilled birth attendants in many cases are not in line with existing standards and prove to be ineffective in trying to address the emergence of complications. Antenatal care is important, but it is not where gains in decreased mortality will be obtained. The continued use of traditional birth attendants (TBA) and delivering at home are contributory factors to maternal mortality in Indonesia. In collecting data from verbal autopsies in three districts, (a widely used government initiative to determine the causes of maternal death) 63 out of 76 deaths occurred in home births that had been assisted by a TBA. In order to improve the access of the poor and the near poor to health services, the government is implementing the social insurance scheme, Jamkesmas. Approximately 104 million people should qualify for assistance but there are presently only 76.4 million people covered by this social health insurance (SHI) plan. Even those who are covered are not always able to afford care because of external expenses such as transportation charges which must be paid up front.Publication Community Midwifery Education Program in Afghanistan(World Bank, Washington, DC, 2013-08-01)In the immediate post conflict period, Afghanistan's health services were in a deplorable and chaotic state. Access and utilization of reproductive health services and skilled care during pregnancy, childbirth, and the first month after delivery are key to saving those women at risk of dying due to pregnancy and childbirth complications. In a society where women seek care only from female providers, one barrier to expansion of services was the lack of qualified female health workers who could be deployed to remote health facilities. Very few midwives who had trained in Kabul or other big cities were willing to work in rural areas, and there were no education facilities and too few female school graduates who could be trained in the provinces. As maternal health was one of the top priorities of the health sector, the shortage of midwives to provide reproductive health services had to be tackled urgently. Hence the Community Midwifery Education (CME) Program was created. The program aimed not only to train more midwives, but also to ensure both their initial deployment in remote health facilities as well as good retention rates. These aims were realized through the creation of a new health cadre known as "community midwives," along with new competency-based curricula; establishment of CME schools in each province; relaxation of the admission criteria for students; and establishment of a strong accreditation board to ensure qualified midwives were trained by the program. The program's success is attributed to stakeholder strong engagement, equity, and strengthened human resource for health. The program should be expanded to address the continuing shortage of midwives. The Mnistry of Public Health considers the program a successful intervention and believes that there is great potential to replicate this model to train other health professionals and tackle the shortage of other human resources for health.Publication A Study on the Implementation of Jampersal Policy in Indonesia(World Bank Group, Washington, DC, 2014-09)Indonesia launched Jampersal in 2011, a nationwide program to accelerate the reduction of maternal and newborn deaths. The program was financed by central government revenues and provided free and comprehensive maternal and neonatal care with an emphasis on promoting institutional deliveries. Jampersal providers were public and enlisted private facilities at the primary and secondary levels. In 2013, the World Bank and the Center for Family Welfare, University of Indonesia conducted a qualitative and quantitative study to assess the implementation and impact of the program in Garut District and Depok Municipality in West Java Province. The study found that Jampersal utilization was highest among women who were least educated, poor, and resided in rural areas. Utilization was also high among women with delivery complications. The study showed Jampersal only had an impact where institutional delivery coverage was still low such as in Garut District. In this district, women were 2.4 times more likely to have institutional deliveries after Jampersal. The finding suggests implementation of Jampersal policy may have to be adjusted according to the utilization pattern for efficiency and effectiveness. The government discontinued Jampersal with the launching of the National Health Insurance Program (JKN) on January 1, 2014. The study s findings indicate the merit in reevaluating the policy to terminate the program, given that Jampersal helped increase institutional deliveries while voluntary participation in JKN remains low.Publication Maternal and Child Mortality Development Goals : What Can the Transport Sector Do?(World Bank, Washington, DC, 2006-08)The reduction of child mortality and the improvement of maternal health are two of the Millennium Development Goals. Child and maternal mortalities continue to represent severe burdens in many developing countries. Every year, 527,000 women in developing countries die of pregnancy-related complications and nearly 4 million children die during their first month (accounting for 40 percent of all deaths under 5 years of age) with nearly all (98 percent) of them in developing countries. The risks of dying from pregnancy-related complications and a child dying under the age of five are highest in Sub-Saharan Africa. The risk of a mother or an infant dying can be significantly reduced by a continuum of basic care, which should include preventive measures and a skilled attendant during childbirth with access to the necessary equipment, drugs, and other supplies for effective management of any pregnancy-related complications. Yet, many women spend excessive time trying to reach a health facility with the capacity to treat obstetric or infant complications. It is estimated that 75 percent of maternal deaths might be prevented through timely access to essential emergency childbirth-related care. This paper focuses on the ways in which transport and road infrastructure play key roles in the overall delivery of and access to health services, and in the effectiveness of the health referral process. Many households do not have the reliable, suitable, and affordable transport services that are essential for access to care during the critical peri-natal and neonatal periods. Emergency access to care is also critical because many childbirth-related complications are unpredictable and the majority of births in developing countries continue to take place at home.Publication Health Financing in Vanuatu : Challenges and Options(World Bank, Washington, DC, 2013-06)Population growth, an unfinished agenda of communicable diseases and maternal health and nutrition, and the rapid rise of Non-communicable diseases are putting increasing strain on not just the Ministry of Health budget, but also the broader financial position of the government as a whole. These pressures are ultimately financially unsustainable, given current and projected future economic conditions. But many of the health burdens and costs can be avoided, or at least delayed, with good primary and secondary prevention. There are practical options for making health financing in Vanuatu more effective, efficient, equitable, affordable, and accountable. Improving efficiency of public expenditure is a key to achieving this.
Users also downloaded
Showing related downloaded files
Publication The Lasting Labor-Market Effects of Cash Transfers(Published by Oxford University Press on behalf of the World Bank, 2022-09-16)Can unconditional cash transfers have long-term benefits for women’s employment in developing countries This study exploits discontinuous exposure to the South African Child Support Grant for mothers whose children were born one year apart to identify the short- and long-term effects of a positive income shock of roughly $400 ($650 PPP in 2010). In the short term, there is a considerable increase in the probability of being active and looking for a job. Five years after receiving the transfer, mothers who benefited for one year are as likely to be employed as those who never received it; the type of occupation is also similar, other than a small decrease in work in the agricultural sector. Overall, the grant appears to facilitate job search for single mothers in the presence of high search costs, but does not significantly change job prospects.Publication Global Economic Prospects, January 2024(Washington, DC: World Bank, 2024-01-09)Note: Chart 1.2.B has been updated on January 18, 2024. Chart 2.2.3 B has been updated on January 14, 2024. Global growth is expected to slow further this year, reflecting the lagged and ongoing effects of tight monetary policy to rein in inflation, restrictive credit conditions, and anemic global trade and investment. Downside risks include an escalation of the recent conflict in the Middle East, financial stress, persistent inflation, weaker-than-expected activity in China, trade fragmentation, and climate-related disasters. Against this backdrop, policy makers face enormous challenges. In emerging market and developing economies (EMDEs), commodity exporters face the enduring challenges posed by fiscal policy procyclicality and volatility, which highlight the need for robust fiscal frameworks. Across EMDEs, previous episodes of investment growth acceleration underscore the critical importance of macroeconomic and structural policies and an enabling institutional environment in bolstering investment and long-term growth. At the global level, cooperation needs to be strengthened to provide debt relief, facilitate trade integration, tackle climate change, and alleviate food insecurity.Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication The Aggregate Income Losses from Childhood Stunting and the Returns to a Nutrition Intervention Aimed at Reducing Stunting(World Bank, Washington, DC, 2018-08)This paper undertakes two calculations, one for all developing countries, the other for 34 developing countries that together account for 90 percent of the world's stunted children. The first calculation asks how much lower a country's per capita income is today as a result of some of its workers having been stunted in childhood. The analysis uses a development accounting framework, relying on micro-econometric estimates of the effects of childhood stunting on adult wages, through the effects on years of schooling, cognitive skills, and height, parsing out the relative contribution of each set of returns to avoid double counting. The estimates show that, on average, the per capita income penalty from stunting is around 7 percent. The second calculation estimates the economic value and the costs associated with scaling up a package of nutrition interventions using the same methodology and set of assumptions used in the first calculation. The analysis considers a package of 10 nutrition interventions for which data are available on the effects and costs. The estimated rate-of-return from gradually introducing this program over a period of 10 years in the 34 countries is17 percent, and the corresponding benefit-cost ratio is 15:1.Publication World Development Report 1987(New York: Oxford University Press, 1987)This report, consisting of two parts, is the tenth in the annual series assessing development issues. Part I reviews recent trends in the world economy and their implications for the future prospects of developing countries. It stresses that better economic performance is possible in both industrial and developing countries, provided the commitment to economic policy reforms is maintained and reinforced. In regard to the external debt issues, the report argues for strengthened cooperation among industrial countries in the sphere of macroeconomic policy to promote smooth adjustment to the imbalances caused by external payments (in developing countries). Part II reviews and evaluates the varied experience with government policies in support of industrialization. Emphasis is placed on policies which affect both the efficiency and sustainability of industrial transformation, especially in the sphere of foreign trade. The report finds that developing countries which followed policies that promoted the integration of their industrial sector into the international economy through trade have fared better than those which insulated themselves from international competition.