By Tariku Yalew
Tigrai Online, October 24, 2013
Recently a man by the name of Zenabu Yalew put up an article in Aiga forum in which he claimed that our country has surpassed the Millennium Development Goals (MDG) with regards to curbing infant death ahead of schedule- three years to be precise. This writer on this same article said that it was one of those times where the western Medias were forced to report the news without their usual “Ifs” and “Buts”, with regards to an Ethiopian success story. This is because many International Institutions who work on the issue have all confirmed that the country has already hit the target which was to reduce infant death rate by 2/3rd (67%), set for 2015.
Of course we can look into this job well-done from the point of the government committed developmental outlook. As it’s known one of the many problems of the country which came crumbling down from the previous governments is poverty. It’s our yesterday memory that the previous monarchy and military regimes instead of solving this embarrassing and the source of the country’s misery, they choose to chase their own political and economical interests, which emanates from their innate behavior.
The FDRE government which took over the country along with its eternal enemy has been fighting with this embarrassing issue for years by declaring ‘winning the fight against poverty for us is an existential issue’. The anti-poverty campaign waged by the incumbent government that emanates from its developmental and democratic outlook (behavior) which gives priority and attention to the peoples’ pressing problems, is achieving great results in its fight. As a result millions of fathers, mothers the young and the women are entering the millennium by shrugging-off the horrible poverty veil from their shoulder. The FDRE government’s formulated policies and strategies; which are responsible for our country’s current third fast and sustainable development after china and India, are working miracles.
They are in fact helping our country achieve UN’s Millennium Development Goals (MDG); which are eight international development goals the United Nation established for developing countries to achieve before the year 2015. According to recent International reports, from the point of fulfilling one of the Millennium Development Goals (MDG) which concerns with reducing the mortality rate of children under the age of 5, Ethiopia has been able to reduce 204 deaths per thousand live births per year in 1990 to 67/1000 in 2012. In other words the mortality rate is reduced by 67% (2/3rd of the rate).
Institutions under the umbrella of the UN like UNICEF (United Nations Children's Fund), WHO (World Health Organization), World Bank Group and the likes have all stated on their reports that the successful works done in the country for the last 22 years has led it to achieve the targeted developmental goals three years in advance. The developmental FDRE government and the dedicated people of our country must take the credit, as both were able to achieve this grand feat by working hand in hand and closely. This achievement on one side has given happiness to the friends of our country, while also giving despair to the country’s enemies who claim that ‘there’s no development’. Most of all, I believe this is an indication to those who claim the Grand Transformation Plan (GTP) is ‘too ambitious’, that the goals set by the GTP can actually be achieved.
Here it’s important to ask ‘what’s the secret behind this positive result?’ I believe we can raise many factors for this achievement: strong political commitment, great leadership exhibited by the Health sector, successful organization from the concerned stakeholders and the publics’ strong developmental will have all contributed for this success story. The other thing worth mentioning here is the government’s belief that creating productive people cannot be seen outside of creating healthy people. Also the government health program which is modeled around servicing the vast rural areas along with the urban–dwellers and the fact that the program gives priority to basic health services has contributed to the success.
The basic health services which centers on self-prevention have allowed the government to create people-based health system that is backed by professionals. It has set up one health posts with two female health-extension officers for 5000 people in every kebele. It has built one health station for every 25 thousand people. I believe on top of fulfilling the human and material needs, creating a serviceable attitude on the health professionals and the works done to make the service have a reach within the pastoralist areas, along with the effective work done with regards to fulfilling the Millennium Development Goals have all contributed to the success.
Most of all, the positive impact the government’s lucid polices and excellent leadership; be it on the health sector or other developmental issues, had on this success story isn’t up for debate.
We can take a look at the recognition given by different international media outlets. Here it’s wise to recall what Elissa Jobson the Deputy Editor of Global: The International Briefing magazine has said on the issue. According to her, the governments committed position on the issue and the fact that it pooled enough resource for issue have all contributed to the success. UNICEF country representative for Ethiopia’s Dr. Peter Salama on his part have said that as the result of the governments ambitious and bold developmental goals backed with real commitment sustained for the last ten years to realize those same goals have led to the country’s success on the issue. He also claimed the fact that the Health Extension program was government-owned as oppose to donor-led has played its own part for the success.
If one thing this few examples I mentioned above implicates is at what pace and sustained drive the developmental government of Ethiopia is solving the publics’ problems. What’s the most important thing that made the health service accessible around the country is the government’s action taken on strengthening the health service giving institutions’ organization and to increase their number at a fast rate.
The Health Extension workers are young women with at least secondary school completion selected from their respective communities. Following selection, the selected workers completes a one-year course of training which includes coursework as well as field work to gain practical experience. These young women will play important role as they have acceptance by community members, especially considering their service takers (patients) tend to be mothers (elder women). Thus, they have been able to have a wide reach to mothers and children at the community level. This has afforded them to supervise mothers and give them education on family planning, healthy lifestyle and to give close care to pregnant mothers before and after birth.
The successful results have elaborated that Ethiopia has the accurate health policies and reflects what the former Prime Minister Meles Zenawi has said about Health Extension Program. What the Prime Minister Said was, “The Health Extension program has 16 points. As a result of this extension program, we are seeing unprecedented change not seen in any other third world countries with regards to health service. Especially considering primary health care, there are some places where we have seen incredible results. There are some kebeles where up to 90% of the families have built their own toilets. There are also huge strides made in reducing infant and maternal mortality”.
To realize the Health Extension Program (HEP) which centers on ‘prevention’, 34,382 Health Extension workers have been deployed around more than 15 thousand kebeles. There are two Health Extension workers deployed in every kebele; and their successful job done on invigorating health and preventing diseases has led to the creation of ‘model families’.
Just as the Prime Minister has said, the program has achieved fundamental changes. Our country has been able to achieve great success on improving maternity health, reducing infant mortality rate and controlling the spread of communicable diseases.
Not only this. Out of the work done to reduce maternal mortality rate are widening family planning services, presenting mothers with adequate and qualified health professional during pregnancy along with surgical service, if necessary.
According to information gathered on the issue, last year alone there were targets to increase the number of women in childbearing age that has access to family planning service to 12.9 million out of the possible 17.05 million women and boost the percentage from 60% to 76.2% in the process. To achieve this target, 130 million birr worth of medicine and other supplies were purchased and distributed to regions. Also, for the last nine month by giving family planning services such as contraceptive coverage to 7.4 million women, it was able to push the service reach to 43.9%.
Also with regards to pre-birth service demand, out of the targeted increase in the number of the pregnant women who has access to the service (give the service to 2.7 million pregnant women from the possible 2.95 million and increase the reach from 89.1% to 90%), the number has exceeded the targeted number and has reached to 93% within nine months.
A delivery care to be given by trained health professionals (to make delivery safer) has its target set to increase the reach to 49.4% from 20.4%, by which in only nine months it was able to give care for 436,810 pregnant mothers out of the expected 2.3 million women, hiking the service to 19%. Also 236,359 mothers have taken delivery care from Health Extension workers. This covers 10% of the expecting pregnant mothers. Generally the Health ministry information indicates that out of the expecting pregnant mothers, 29% of them have got delivery care from health professionals and Health Extension workers.
As any reader of this article knows one of the objective of the five-year grand transformational plan (GTP) was to make health service easily accessible. Based on former plans, there was a target to increase health station number from 644 in the year 1998 to 3,300 in order to accommodate 25,000 residents per health station. At the end of 2004 fiscal year the number of health station has reached up to 2,999. There are successful works being done to finish the building of other 486 health stations in the year 2005 there by fully hitting the target. When on-going building projects are finished, the number of health station will reach 3,546. With this, basic health care reach given through health stations has reached 92.9%. On top of this, the government has trained 4,500 women on child care and has deployed them to every kebele within three years.
It’s projected that this number will rise to 13 thousand by the year 2015. During this period, the number of health (medical) schools has risen to 25 from a meager 3. Also it’s expected that when the building projects of 15 thousand health posts, three thousand health stations and 300 primary hospitals undertaken all over the country is finished, it’s expected that they’ll bring quality and fair (accessible) health service for all parts of the society. Looking at this all effort (and great undertakings), I believe we won’t be far off the mark, if we claim the governments commitment has been reflected on the health policy, especially considering the change in the sectors finance instances which is unprecedented. The government has made a major structural change on its health budget starting from 1992. The first of those changes is the reduction of the budget used to spend on human resource and non-medical issues by 53% and transferring that budget to medical and medicine related supplies. The second is the transfer of resources to primary health care based outside of Addis Ababa. Thus, since 1994 the country’s capital budget allocation to health posts and stations have risen from 17% to 40%. Thirdly, during this period more than half of the public health services budget was allocated to primary health care services. Lastly, the health expenditure (at regions) in the aforementioned years which was between 83 to 88% has gone to 83% (out of the annual budget) and 95% of the capital budget in 1996.
These steps taken by the government shows how the government’s committed effort given on infant mortality rate reduction and generally on the health sector have helped it reach to where it standing today. Here I would like for my dear readers to understand that although the government has achieved the reduction of children mortality objective well before the MDG target date by decreasing to 68 deaths per thousand live births per year, it doesn’t mean it will stop working on this age group in the future. This is because the government has issued a statement in which (it stated that) it will work to further decrease the rate from 68 to 20 by the year 2035 (by strengthening itself with knowledge gained from past experience) even though it will be hard and bumpy road ahead.
These successful developmental results implicates that the other Millennium Development Goals (MDG) will be realized, either before or at the scheduled target date. The developmental projects being undertaken in the country to achieve the Millennium Development Goals (MDG) are garnering positive results. Out of the 35 billion birr budget set by the government to achieve the MDG’s goal in the country’s regions, more than 80% of it has been put to work. With this, the projects which are being done to achieve the MDG all over Ethiopia are garnering positive results.
Works done on Infrastructure are not only developmental projects undertaken to fulfill the targeted goals, but also in the long run they will have a major role to play on the country’s economic progress. With regards to roads, rail project, fixed and mobile telephone services and electricity services, many city woredas and rural kebeles are becoming benefactor of such services not seen in the country before. The projects being done on infrastructure have led for economic integration to bolster between regions, regions and the centre, also between Ethiopia and its neighboring countries. This trend is also playing a major role in creating mutual development and economic progress to ensue within these players.
With regards to foreign currency earned as a result of these projects, it can be used to put the country’s economic on a sustainable and thriving path. Also it has made possible for the principle of mutual development to reign within the horn of Africa states, by seeing how working out differences to come together through a give and take approach can lead to mutual benefits.
Since the 1990s our country’s economy more than ever has been recording a double digit (11.5%) economic growth in fast and sustainable fashion. And according to recent Ministry of Finance and Economic Development statement the GDP per capita of Ethiopia is growing by 3.8% on average, reaching to 588 US dollars a day. On top of this, it’s known the more than 4 thousand education, health, road, water resource development and clean water projects being undertaken can attest to the fact that the MDG projects are going well. I believe the positive results achieved on reducing infant mortality rate that has been reported by International Medias to be taken as a benchmark, can be a demonstration of that fact.