“Our country has made huge strides in improving access to health services and improvements in health outcomes,” said Dr. Lia Tadesse Gebremedhin, Ethiopia’s minister of health and an obstetrician-gynecologist, at a December 2022 workshop organized by the Countdown collaboration, “Ethiopia’s health indicators have been remarkably improved from one of the worst in sub-Saharan Africa to amongst the standout performers in just two decades. The lives of millions of children have been saved …. All this was done while building a health system that can sustain the gains over the long term.”
The Ethiopia Public Health Institute (EPHI), the lead of the Countdown to 2030 country collaboration, organized the workshop for more than 100 representatives of the ministry of health, academic institutions, and civil society organizations.
Minister Tadesse also emphasized the importance of learning from the past, “The ministry is looking for collaboration work for generating evidence that will help to evaluate the strategies, plans, and programs of the health system.”
The Countdown collaboration has provided a unique opportunity for Ethiopia to reflect on the past and to use data to plan for the future. First, the Ethiopia-Countdown collaboration team has been working with the Ministry of Health to better understand key drivers of the country’s remarkable progress, especially in maternal and newborn survival since 2000, as part of a global health exemplars initiative of Gates Ventures. The study used a positive public health approach to identify factors that led to major progress.
“We learned how Ethiopia initiated major health system changes around 2000, which resulted in major improvements in health service coverage and survival over about a decade and in all regions of Ethiopia. But we also saw that large inequalities within the country persisted and that there is much scope for further improvements,” said Ashenif Tadele of the EPHI, who leads the Countdown collaboration. The striking findings of the Ethiopia exemplar study showed how massive community mobilization and strengthening of the health system with a focus on disadvantaged rural populations were key factors in bringing about rapid change, especially from 2010.
The workshop also provided a platform for dissemination of the second major activity of the Countdown collaboration: providing the ministry and development partners with a comprehensive assessment of achievements and challenges to inform the endline review of the five-year national health plan, the Health Sector Transformation Plan 2015/16-2019/20 (HSTP-I).
“We focused on the indicators and targets of HSTP-I, which is a rich dataset including specific equity indicators,” said Dr Dessalegn Melesse, assistant professor at the University of Manitoba and global Countdown focal point for the Ethiopia work. “Our analysis of all available data showed the achievements and gaps in health coverage, equity, and quality of health services.” This analytical work contributed to the next five-year health sector plan and laid the foundation for further support to monitoring HSTP-II.
The workshop participants discussed the technical issues and implications of the findings on current health system performance for development of the next phase of the national health plan (HSTP-II) and beyond. “We feel that working closely with the Ministry of Health and Ethiopia public health institutions is essential to learn from the past and to strengthen analytical capacity, to jointly develop lessons learned. Our work is embedded, so to speak”, said Dr. Melesse.
Ethiopia has a culture of using data to inform its strategies and plans, wanting to know if our programs are performing as intended and reaching the populations in greatest need. As the Minister of Health indicated, “Reproductive, maternal, newborn, child, adolescent health and nutrition will continue to be top priority for the next five years. The Ministry of Health hopes the Countdown to 2030 country collaboration study will continue to generate evidence and inform health sector policies and programs.”