HSDP

Based upon the national Health Policy (1994), the Government of Ethiopia launched its Health Sector Development Programme (HSDP) in 1998. The HSDP is Ethiopia's sector wide approach to improve the health status of its population and National Health Service delivery system to acceptable levels in 20 years.  Major objectives and basic principles are equity in health delivery, universal access to health services, strong focus on Primary Health Care and an integrated approach. HSDP provides the necessary framework for all stakeholders, such as government, civil society and donors, to support the health sector in a more harmonised and effective way.

The Sustainable Development and Poverty Reduction Programme (SDPRP) is the guiding development strategy of the Government of Ethiopia and is aimed at achieving the Millennium Development Goals.

Under this programme, the health sector is identified as a key sector for development and poverty reduction.

HSDP I was completed June 2002.  It’s basic objection was to improve the coverage and quality of health care services. An evaluation indicated that Ethiopia still continued to face enormous challenges in providing Primary Health Services to the people. In spite of impressive progress in expanding access, utilisation of services remained low, while quality continued to be of concern. Availability of human resources remains low and management and information system urgently require improvements.  HSDP II, which follows the basic principles of HSDP has ended in June 2005 and will be evaluated at the end of the year.  It is however already clear that the limited human resources capacity has been a major bottleneck for rapid developments in the sector.  Moreover, HSPD II execution was challenged by the necessary integration of many national and global policies and initiatives, particularly in the area of Health and HIV/AIDS.

Currently, the SDPRP II and the HSDP III are being implemented.  The focus on achieving the MDG’s has been intensified and in the health sector the roll-out of the Health Extension Programme and Accelerated Expansion of PHC Coverage are being stepped up considerably.  Implementation of these two community-based approaches is expected to bring health services closer to the rural population.  The Demographic Health Survey of 2005 has shown that Ethiopia has made considerable progress in decreasing the infant and child mortality rate.

HIV/AIDS

HIV/AIDS has become an important problem in Ethiopia, and not just in the health sector. The national multi-sectoral response is based on the National Strategic HIV/AIDS Plan. Its implementation is guided by National HIV/AIDS Council and the national HIV/AIDS Prevention and Control Office (HAPCO). Improved surveillance efforts have led to a revision of prevalence data.  The latest official national prevalence among adults is estimated to be between 1.4% (DHS 2005) and 3.2% (MOH 2005-ANC data). There are signs that the urban incidence might be stabilising. The rural incidence rose slowly until 2000 and is levelling off, but at a much lower rate than the urban. Ethiopia, with strong financially support from global initiatives and bilateral donors, has started a national roll-out programme for free antiviral treatment.  The number of persons living with HIV/AIDS on ART is now rising rapidly. The Government of Ethiopia is aiming at the ambitious target to put 250,000 patients on ART treatment by 2008.

Involvement of the Netherlands Embassy in the Health sector, including HIV/AIDS

The Embassy works within the overall context of the SDPRP and HSDP, and of the Netherlands development policies in Health and HIV/AIDS.  The Embassy is member of various fora for national dialogue, harmonisation and implementation, as well as of a number of joint MOH/donor working groups.  The total annual budget for the health sector, including HIV/AIDS is around Euro 10 million.

The Embassy has signed a Memorandum of Understanding with the Development Co-operation Ireland with the aim of making a concrete contribution to harmonisation of the development programmes of between both agencies.  In the health sector this so far led to the formulation of a joint policy document and to joint financing arrangements with the NGOs,  DKT ans Family Guidance Association and the Regional Health Board in the SNNPR.

Moreover, together with DFID and DCI, the Embassy has created the first pooling arrangement in the health sector, the ‘Health Pooled Fund’, which is designed to finance all kinds of activities related to the Annual Planning, Budgeting, Implementation and Monitoring Cycle of the Federal MOH, including co-ordination and further harmonisation of donor inputs.

In line with MDG's, SDPRP and the Dutch development policy in the health sector, the Embassy is focussing on Reproductive Health, HIV/AIDS in particular where these are linked.  Special attention is given to fundamental problems in areas, such as Gender Inequity, Reproductive Rights, (un)safe abortion and rape. The Embassy promotes a greater involvement of the Civil Society (CS) in these areas and focuses on advocacy, prevention and on mitigating the effects of HIV/AIDS. At present, the Embassy channels its support to Sexual and Reproductive health and Rights and to HIV/AIDS through mainly the CS-organisations, such as the Family Guidance Association of Ethiopia (FGAE), DKT and IPAS.

The Embassy has created of Fund for small HIV/AIDS Initiatives, which is being managed by UNAIDS.  Many small NGO’s and CBO’s, which often have no easy access to external funding, are making use of this facility.

Through the years, the Embassy has contributed to the national Extended Programme on Immunisation (EPI).  Also in 2006, the Embassy has enabled UNICEF to procurement essential vaccines for EPI of the MOH.

In the past the Embassy has contributed to many emergency situations in the health sector, such as for outbreaks of meningitis and malaria.  In 2005 and 2006, the Embassy has again responded favourably to a consolidated emergency appeal for malaria outbreaks in several regions of the country.  With this support UNICEF has procured an important amount of the drug Co-Artem for the MOH.

The Embassy supports the development of health services in remote, under-served areas, such as in serveral zones of the Oromia and Afar region through CARE/Ethiopia.

Lastly, the Embassy has joined the new modality " Protection of Basic Services (PBS)", of which component II constitutes a Trust Fund for health commodities to be used at health center and health post level.