EXECUTIVE SUMMARY

ANNUAL PERFROMANCE REPORT 2015 EFY

 EXECUTIVE SUMMARY
ANNUAL PERFROMANCE REPORT 2015 EFY

ጠንካራ የጤና ፋይናንስ ለዘላቂ የጤና ልማት!

Strong Health Financing for Sustainable Health
Development!
 CONTENTS

FOREWORD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . III
1. STATUS OF HSTP-II TRANSFORMATION AGENDAS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. HEALTH EXTENSION PROGRAM AND PRIMARY HEALTH CARE . . . . . . . . . . . . . . . . . . . . . . 3
3. HYGIENE AND ENVIRONMENTAL HEALTH. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
4. REPRODUCTIVE AND MATERNAL HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
5. NEONATAL AND CHILD HEALTH SERVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
6. IMMUNIZATION SERVICE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
7. NUTRITION SERVICES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8. HIV PREVENTION AND CONTROL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9. TUBERCULOSIS AND LEPROSY PREVENTION AND CONTROL . . . . . . . . . . . . . . . . . . . . . . 9
10. MALARIA PREVENTION AND ELIMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11. PREVENTION AND CONTROL OF NON-COMMUNICABLE DISEASES . . . . . . . . . . . . . . . . 10
12. NEGLECTED TROPICAL DISEASES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
13. CLINICAL AND EMERGENCY SERVICES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
14. BLOOD SERVICES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
15. REGULATORY SERVICES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
16. HEALTH INFRASTRUCTURE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
17. HUMAN RESOURCE FOR HEALTH. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
18. HEALTH INFORMATION SYSTEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
19. PHARMACEUTICAL SUPPLY AND SERVICES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
20. HEALTH FINANCING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
21. PUBLIC HEALTH EMERGENCY MANAGEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
22. COVID-19 PREVENTION AND RESPONSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

III EXECUTIVE SUMMARY

FOREWORD
I am pleased to share with you the 2015 EFY performance report of the
health sector of Ethiopia. The 2015 EFY marks the end of the second
health sector transformation plan (HSTP-II) and the sector prepares a
three years medium term health sector development and investment plan
(HSDIP) for the period 2016 EFY to 2018 EFY. This annual performance
report indicates the progress made during the three years of the HSTP-
II period and the report mainly presents the performance of the health
sector in 2015 EFY, the major initiatives, major activities implemented and
achievements during the fiscal year. In addition, the major challenges and
the next focus areas for each program area are outlined in the report.
The health sector has registered remarkable results during the fiscal year
despite the presence of challenges such as conflicts and other emergencies
that affected the health system. We were able to improve access to and
utilization of health services by enhancing the implementation of essential
health interventions at all levels of the health system, with due emphasis
to primary health care. The report shows that utilization of maternal and
child health interventions and services have improved; and registered
encouraging results in the prevention and control of major communicable
Lia Tadesse, MD, MHA diseases such as HIV and tuberculosis. However, incidence of malaria
Minister, Ministry of Health, has increased this year due to climate change and other related factors.
The sector strengthened NCD prevention and control interventions
Federal Democratic Republic of Ethiopia that resulted in improved screening, service integration, treatment and
management of major NCDs such as hypertension, diabetes mellitus
and cancer. Promising progress was also registered in the expansion of
specialty and sub-specialty services. In addition, we have been successful
in improving health system investments such as improving the number
and mix of health workforce, strengthening health information system,
improving the supply of pharmaceuticals, regulation and health financing.
We have strengthened our public health emergency management through
which occurrence of disease outbreaks were prevented and the reported
outbreaks were effectively controlled without causing significant harm to
the population. The MOH in coordination with partners have developed
a resilient recovery and reconstruction plan for conflict affected areas
based on which health service restoration and recovery activities have
been conducted. Through our emergency management efforts, we have
learned lessons to ensure that our health system is resilient and accelerate
progress towards universal health coverage.
These results were registered through the determination and hard work
of our health workers and health leaders at all levels, and through a
strong partnership and collaboration with all our stakeholders. I would like
to express my sincere appreciation and gratitude to all health workers,
donors and development partners, civil society organizations, academic
and research institutions, the private sector, professional associations and
all other stakeholders for the continued partnership and collaboration.
Thanks for being part of the effort towards improving the health of our
population.
The sector has developed a three years strategic plan, the HSDIP, which
identifies the major priorities, initiatives and activities for the next three
years. The year 2016 EFY will be the first implementation year of the HSDIP,
during which we will build up on our strengths, overcome challenges to
achieve the targets we set. We will continue to strengthen our health
system towards universal health coverage and improve the health of
our population. I call upon all stakeholders to strengthen our partnership
and collaboration to a greater level, work together towards achieving the
objectives and targets of the HSDIP. “Alone we can do so little; together
we can do so much.”
Lia Tadesse, MD, MHA
Minister, Ministry of Health

IV EXECUTIVE SUMMARY
1. STATUS OF HSTP-II TRANSFORMATION AGENDAS

1.1 Leadership
• Organizational Re-structuring
» Organizational re-structuring of Ministry of Health (MOH) done and the new organizational
structure implemented in 2015 EFY
• Leadership Capacity Building
» Over the past three years, various leadership capacity building development initiatives like the
Leadership Incubation Program for Health (LIP-H), and the Clinical Leadership Improvement
Program (CLIP) and the new High Impact Leadership Program for Health (HIL-PH) capacity
building initiatives are implemented to enhance the capacity of the leadership
• Ensuring Accountability
» Community scorecard implementation expanded to 760 Woredas and 2,760 health centers. In
addition piloting of Managerial accountability program in selected health institutions is started
• Stakeholder engagement and collaboration
» MOH has successfully conducted a diagnostic exercise to assess the country's status in relation
to the domains of One Plan, One Budget, and One Report. Alignment Action Plans were
developed and approved by all stakeholders, providing a solid foundation for implementation
» MOH leadership has actively engaged in rehabilitating and resuming services in conflict-
affected areas, mobilizing resources from stakeholders
» Regular Joint Core Coordinating Committee (JCCC) meetings with partners was conducted
• Ensuring collaboration with other sectors
» Collaboratively worked with other sectors on different programs such as Nutrition program,
Seqota Declaration, WASH and other endeavors

1.2 Transformation in Quality and Equity

• To operationalize the quality agenda in the health sector, a National Quality and Safety Strategy-II
(NQSS-II, 2020/21-2024/25) was developed and launched in 2020/21
• Various measures were put in place, including the development and implementation of a health
center clinical audit tool, the completion of an accreditation roadmap, and the creation of guidance
for the National Healthcare Safety High-risk Clinical Conditions and Incident Reporting System
• A guide for the workflow of surgical service provision was developed and implemented in twelve
hospitals with high surgical patient loads, and a guideline for surgical safety improvement was
developed
• Healthcare Quality and Safety Hubs established in six University Hospitals
• System Bottleneck Focused Reform (SBFR) is being implemented in thirty-eight public hospitals
so as to identify and address bottlenecks in the health system, improve the quality of care, and
increase access to health services by implementing evidence-based interventions
• Quality improvement initiatives such as the Saving Lives through Safe Surgery (SaLTs) and Maternal
and Newborn Quality of Care (MNH QoC) initiatives were implemented
• A National Health Equity Strategy (NHES- 2020/21-2024/25) is developed and on implementation
with ambitious goals to narrow the health equity gaps and improve the quality of healthcare services
• Several initiatives have been implemented to improve equity, including customization of the national
equity into regional contexts, designing and implementing a mobile health service approach to
address the inclusion of vulnerable and targeted groups and a national health equity survey was
done to enhance evidence-based informed decisions
• Different projects were designed and implemented to reduce geographic inequities in four selected
Regional States (Afar, BG, Somali and Gambella)

1 EXECUTIVE SUMMARY
1.3 Information revolution

• DHIS2 customized and upgraded to version 2.36 and implemented in more than 95% of the
public health facilities
• eCHIS implementation started in more than 7,806 health posts; 6,913 health posts registered
more than 85% of their catchment population; 5,740 health posts have started capturing the
services provided using eCHIS app
• Electronic Medical Record (EMR) implementation initiated in 27 hospitals and 11 health centers
• Interoperability and Messaging Standards document developed
• Civil registration and Vital statistics implementation: birth notification rate was 75% and death
notification rate was 4%
• Different HIS governance documents revised and HIS governance platforms were functional
• Master Facility Registry (MFR) created and more than 47,000 health facilities (both private and
government-owned facilities) are registered in the MFR
• By the end of 2015 EFY, IR model woreda strategy implementation was conducted by 36% of
all Woreda health office and 48% of health facilities (HCs and hospitals). Of all institutions that
conducted the IR self-assessment, 948 (39%) reported reaching model status

1.4 Health financing

• Resource proactively mobilized from domestic and international sources
• Share of government health budget from the total health budget was 12.38%
• More than 555 million USD disbursed from development partners in 2015 EFY
• Health care financing reform components implemented at more than 90% of public health facilities
• The amount of internal revenue collected by health facilities has consistently increased over the
past five years, increasing from 3.1 Billion ETB in 2011 EFY to 8.8 Billion ETB in 2015 EFY.
• Public-private partnership (PPP) implementation for three projects approved and implementation
initiated
• Community Based Health Insurance (CBHI) implementation expanded to 1,011 Woredas. More
than 12 million (78%) of eligible households in CBHI Woredas become members of CBHI

1.5. Motivated, competent and Compassionate (MCC) Health workforce

• Capacity building on MCC health service was provided to MCC focal persons and other health
professionals
• Continuous professional development implementation is being provided by 37 accreditors and
219 CPD providers. In addition, CPD is integrated with re-licensing in nine regions
• Awareness creation was done in higher education institutions about the selection of health
professions based their passion
• implementation of system bottle neck focused reform (SBFR) was initiated in 38 hospitals where
creation of MCC is one of the focus areas

2 EXECUTIVE SUMMARY
2. HEALTH EXTENSION PROGRAM AND PRIMARY HEALTH CARE

Health Extension Program Optimization (HEPO) Health Post categorization

A 15 years HEPO roadmap was approved and Based on the HEPO roadmap, health post re-
lunched at national and regional levels. In this year, categorization was done. As a result, 16,898 health
advocacy and capacity building trainings were posts were categorized, from which 12,470 (74%) were
provided basic, 1,873 (11%) were comprehensive and 2,555
(15%) were to be merged with health centers

Comprehensive health posts Women Development Army (WDA) training

49 health posts started comprehensive 278,453 completed Competency Based Training
health service (CBT), among these 198,207 were assessed for their
competency and 160,445 (81%) were found to be
competent

Alternative community engagement

• Inclusive community engagement approaches are designed and piloted. It includes optimizing the existing WDA
platform, Men Development ARM (MDA), youth engagement, other social structures and re-inventing community
engagement strategy through producing village health leaders (VHLs)
• Piloting on optimizing the existing WDA platform and re-inventing community engagement strategy through
producing village health leaders (VHLs) was started in 2013 EFY in 4 Woredas. In 2015 EFY, VHLs is scaled up to
80 Woredas.
• Community engagement strategy is customized to pastoral communities of Afar and Somali region and piloting is
started in four Woredas of Somali and 3 Woredas of Afar

Primary Health Care Strategic Framework Ethiopian health center reform implementation
guideline (EHCRIG)
• Revised to include 12 chapters and 131 standards
Developed • 70% of health centers implemented the revised
EHCRIG
• Average EHCRIG on the fourth quarter of 2015 EFY was
79%

Health Centers Emergency Surgery Service (OR-Block health centers)

• 32 HCs started OR service in 2015 EFY
• The cumulative number of HC with OR service reached 106

3 EXECUTIVE SUMMARY
3. HYGIENE AND ENVIRONMENTAL HEALTH

Sanitation Sanitation marketing Menstrual Hygiene

Management (MHM)
• Percentage of households with • In 2015 EFY, 121 new sanitation
access to basic sanitation: 52% marketing centers have been • MHM blocks have been
• Percentage of households with solid established. Currently the constructed and equipped in
waste management: 44% cumulative number of sanitation 1,080 schools
marketing centers reached 551
• Percentage of households with Liquid
waste management: 31%
• Open defecation free kebeles: 36%

4 EXECUTIVE SUMMARY
4. REPRODUCTIVE AND MATERNAL HEALTH

Contraceptive Antenatal Care (ANC) Early Initiation of ANC

Acceptance Rate
Immediate Post- ANC 4+ coverage: More than
Partum Contraceptive
More than
15.38 million 76% Acceptance Rate
2.69 million (79%) pregnant
women attended four or
Only 22%
more ANC care contacts
Women in the reproductive
8% of pregnant women started
ANC 8+ coverage: 502,878 ANC within 12 weeks of
Health Received a modern (15%) pregnant women gestation
Contraceptive Method attended eight or more ANC
contacts

Iron folate (Fefol)

supplementation Skilled Delivery Caesarean Section (C/S)
Syphilis screening
during pregnancy Attendance service

67% More than

2.69 million
74% More than
2.55 million
75% 5.4%
of pregnant women have
received iron and folic pregnant women were tested pregnant women delivered at women delivered by a C/S
acid supplement at least for syphilis health facilities and attended
90+ by a skilled birth attendant

Early Post Natal Care

(PNC) Service Abortion Service Still birth rate

More than
3.12 million 92% 261,724 10.8
women received PNC within women received comprehensive abortion care service, stillbirths per 1,000 births
seven days after delivery among which 138,185 (53%) were safe abortion service
while 123,539 (47%) were post-abortion care services)

5 EXECUTIVE SUMMARY
5. NEONATAL AND CHILD HEALTH SERVICES

Treatment of childhood illnesses

22%
of under 5 children with
78%
of children with expected
57,331
neonates with asphyxia were
expected diarrhea received pneumonia received treatment resuscitates, among which 47,561
treatment with ORS and Zinc with antibiotics (83%) survived

Kangaroo mother care (KMC)

Among the 39,763 reported cases of underweight (< 2000 grams) or premature infants,
70% received Kangaroo Mother Care (KMC).

Integrated Community Case Management of Integrated Management of Newborn and

Newborn& Childhood Illness (iCMNCI) Childhood Illnesses (IMNCI)

90% 93%
of health posts provide of health centers providing
CBNC service ICMNCI service

Neonatal Intensive Care Unit (NICU) services

222
hospitals provides NICU services
A total of 146,256
neonates were reported as discharged from NICU, among
which 80% of them were recovered and 9% were died

6 EXECUTIVE SUMMARY
6. IMMUNIZATION SERVICE

PENTA 3 COVERAGE MEASLES 1 COVERAGE

More than 3.3

million
children under 1 year of
100%
age received the third
dose of pentavalent
vaccine

infants under 1 year of

age were vaccinated with
measles first dose

Dropout Rate MEASLES 2 FULL IMMUNIZATION

(Pentavalent-1
to Measles More than 3
Vaccination)
89% million

10% 97%
of children aged 15-24 under one infants received all
months of age received the types of basic antigens before
A national integrated measles SIA was conducted second dose of Measles celebrating their first-year birthday
reaching a total of 15,070,279 (98%) children
of age 9-59 month and more than 109,084
zero dose children vaccinated

7. NUTRITION SERVICES

Growth and promotion Vitamin Supplementation Deworming Service

More than 3.2 million (63%) More than 15.9 million children More than 10.6 million
children under 2 years of age aged 6-59 months received two children aged 24-59
participated in growth monitoring doses of vitamin A months received bi-annual
and promotion service deworming service

Nutritional screening Seqota declaration expansion phase

More than 8.45 million under 5 children
were screened for malnutrition, among Implementation started in 240 Woredas
which 6% had moderate malnutrition and
0.7% had severe malnutrition

7 EXECUTIVE SUMMARY
8. HIV PREVENTION AND CONTROL

PMTCT

• More than 3.35 Million (99%) pregnant and lactating women were tested for HIV and know their status
• 11,359 (77%) HIV-positive pregnant and lactating women received ART to reduce the risk of mother-to child
transmission
• Early Infant Diagnosis: 10,511 (72%) HIV exposed infants received virological test within 12 months after birth
• ARV prophylaxis for HIV exposed infants: 7,969 (54%) of HIV exposed infants received ARV prophylaxis for 12
weeks

HIV testing and counselling service People receiving ART

6,629,187 individuals received HIV testing and A total of 473,625

counselling service, among which 36,182 (0.55%) PLHIVs were on ART at
new HIV positives were identified the end of the fiscal year

First 95 performance Second 95 performance Third 95 performance

85.5% 98% 96.4%

From the total estimated PLHIVs From the total PLHIVs who know Among PLHIVs who were receiving
in Ethiopia, 85.5% of them know their status, 98% were receiving ART, 96.4% of them had viral load
their HIV positive status Anti-Retro therapy (ART) service suppression (<1000 copies/ml)

Pre-Exposure Prophylaxis of HIV (PrEP) Post-Exposure Prophylaxis of HIV (PEP)

15,482 5,770
individuals at high risk of HIV (13,273 female sex individuals has received PEP service
workers and 2,209 sero-discordant couples)
were newly enrolled to PrEP in the fiscal year

8 EXECUTIVE SUMMARY
9. TUBERCULOSIS AND LEPROSY PREVENTION AND CONTROL

TB Incidence TB treatment coverage TB Cure rate

119 new TB cases per 100,000 95%. In the fiscal year, 134,616 (95%) 84% among bacteriologically
population all forms of TB cases were detected confirmed new PTB cases
and treated

Treatment success rate Drug resistant Tuberculosis (DR-TB)

96% among bacteriologically 882 drug resistant TB (DR TB) DR TB treatment initiation has
confirmed new PTB cases cases were detected and put on been provided in 57 treatment-
DR TB treatment initiating centers (TICs)

LEPROSY

2531 cases were detected (a notification Grade II disability rate was 12%
of 0.25 per 10,000 population) among new cases of leprosy

9 EXECUTIVE SUMMARY
10. MALARIA PREVENTION AND ELIMINATION

Number of malaria cases and incidence

A total of 3.303469 malaria cases were

diagnosed and treated

Incidence: 47.2 malaria cases per 1,000

population at risk of malaria

Malaria deaths LLTIN distribution LLTIN spraying

296 deaths due to malaria 1,214,287unit structures were
16,991,437 LLINs were distributed
in the fiscal year. This is 0.42 sprayed, covering 1,456 kebeles in
deaths per 100,000 population 200 Woredas
at risk of malaria

Malaria elimination activities

From the identified 138,042 malaria cases in

Implementation ongoing in
elimination Woredas, 93,031 index cases were
565 Woredas
eligible for case investigation and investigation
done for 56,423 (61%) index cases

11. PREVENTION AND CONTROL OF NON-COMMUNICABLE DISEASES

Hypertension Diabetes Mellitus

More than 14. 38 million individuals were More than 2.67 million individuals were
screened for hypertension. screened for diabetes.

In the fiscal year, 190,439 newly diagnosed 49,030 individuals were newly enrolled
hypertension patients were enrolled to care to DM care

Cervical Cancer screening

Cervical cancer screening and A total of 529,507 women aged 30-49

treatment sites: 1330 provided VIA were screened for cervical cancer; among
and cryotherapy service and 50 which 492,195 (93%) are screened by VIA
provide LEEP service while the rest are by HPV/DNA test

10 EXECUTIVE SUMMARY
12. NEGLECTED TROPICAL DISEASES

Trachoma Onchocerciasis and lymphatic filariasis

More than 17.7 million Zithromax treatment was More than 19.3 million people treated with
administered in 136 endemic districts Ivermectin drug for the prevention of onchocerciasis
in 232 woredas

Surgery was done for 134,939 people with

More than 2.3 million people were treated
Trachomatous Trichiasis (TT)
for lymphatic filariasis

Schistosomiasis and Soil Transmitted

Helminthiasis (STH) Leishmaniasis

More than 46.4 school age children,

adolescents, and women of reproductive
age group were treated for soil transmitted
1,902 visceral and 2,143 Cutaneous leishmaniasis
helminths in 189 districts
patients received treatment

More than 5.1 million school-age children

were treated for Schistosomiasis (SCH) in 177
districts

11 EXECUTIVE SUMMARY
13. CLINICAL AND EMERGENCY SERVICES

OPD attendance per capita Inpatient admission rate Hospital Bed Occupancy Rate
More than 151 million OPD visits,
with an OPD attendance per
capita of 1.50
15.4 per 1,000 population 68%

Average Length of Stay (ALOS) Bed Density Per 10,000 Population Inpatient Mortality Rate

4.1 3.1 1.04%

days

EMERGENCY AND CRITICAL CARE

• Major Cities Emergency and Critical Care Improvement Program implementation in 12 major cities
• National emergency mortality rate was 0.2%
• Critical Care Services
» From the 506 mechanical ventilators in the country only 66% of the mechanical ventilators were functional
» Intensive Care Unit (ICU) mortality rate was 26%

Road Traffic Injury

A total of 306,390
road traffic injuries were reported in the fiscal year

14. BLOOD SERVICES

Blood banks
The number of blood banks that collect
blood from voluntary blood donors: 46

Blood donation Post donation counselling Blood Component Production

352,962 units of blood was A total of 19,022 (5.4%) blood From the total blood donated,
collected, of which 99.99% was donors received post donation 50,372 (8.5%) was converted to
collected from voluntary non- counseling service its components
remunerated blood donors

12 EXECUTIVE SUMMARY
15. REGULATORY SERVICES

Quality and safety regulation of food products

• 94 dietary supplements, 15 baby foods and other different types of food were registered and 586
market authorization and 2,230 notifications was given
• 147 manufacturers and 813 (Importers and distributors) were issued certificate of competency
• A consignment test was performed for 41 imported food items and 1,359 (97.6% from sample) were
found to comply the national standard, while 8 failed and detained them from entering the country
• Post market surveillance (PMS) was conducted for 9 food items. Of the 1033 PMS samples, 578
(56%) were found to comply the national standard, while 450 failed and collected from the market
• A total of 13,319.445 tons and 4,605,335 Birr worth of food products that are not suitable for human
use were seized for various reasons or prevented from being used for human use

Regulation of medicine products and devices

• A total of 25.23 billion birr worth of medicine and 382.08 million birr worth of medicine raw materials
were given import permits
• A total of 42.5 million-birr worth of medicine and medical products, that are not suitable for human
use were seized for various reasons or prevented from being used for human use
• Registration and licensing of medical devices are essential to ensure their quality. The EFDA planned
to issue 860 new market authorizations for non-in-vitro diagnostic (NIVD) devices and 720 new
market authorizations for in-vitro diagnostic (IVD) devices during the fiscal year.
• New market authorization was issues to 658 non-in-vitro diagnostic (NIVD) devices and 601 in-vitro
diagnostic (IVD)
• New licenses were issued to 2 medical device manufacturers, 49 importers and distributors, and 14
low-risk medical device manufacturers
• At the entry checkpoints, medical devices worth 13.52 billion birr were inspected and allowed to enter
the country. In contrast, medical devices worth 33.4 million birr were seized from being imported and
distributed in the country because they did not meet the requirements set by the authority

Control of tobacco and tobacco products

• Inspections of public places to control tobacco smoking was conducted at 64,677 public places, and
all the inspected areas were found to be smoke-free
• Addis Ababa smoke free initiative started, for which a technical working group was established to
coordinate and engage all relevant stakeholders

Regulation of health and health related facilities

• Inspection of health institutions and health related institutions were done

• Caesarean section clinical audit was done in 40 health facilities; diagnostic investigations clinical
audit in 50 health institutions and sudden inspection was done in 42 health institutions
• 12 health institution standards were revised and 8 new were developed; and 13 health institution
standards were approved by the standards council

Ensuring Health Professional Competence and Licensure

• Licensure exam was administered to 62,656 professionals who graduated from government and
private higher education with first degree in thirteen disciplines
• From the total evaluated candidates, 29,443 (47%) of the candidates pass the competency
assessment test

13 EXECUTIVE SUMMARY
16. HEALTH INFRASTRUCTURE

379 Public Hospitals 52

functional hospitals (254 primary, 98 hospitals on construction
general and 27 specialized)

Health Centers
3,826 91
functional health centers health centers on construction

Health Posts
17,569 116
functional health posts health posts on construction

Comprehensive health posts construction

Second generation health post Upgrading construction progress of
upgrading to comprehensive health other 52 projects has reached to an
post was completed for 52 projects average construction progress of 96%

17. HUMAN RESOURCE FOR HEALTH

Staff Deployment Stock of Health workforce

• Total health workforce who are employed in public
• In the fiscal year, 1,629 physicians (GP) were and private institutions: 462,820
employed using matching fund • 310,591 (67%) are health professionals and 152,229
(33%) are administrative/supportive staff

Health Professional to population ratio Capacity Building

• Physician to population ratio: 1: 5,737 • Accreditation has been granted to 37 accreditors
• Nurses to population ratio: 1: 983 and 219 Continous Professional Development
(CPD) providers
• Midwives to population ratio: 1: 4,343
• Linkage of CPD with regional regulatory bodies
• Health Officers to population ratio: 1: 3,055
was started in nine regions

14 EXECUTIVE SUMMARY
18. HEALTH INFORMATION SYSTEM

SERVICE REPORT SERVICE REPORT

COMPLETENESS TIMELINESS
85% 41%

DHIS2 eCHIS
7,806 health posts have started
Upgraded to version 2.36 and implementation of eCHIS
implemented in more than 95% of public
6,913 health posts registered more than
health institutions; in addition upgrading to
85% of their catchment population
version 40 is started
5,740 health posts have started capturing
the services provided using eCHIS app

Electronic Medical Record

Birth Notification Death Notification
system implementation
implementation ongoing in 75% 4%
38 public health facilities (27 of the expected births of the estimated deaths
hospitals and 11 health centers)

19. PHARMACEUTICAL SUPPLY AND SERVICES

Procurement Distribution
A total amount of ETB 42.65 Billion Birr Ethiopian Pharmaceuticals Supply Service
worth of pharmaceuticals and medical (EPSS) has distributed pharmaceuticals
supplies was procured in 2015 EFY and medical supplies worth of ETB 37.2
Billion Birr to health facilities

Availability of essential drugs (hub level) Wastage rate

The availability of essential The wastage rate of pharmaceuticals

pharmaceuticals at EPSS hubs was 84.3% in the pharmaceuticals supply chain
system (at hubs) was 0.72%

Procurement lead time Medical equipment management

823
194 days medical equipment’s are
maintained in the fiscal year

Auditable Pharmaceutical and Transaction Service (APTS)

47 new facilities started APTS in 2015 EFY. Total APTS

implementing facilities reached 408

15 EXECUTIVE SUMMARY
20. HEALTH FINANCING

Budget allocation

In 2015 EFY, 12.3% of the total government budget was allocated to health

Development partners contribution to the health sector

More than 590.6 million USD was committed from development partners (DPs),
from which more than 555 million USD (94.6%) was disbursed to the health sector

Performance Based Financing

Piloting started in three regions (Addis Ababa, SNNP and Somali)

Private sector engagement

• As part of the foreign direct investment, seven projects were registered of which 6 of
them are at the pre-implementation phase
• There were 130 domestic private investments on health sector, of which 125 of them are
in pre-implementation phase

Public Private Partnership

Three Public Private Partnership pipeline projects were registered by the Ministry of
Finance - diagnostic services (Laboratory, pathology and imaging), medical gas plant and
oncology services

Coverage of CBHI implementing Woredas

At the end of 2015 EFY, 1,011 (87%) Woredas were implementing CBHI

CBHI Membership
Community Based
More than 12.1 million (78.4%) of the total eligible households were enrolled
Health Insurance into CBHI program
(CBHI)
CBHI Membership Fee Collection
More than 4.4 billion ETB was collected from CBHI members

Social Health Insurance

Preparatory activities started, different guideline and manuals are prepared,

advocacy activities conducted

16 EXECUTIVE SUMMARY
21. PUBLIC HEALTH EMERGENCY MANAGEMENT

Prevention and control of epidemic prone diseases

Measles Outbreak Response

• Measles outbreak occurred in 219 Woreda from Amhara, SNNPR, Oromia and Somali
regions since Tahisas 2013 EFY
• A total of 23,019 confirmed measles cases were reported
• 228 deaths from measles

Cholera outbreak
• Cholera outbreak was reported from 140 Woredas in five regions (Oromia,
SNNP< Amhara, Sidama and Somali)
• A total of 16,857 suspected Cholera cases and 229 deaths were reported
(Case fatality rate at 1.36%)

Acute Flaccid Paralysis (AFP) /Polio Rabies exposure

In this fiscal year, 1024 Suspected A total of 12,888 rabies exposer (dog bite)
AFP/polio case were reported was reported with 50 deaths

22. COVID-19 PREVENTION AND RESPONSE

Number of cases and deaths due to COVID-19 (as of July 27, 2022)

Cumulative total cases Cumulative total deaths Total COVID-19 tests COVID-19 test positivity rate

501,049 7,574 5,561,223 9.01%

COVID cases (case fatality rate =1.6%) samples

COVID-19 Vaccine Status

Total that completed primary series of

Total doses given (at least one dose)
COVID-19 vaccination

54.2 million 44 million

(80%) (65.5%)

17 EXECUTIVE SUMMARY
EXECUTIVE SUMMARY
ANNUAL PERFROMANCE REPORT 2015 EFY
Strong health financing for sustainable health development