Background

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BackgroundBackground

• Ethiopia: second populous country in Africa, 80 million

- women and children constitute 72% of the population. - 49.7% of Ethiopia's’ population are female - TFR is estimated 4.8 - Maternal mortality rate is estimated at 673 /100,000 live births.

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Background Background

• Per capita expenditure on health $ 2.31 compared to India $ 9, S. Africa $ 100, U.K $ 1780

• Doctor to population ratio 1: 42,700• Nurse to population ratio 1: 4,200

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Child healthChild health

• Under 15 years constitute 44.7% of the population

• Of which 40% are under five and 8% are under one year.

• Infant mortality rate is 59/1000 live births• Under five mortality rate 88/1000 live

births• Neonatal mortality rate 37/1000 live births

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Child healthChild health

• 1/20 born alive die in their first month of life• 1/10 die before reaching their 1st birth day• 1/6 die before reaching their fifth birthday

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Child healthChild health

• More than 70% of these deaths are due to the five diseases.– Pneumonia 28.9%– Malaria 21.6%– Diarrhea 12%– Measles 5%– 60% of these deaths are associated with malnutrition– Perinatal 22%– HIV/AIDS 11%

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Malaria Malaria

• Prevalent in 75% of the country• 4-5 million are affected every year• 40 million are at risk• Morbidity and mortality is high in children• Only 20% of children under five who

experience malaria visit existing clinics• The case fatality rate currently ranges from

17-35%

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diarrheadiarrhea

• One of the major causes of under five mortality and morbidity next to lower respiratory infection and measles

• In a nationwide rural survey 12.5% of children 6-59 months had diarrhea in the past two weeks.

• There is an estimate of 230,000 under five deaths each year due to diarrhea.

• The median incidence of diarrhea is estimated to be 5 episodes/child/year.

• Clean water coverage is about 31%

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HIV/AIDS (2001)HIV/AIDS (2001)

• Prevalence rate 2.1%• Number of orphans – current report is 4

million• Prevalence in pregnant women 6%- 23%• 60,000 newborns infected through MTCT• 40% of infected children die before 1 yr of

age• 50-75% die before 5th birthday

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Nutrition Nutrition

• Ethiopian Ministry of Health document shows that :

47% of under fives are stunted 8% are wasted37% are underweight15% are low birth weight

• Malnutrition, underlying cause of death in >50% of deaths of under fives

• In Ethiopia more than five out of ten under fives are chronically malnourished

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Health and health related Health and health related indicators –MOH/2011indicators –MOH/2011

Indicator Rate/coverage

Total fertility rate 4.8

Maternal mortality rate 673

Antenatal service coverage 34%

Attended skilled delivery coverage

26.4%

Postnatal service coverage 15.8%

Family planning service coverage 29.0%

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Basic health indicators, MOH, 2011 Basic health indicators, MOH, 2011

INDICATOR CURRENT ESTIMATESLife expectancy at birth 53.4(M), 55.4(F) yearsIMR/1000 live births 59/1000Crude birth rate 44/1000Total fertility rate 6.1 children per womanCrude death rate 15/1000 Access to Basic Health Service

86%

Contraceptive usage 29%Population growth rate 2.9%

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The way forward The way forward

• The IMNCI strategy 1. Improve health worker skill

2. Improve the health system 3. Improve family and community health seeking behavior• ENA approach• PMTCT • Roll back malaria initiative – new drug

introduced

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Essential Nutrition Action, program Essential Nutrition Action, program objectives objectives

• Additional feeding for pregnant and lactating mothers

• Exclusive breast feeding for 6 months• Complementary feeding after 6 months of

age• Extra feeding for the child during illness• Micronutrient supplementation• Immunization

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Prevention of Mother to child Prevention of Mother to child transmission of HIVtransmission of HIV

• The four prongs:– Primary prevention– Prevention of unintended pregnancies in HIV

infected mother– Prevention of mother to child transmission of

HIV– Care and support to HIV infected women,

their infants and families

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Roll back malaria initiativeRoll back malaria initiative

• Systematic data collection• Vector control

– Insecticide treated nets– Indoor residual spraying– Integrated vector management

• Case management• Support research

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There is still great hope!There is still great hope!

• The promised land!

“ Let Ethiopia hasten to stretch out her hands to God” Psalm (68:31)

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Thank youThank you

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