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Working in partnership Countdown for Child Survival in Ethiopia London 13-14 December 2005

Working in partnership Countdown for Child Survival in Ethiopia London 13-14 December 2005. Federal Ministry of Health of the Democratic Republic of Ethiopia. Outline. Background Partnership HSDP III and areas of focus The two acceleration vehicles Challenges and the way forward

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Working in partnership Countdown for Child Survival in Ethiopia London 13-14 December 2005

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  1. Working in partnership Countdown for Child Survival in EthiopiaLondon 13-14 December 2005 Federal Ministry of Health of the Democratic Republic of Ethiopia

  2. Outline • Background • Partnership • HSDP III and areas of focus • The two acceleration vehicles • Challenges and the way forward • Conclusion

  3. Utilization of healthservices: 0.36/person/ year (2004) Per capita Health expenditure, all sources: US$ 5.60 (2000) Projected population : 77,4 million in 2005 (85 % rural) U5 mortality : 140/1000 29% of deaths in neonatal period MMR : 871/100,000

  4. What are Children Dying from? Other, 2% Measles, 4% AIDS, 1% Neonatal, 25% Malnutrition57% Diarrhea, 20% HIV/AIDS11% Malaria, 20% Pneumonia, 28%

  5. Experience of working in partnership • First Global Child Survival Partnership mission in December 2003 to initiate discussion on Partnership • National Child Health situation analysis done • First National Child Survival Partnership Conference held - April 22-24, 2004 • National Child Survival Core Technical Working Group established • Child Survival strategy developed and endorsed November 2004.

  6. Strong partnership led by government • Government commitment at all levels • effective linkage of HSDP III with PASDEP • Consensus among partners on HSDP III • 13 partners Signed Code of Conduct on harmonization One Plan, One Budget, One Monitoring system (Harmonization)

  7. Institutionalization of the Child Survival Strategy • Incorporated in the third Health Sector Development Program • Central to the MDG based Plan for Accelerated and Sustainable Development Program (PASDEP) • Improved harmonization and alignment of in-country partners • Health Extension Program identified as the principal vehicle for delivery of essential Child Survival interventions • Community ownership Institutionalization is critical in translating vision into action

  8. HSDP III priorities • Focus Areas • Maternal Health; CPR 75% • Child Health; DPT 3 = 90% • HIV/AIDS prevention and control • Malaria prevention and control • 2 bednets/HH – all HHs in malarious areas

  9. Government commitment: No more “business as usual”

  10. HSDP III priorities • Vehicles (the two lines of 1o health care) • Health extension Program (HP) • Accelerated health center expansion • Systems • Health Management and info System (HMIS) • Logistics management system (LMIS) • Finance System

  11. Universal Primary Health Care by 2008 The two acceleration vehicles - strategies • Accelerated expansion of Health Posts – 1 HP/village (Health Extension Package) • Accelerated expansion of Health Centers – 1 HC/ 25,000 population

  12. Health Extension Program • Train > 30,000 Health extension workers – 2HEWs / village of 5,000 population • 2800 deployed in 2004 and 7,100 will be deployed this month = 9900 • Build 12,500 Health Posts • 4148 built “Households are the primary producers of Health”

  13. HEP’s Major Components • Family Health • Communicable Disease Prevention and Control • Hygiene and Environmental Health • First Aid There are 16 packages under the above 4 broad areas

  14. Action Steps – HEP implementation • Discuss with administrators and association leaders and reach consensus • Conduct base line survey • Select model families (30-45 households at once) on voluntary basis • Train selected households for 96 hours • Graduate trained households in 2-3 months (Oath) • Monitor progress after graduation (HEW and CHWs) • Enforce environmental law and penalize community members who practice otherwise (Social court)

  15. In many areas where HEP is being implemented, CPR is reaching up to 80%

  16. Accelerated expansion of Health Centers • Train 3,000 Health Officers in 3 Years • Up to 2000 HOs already enrolled • Upgrade 2167 clinics to health centers, build 563 new • 619 HCs exsting, 443 will be upgraded this year • We are on schedule in relation to the two acceleration targets set for 2008

  17. US$ 3.1 Billion needed to reach child health MDGWith estimated average annual allocation of US$ 307 Million Marginal Budgeting for Bottlenecks model: overall reduction of under-5 mortality of 48% by 2010 and 61% by 2015

  18. Key Challenges • Moving from strategy to accelerated implementation • Human Resource development • System strengthening • Expansion of health infrastructure • Resources for HEP • Effectively broadening the National Partnership to MNCH

  19. Sustainability Issues - • Organizing around priorities and outcomes • Integrated health system • Social mobilization with concrete expectations from communities • Health financing (HI - tap own resources) • Accelerate implementation (Scale-up) expansion of health services – Piloting only in exceptional situations - BBP

  20. Conclusions • Government commitment • Set clear directions in PASDEP II and HSDP III child survival being a key focus area • Prepared Child survival strategy • Identified two acceleration vehicles for fast scale-up • Started implementing the two strategies and on schedule in relation to set targets for 2008 • Harmonization is taking shape (CoC) • Above all, we are ready to face any challenge and take any risk to reach our goals – we value your partnership to realize our vision. We are determined to win the fight.

  21. 1stNational Child Survival Partnership Conference, April 22-24, 2004

  22. Together we can make a difference for the future of our Globe Thank you

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