ETHIOPIA Last update: 27 July 2004

Transcription

1 ETHIOPIA Last update: 27 July 2004 Present context Ethiopia has experienced recurrent droughts and conflicts. Drought has become a chronic occurrence in the country. In 2001, approximately 10.2 million people were reported to be in need of food and non-food assistance. Crop failures have also become commonplace. From time to time there have been internal displacements. due to floods. The associated food shortages have resulted in malnutrition and under-nutrition. People from neighbouring countries have been taking refuge in Ethiopia due to conflicts in their own countries. There have also been internally-displaced people within the country. There are concerns about the volatile situation in the Somali Region, which has a large IDPs population, and in Gambella Region The Ethiopia-Eritrea border dispute continues. In the area of health, the humanitarian community was also able to provide a strong response throughout Vitamin A campaigns and supplementary immunization activities were expanded geographically and extended to broader age group targets. More than 11 million children received measles vaccination and vitamin A doses which has prevented large scale measles outbreaks. Out of the required 1,500 emergency drug kits for 2003, 1,463 emergency kits were distributed to the most affected regions. Main Public Health issues and concerns Health Status The country has a maternal mortality ratio ranging from 560 to 850 per 100,000 live births. HIV/AIDS/STI: According to MOH estimates, the HIV/AIDS prevalence rate among adults is around 4.4%. According to the Ethiopian DHS % of all men had experienced symptoms of sexually transmitted infections. T Malaria: The incidence of malaria has been increasing steadily over the years. In 1995, there were 1.1 million cases, which increased to 1.5 million in Tuberculosis: In 2001, about 93,000 new cases of tuberculosis were reported. The management of TB poses a special challenge to the health sector, as only about 50% of the population is within walking distance from health facilities.

2 Vaccine-preventable diseases: The national DPT3 coverage is 42%. Malnutrition. the total number of people affected by food shortage is around 13.2 million; nutritional surveys showed up to 21% Global Acute Malnutrition (GAM) in An unprecedented donor and public response throughout 2003 met 94% of requirements and prevented widespread famine-related mortality. Non-communicable diseases: The prevalence of non-communicable diseases, including hypertension, cardiovascular diseases and diabetes mellitus, is increasing with changes in people s lifestyles. According to the Health and health-related indicators of MOH ( ), hypertension was the seventh leading cause of death in the country in Blindness: According to the MOH, the estimated prevalence rate of blindness is 1.25%; cataracts were responsible for 2.4% of all admissions to hospitals in Health system The limited number of health institutions, inefficient distribution of medical supplies, and disparity between urban and rural areas have made it difficult to increase people s access to health-care services. Health system main indicators show: A severe underfunding of the sector, which puts the country at the lowest end of health expenditure (total spending of less than $4 per capita per year) Limited access to health care, with a small hospital network (0.2 beds per 1,000 population) and geographical constraints (more than 50% of the population lives more than 10 km from the nearest health facility, usually in regions with poor transportation infrastructure) accessed 12/1/04

3 Health priorities 2004 include: strengthening the control of communicable diseases including malaria, meningococcal meningitis, measles, HIV/AIDS Controlling malnutrition through development of national emergency nutrition strategy and expansion of FTP and SFP centers to treat acute malnutrition. Expanding and strengthening reproductive health services for emergency-affected populations Building response capacity of the Federal, Regional, Zonal and district level health workers. Other Priority humanitarian Needs Food insecurity, combined with poor health infrastructure and service delivery, continues to manifest itself in growing epidemics. The current wide spread malaria outbreak, mainly in the mid and lowland areas, continues to exacerbate food shortages and raise mortality making recovery from the crisis of 2003 slow, if not impossible, for some households due to loss of labour. The loss of labour to a household is as critical in household food insecurity as rain failure. Underfunding particularly of water and sanitation and health has affected the emergency response The major challenge likely to be faced by the humanitarian efforts in 2004 will be to link medium and longer-term initiatives that address food and livelihood insecurity.

4 Health Actors Ministry of Health, the Regional Health Bureaus (RHBs). UN agencies participating in the meeting are UNDP, UNFPA, UNICEF and WHO. The main countries participating in the HPN are Belgium, Germany, Ireland, Italy, Japan, Norway, The Netherlands, Sweden, USA and the Christian Relief and Development Organization (CRDA). NGOs involved in both preventive and curative health services are important partners in the health sector. Close to 200 NGOs work under the CRDA, the umbrella organization that coordinates the overall NGO effort in the country. Sixty per cent of the CRDA members are involved in the provision of curative and preventive health services. Some of the priority activities of NGOs include HIV/AIDS, reproductive health, child health, environmental health and human resources development/training. Overall, NGOs provide about 10% of the total health care in the country. The role of CRDA as a liaison agency between NGOs and MOH needs to be strengthened. Although WHO works with selected NGOs on hygiene and environmental health, capacity-building and HIV/AIDS, it lacks a clearly defined mechanism to guide the type and degree of work that it undertakes with these groups. Disclaimer The emergency country profiles are not a formal publication of WHO and do not necessarily represent the decisions or the stated policy of the Organization. The presentation of maps contained herein does not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or areas or its authorities, or concerning the delineation of its frontiers or boundaries. Key Contact/Reference Information WHO Representative Dr Olusegun Ayorinde Babaniyi Phone: Mobile: babaniyio@whoet.org Minister of Health Dr Kebede Tadesse Ministry of Health of the Federal Democratic Republic of Ethiopia PO Box 1234 Addis Ababa, Ethiopia Phone: Fax: moh@telecom.net.et HAC Focal Point Dr A Ahmed Phone: Mobile: ahmed@iss.it HAC Focal Point Dr Mulugeta Gebru Phone: Mobile:

5 Readings and links The UN-CAP-Ethiopia The Country Cooperation Strategy, 2003 WHO-AFRO Country Profile Internal WHO reports (see WHO/CDS baseline statistics unless indicated otherwise May 2004 The World Bank Annual Report, 2003 UNDP Human Development Report 2004 UNAIDS 2004 Report on the global AIDS epidemic Disclaimer The emergency country profiles are not a formal publication of WHO and do not necessarily represent the decisions or the stated policy of the Organization. The presentation of maps contained herein does not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or areas or its authorities, or concerning the delineation of its frontiers or boundaries.

6 Annex 1: Health Profile - Ethiopia 2 General Indicators Population (2004) 72,420,000 Refugees Internally Displaced Persons 3 131,991 Healthy life expectancy at birth m/f (years) (2002) 47/49 GNI (Gross National Income) per capita (US $, 2002) Infant Mortality rate (deaths/1000 live births) (2000) 114 Under-five mortality rate (deaths/1000 live births) (2000) 179 Total adult literacy by % m/f (2000) 47/31 Population using improved drinking water sources (2000) 24% Population using adequate sanitation facilities (2000) 12% UNDP's Human Development Index ranking 5 170/177 Health Systems Profile Total expenditure on health as % of GDP (2001) 3.6 Total per capita health expenditure (US $) (2001) 3 Nurses rate per 100,000 population NA Physicians rate per 100,000 population NA Hospital Beds per 1000 population 0.2 Tuberculosis Prevalence per 100, Mortality rate per 100, HIV/AIDS 6 Adult prevalence of HIV/AIDS (15-49 years) (2003) 4.4 Estimated number of adults living with HIV/AIDS (2003) 1.4 million Reported number of people receiving antiretroviral therapy 4,500 (15-49 years) (June 2004) Orphans due to AIDS 720,000 Malaria Mortality rate per 100, Immunization (2002) 7 BCG 76% DPT3 42% Measles 52% Polio 57% Pregnant women receiving tetanus vaccine 24% Women's Health Total fertility rate (2002) 6.2 % of antenatal care coverage 27 %of skilled attendant at delivery (2000) 9.7 Maternal mortality ratio (2000) WHO/CDS baseline statistics unless indicated otherwise 3 May The World Bank Annual Report, UNDP Human Development Report UNAIDS 2004 Report on the global AIDS epidemic 7

7 Annex 2: Affected population As of August 2003, there were between 169,000 and 228,000 internally displaced people unable to return to their areas of origin. Causes of displacement: armed conflict between Eritrea and Ethiopia displaced civilians living along the border ( ); thousands displaced due to ethnic clashes ( ); causes of conflict which displaced 10,000 people in Gambella (2003) and a Government resettlement schemes and relocations (2003). IDPs have predominantly been displaced in Tigray (c.75,000); Afar (c.30,000) and the Somali Region (c.59,000). Ethiopia has around 133,000 8 refugees, including more than 80,000 Sudanese, about 30,000 Somalis, and more than 4,000 Eritreans 9. Refugees have predominantly been settled in Binshangul Gumuz (c.23,000); Gambella (c.62,000) and the Somali Region (c.52,000). Other vulnerable groups include political detainees (c.4,800); drought affected (c.5,900,000); PoWs (c.1,500); HIV/AIDS (c.2,200,000); HIV/AIDS Orphans (c.750,000) and street children (c.100,000). 8 accessed 12/1/ accessed 12/1/04

8 Annex3: Populations of current humanitarian concern

9 Annex 4: Security Security 10 : Capital: Addis Ababa (Phase I). PHASE III is in effect in the regions in Ethiopia that have the following boundary revisions: North North of Adigrat-Axum-Inda Sellasie to Sudan border along Angereb River. Northeast East of Dessie -Mekele Road bounded by borders and Dessie Djibouti Road and border with Eritrea/TSZ and Djibouti. (Road to Djibouti and Town of Assaita remain in PHASE I). East and South South west of Awash-Djibouti Road, East of Harar, Dire Dawa, Ginir, Negele and South of Dila-Yabellow Road and South of Kelem-Yabello Road. West-Gambela region. The rest of the country remains in PHASE I. Road travel should take place only during daytime; long trips outside main cities should be with at least two four-wheel drive vehicles (if possible). Advice about security conditions should be sought from the respective Agency Head. Mr. K.Y. Amoako, the Executive Secretary of ECA is the Designated Official for Addis Ababa, tel: , fax: , kamoako@uneca.org; and Mr. Samuel Nyambi, the UN Resident Coordinator/UNDP Resident Representative is the Deputy Designated Official, with special responsibility for outside Addis, tel: /511027, fax: /515147, samuel.nyambi@undp.org. Requests for clearance should be faxed to , syscoord.eth@uneca.org. CSO based in Addis Ababa, Ethiopia is Peter Marshall, tel: , fax: , cell: ; pmarshall@uneca.org. FSCO a.i. is Rolf Helmrich, tel: , , cell: , rhelmrich@uneca.org, rolf.helmrich@undp.org. 10 UNSECOORD, 7 July 2004