[et_pb_section fb_built=”1″ admin_label=”!! PLEASE DO NOT EDIT !!!” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_row use_custom_gutter=”on” gutter_width=”1″ admin_label=”!!! PLEASE DO NOT EDIT !!!” _builder_version=”4.20.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_text admin_label=”TEXT – BLOCK 1 ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n
Ethiopia, a low-income country (LIC) with a population of about 107 million in 2023[1]<\/a><\/sup>, has experienced economic growth and made remarkable improvements in health outcomes. Ethiopia\u2019s 2019\/2020 National Health Accounts report shows government health expenditure increased substantially between 2017 and 2020. The government introduced various health financing initiatives to advance universal health coverage (UHC), implementing fee waivers for the most vulnerable. In 2019, Ethiopia\u2019s composite UHC service index was 38, lower than the average for LICs in sub-Saharan Africa [2]<\/a><\/sup>.<\/span><\/p>\n [\/et_pb_text][ba_gradient_heading title=”Ethiopia\u2019s pathway to UHC and health security” html_tag=”h3″ primary_color=”#455A64″ secondary_color=”#455A64″ admin_label=”HEADING (50-60 characters)” _builder_version=”4.21.0″ _module_preset=”default” title_font=”||||||||” title_font_size=”24px” title_line_height=”1em” custom_padding=”||10px||false|false” global_colors_info=”{}”][\/ba_gradient_heading][et_pb_text admin_label=”TEXT – BLOCK 2 ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″]<\/p>\n Since 2000, Ethiopia executed consecutive five-year plans, including four Health Sector Development Plans and two <\/span>Health Sector Transformation Plans<\/span><\/a>. The country introduced the Health Sector Medium-Term Development and Investment Plan, a strategic road map (2023\/24 to 2026\/27). Strengthening Primary Health Care (PHC) is Ethiopia\u2019s key strategy to advancing UHC. <\/span><\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 3″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n Community-based health insurance (CBHI) covers over 89% of administrative districts, with approximately 81% of households enrolled, benefiting over 55 million people (60% of the target). Despite being voluntary, CBHI membership has provided improved financial protection. Subsidies and premium waivers financed by federal and subnational governments ensure CBHI is relatively equitable and targets people living in poverty. Still, challenges such as better aligning CBHI with UHC objectives of equity, efficiency, transparency and accountability remain.\u00a0<\/span><\/p>\n [\/et_pb_text][ba_gradient_heading title=”The way forward and policy options ” html_tag=”h3″ primary_color=”#455A64″ secondary_color=”#455A64″ admin_label=” HEADING (50-60 characters)” _builder_version=”4.21.0″ _module_preset=”default” title_font=”||||||||” title_font_size=”24px” title_line_height=”1em” custom_padding=”||10px||false|false” global_colors_info=”{}”][\/ba_gradient_heading][et_pb_text admin_label=”TEXT – BLOCK 4 ” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n Ethiopia plans to launch formal sector social health insurance (SHI). To avoid a two-tier health system \u2013 one tier for the formal sector and one for the informal \u2013 equity and fragmentation implications need to be managed. CBHI and SHI scheme integration merits consideration. If integration into one national health insurance scheme is not feasible, policy tools might be introduced to improve pooling. These include cross-subsidization and harmonization of benefit packages, contracting arrangements and provider payment mechanisms and renumeration rates. Shifting to regional or national PHC\u2013level pooling<\/a> and capitation can improve risk pooling, reduce costs and improve financial sustainability.\u00a0<\/span><\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 5″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n While introducing mandatory health insurance could improve coverage for members, full enforcement would be difficult given Ethiopia\u2019s large informal sector. To enable wider enrolment among households living in poverty, the government could further increase subsidization for them.<\/span><\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 6″ _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n Well-documented supply side challenges remain, like perceived low quality of care and stock-outs of medicine and supplies. Challenges undermine CBHI roll-out, as members may turn to the private sector, facing higher prices and potentially greater catastrophic health expenditure.<\/span><\/p>\n [\/et_pb_text][et_pb_text admin_label=”TEXT – BLOCK 9 – footnotes” _builder_version=”4.21.0″ _module_preset=”default” text_font_size=”13px” custom_margin=”20px||||false|false” custom_padding=”||||false|false” global_colors_info=”{}”]References<\/strong><\/p>\n [1]<\/span> Federal Democratic Republic of Ethiopia, Ministry of Health. (2023\/24\u20132025\/26). Health Sector Medium Term Development and Investment Plan (HSDIP). <\/span><\/p>\n