1 background ethiopia: second populous country in africa, 80 million - women and children constitute...
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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 ESTIMATES
Life expectancy at birth 53.4(M), 55.4(F) years
IMR/1000 live births 59/1000
Crude birth rate 44/1000
Total fertility rate 6.1 children per woman
Crude 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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