Strengthening Rehabilitation within Ethiopia’s Health Systems (2024)

Rehabilitation is a core component of Universal Health Coverage (UHC) [i] that enables optimal functioning, improves quality of life, reduces disability, and maximizes the effectiveness of health interventions. The WHO Rehabilitation Needs Estimator[ii] shows that in Ethiopia, approximately 1 in 5 people (21 million) had health conditions that could benefit from rehabilitation, primarily musculoskeletal disorders and sensory impairments. This need will continue to grow as the population ages, non-communicable diseases surge, and conflict-induced injuries increase.[iii]

While rehabilitation is often overlooked in low- and middle-income countries (LMICs),[iv] Ethiopia has taken significant steps in recent years to prioritize rehabilitation within its health system. Policymakers included rehabilitation in the Health Sector Transformation Plan II as a key component of the continuum of care and the five-year National Rehabilitation and Assistive Technology Strategic Plan. With key strategies in place, the Ministry of Health (MOH) is on the path to integrate rehabilitation into the health systems agenda.

With funding from the U.S. Agency for International Development’s Patrick J. Leahy War Victims Fund, the MOH and the Health Systems Strengthening Accelerator (Accelerator) have partnered to implement these strategies and strengthen rehabilitation within Ethiopia’s health systems. While ongoing, this collaboration has produced promising developments that will create the foundation to improve access to needed services.

Strengthening governance and coordination for rehabilitation

Rehabilitation governance was recently transferred to the MOH from the Ministry of Women and Social Affairs (MOWSA). To promote the MOH’s efforts, the Accelerator supported the MOH in finalizing the five-year Strategic Plan and a strategic plan for the Ethiopian Prosthetic and Orthotic Service (EPOS), a newly reinstated comprehensive rehabilitation center. The Accelerator also supported the MOH to revitalize the Rehabilitation Technical Working Group (TWG) and conduct regular performance review meetings for representatives from the TWG, Regional Health Bureaus (RHBs), rehabilitation facilities, and civil society organizations to discuss challenges and share experiences in rehabilitation service delivery, and assess progress towards key goals in the Strategic Plan. These new platforms allow relevant stakeholders to make collective decisions to further Ethiopia’s progress.

Improving service data management and use for rehabilitation

Quality data is necessary for informed decision-making from the facility to the national level. Recognizing this, a strategic objective of the MOH’s Strategic Plan is to improve health information systems to more accurately measure rehabilitation needs and patient outcomes. To address this objective, the Accelerator collaborated with the MOH and the TWG to develop six new rehabilitation and assistive technology (AT) indicators and associated manual data collection tools, which are currently being piloted in three rehabilitation centers and two hospitals. The eventual goal is to integrate these indicators into the District Health Information System 2.0 (DHIS2), Ethiopia’s routine health data collection and reporting system. With new information reported on a regular basis, policymakers and facility managers will be better equipped to plan for the needs of the Ethiopian population.

Integrating rehabilitation into primary health care

As part of the Rehab 2030 initiative, WHO recommends that countries work to integrate rehabilitation at the community and primary health care (PHC) levels to expand access to services and bring them closer to those in need.[v] This is also a priority in Ethiopia, as stated in the MOH’s National Rehabilitation and Assistive Technology Strategic Plan and the second Health Sector Transformation Plan (HSTP-II), which outlines strategic initiatives for the entire health sector. In partnership with the MOH, the Accelerator supported a landscape analysis to understand how rehabilitation could be integrated into the community and PHC levels given the current state of rehabilitation services and governance at the national and regional levels. Findings from this landscape analysis will inform recommendations to the MOH and opportunities for further technical support.

Building capacity for resource management and mobilization

The Accelerator and the MOH facilitated a capacity-building training in August 2022 for policymakers and rehabilitation facility heads to better manage and mobilize resources for rehabilitation within the context of resource constraints. Participants identified the deeper root causes of their day-to-day challenges as lack of awareness of rehabilitation among policymakers, lack of AT equipment, and inadequate human resource capacity, all of which stem from underfunding and under-prioritization. Using the resource mobilization process, participants identified key stakeholders, mapped required resources, created action plans to address these root problems, and drafted targeted funding proposals to execute their plans. After the training, participants expressed interest in continued learning and expanding the training’s audience, as the training’s planning and advocacy skills are applicable in multiple scenarios.

While the MOH and Accelerator have made large strides in recent years to strengthen rehabilitation, the work is just beginning. Key to this partnership has been the MOH’s prioritization of rehabilitation within the health agenda and the Accelerator’s ongoing support. Continued multi-stakeholder collaboration in implementing Ethiopia’s national rehabilitation strategy has the potential to increase access to much needed rehabilitation services, reduce disability, and enhance the well-being of Ethiopians across the country

Strengthening Rehabilitation within Ethiopia’s Health Systems (2024)

FAQs

Why is rehabilitation important in healthcare? ›

Rehabilitation helps to minimize or slow down the disabling effects of chronic health conditions, such as cardiovascular disease, cancer and diabetes by equipping people with self-management strategies and the assistive products they require, or by addressing pain or other complications.

What is the current Ethiopian health system? ›

current Ethiopian health system is decentralized, with three tiers " Fig 1". These include, at the primary care level, a Woreda-based (District-based) system that includes one Primary Hospital, Health Centres, and Health Posts form the primary health care. ...

What is the main health problem in Ethiopia? ›

Nevertheless, communicable diseases like HIV/AIDS, TB, malaria, hepatitis B&C, respiratory infection, leprosy, and diarrhea remain a serious challenge in Ethiopia. Premature death, suboptimal quality of life, and nutritional diseases constitute a major health challenge.

What is the most important part of rehabilitation? ›

The first stage of physical rehabilitation is the Recovery Stage. This is the most important stage of the treatment process and, depending on the severity of your injuries, can also be the longest. The goal of this first stage is simple: to recuperate and allow your body to begin the healing process.

What is the main goal of rehabilitation? ›

Rehabilitation is care that can help you get back, keep, or improve abilities that you need for daily life. These abilities may be physical, mental, and/or cognitive (thinking and learning). You may have lost them because of a disease or injury, or as a side effect from a medical treatment.

Why is rehabilitation so effective? ›

Addressing Underlying Issues. Many individuals in the criminal justice system struggle with mental health issues, substance abuse, or a history of trauma. Rehabilitation focuses on addressing these underlying issues, providing support and treatment, which is often more effective than mere punishment.

How to strengthen health systems? ›

IMPROVING HEALTH THROUGH STRONGER SYSTEMS
  1. Improved health service delivery. ...
  2. Health workforce development. ...
  3. Information systems. ...
  4. Access to essential medicines. ...
  5. Health system financing. ...
  6. Leadership and governance.

What are the health priorities in Ethiopia? ›

As part of its priority of advocating for increased access to quality health services, the WHO said it will focus on sexual and reproductive health services, the inclusion of people with disabilities, older people, and people living with HIV, as well as addressing remote populations through the inclusion of mobile ...

What do Ethiopians believe about health? ›

To Ethiopians, health is an equilibrium between the body and the outside. Excess sun is believed to cause mitch (“sunstroke”), leading to skin disease. Blowing winds are thought to cause pain wherever they hit. Sexually transmitted disease is attributed to urinating under a full moon.

What does Ethiopia need to improve? ›

Ethiopia has achieved major health improvements over the past decade. However, ensuring access to good quality healthcare for over 110 million Ethiopians remains a challenge. Infectious disease, lack of safe water, sanitation and hygiene, and malnutrition continue to threaten the gains made in health outcomes.

What is the main cause of death in Ethiopia hospitals? ›

Nearly 56% of the males and 68% of the females deaths were due to five leading causes (conditions arising during perinatal period, HIV/AIDS, tuberculosis, cardiovascular diseases and respiratory infections).

Are people in Ethiopia healthy? ›

The health of the people in Ethiopia has improved significantly in the last decade. The current life expectancy is 65 years compared to 58 in 2010. The infant mortality rate in 2021 was 34 per 1,000 live births compared to 54 in 2010. The under-five mortality rate is 46.8 deaths per 1,000 live births.

What is the main focus of rehabilitation? ›

Rehabilitation is the idea of reforming a prisoner so that they can reintegrate back into society upon their release. This process involves various programs including anger management, education programs and even creative workshops to form another outlet for expression.

What is a successful rehabilitation? ›

'Successful rehabilitation' is: (1) person and family centred; (2) effective; (3) inter-professional; (4) accessible; (5) goal oriented with meaningful outcomes; (6) connected to the continuum of care; (7) evidence-based and supportive of innovation and research; (8) appropriately funded and skilled; (9) satisfying and ...

What are the problems of rehabilitation? ›

Another issue rehabilitation is tackling, especially in places like India is the insufficient rehabilitation personnel with appropriate training and experience. Lack of proper physiatrists is a significant hurdle physical medicine and rehabilitation has to overcome.

What are the general benefits of rehabilitation? ›

Rehabilitation can help to improve muscle strength and improve co-ordination for better mobility and easier movement. Improves flexibility: Physiotherapists may recommend a range of different low impact and low intensity exercises which can help to improve movement and flexibility.

Why is rehab so important to the healing process? ›

When you've endured an injury, rehabilitation therapy allows you to do precisely as it sounds: recover from the injury. More than that, however, rehabilitation can expedite the healing process while guarding against potential complications along the way.

What is the purpose of the rehabilitation benefit? ›

Rehabilitation benefit is the feature of a workers' compensation policy that gives someone who has been injured at work access to rehabilitative treatments that will give them a chance to regain their full physical or mental capacity.

What is the importance of rehabilitation in nursing? ›

rehabilitation helps a child, adult, or older person to be as independent as possible in everyday activities and enables participation in education, work, recreation, and meaningful life roles such as taking care of family."

References

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