Project Summary

Ethiopia is currently implementing a healthcare development programme in which the primary healthcare unit is a Health Centre with 5 satellite Health Posts. Each Health Post (serving about 5,000 people) will be staffed by two Health Extension Workers - local women who have completed school education to grade 10 and undergone a one-year training course. There is a description of the work of a Health Extension Worker here. Several countries, including the UK, provide funding and support at a strategic level. Charities mainly provide support at a community level, for example by helping fund the building and equipping Health Posts

The government healthcare plan is well thought out, but we saw on our visit that implementation is happening progressively, with some elements in place before others. This is mainly because of limited resources, but also because of the time it takes to do some things such as train staff or construct buildings. In rural Ethiopia there is difficulty recruiting trained staff to work in areas with few basic services and there is such a shortage of doctors that health centres are normally led by a senior nurse.

We visited places in three of the federal regions of Ethiopia with SUNARMA. In all of them people faced a variety of difficulties in getting access to basic healthcare. The area where we and SUNARMA felt that an organisation like SHAPE could help the community most is just two hours drive from Addis Ababa but has only recently had a road usable throughout the year and lacks many services. SUNARMA are working in the area on a "Conservation through the Market" project funded by Send-a-Cow UK. For more information about the SUNARMA project and their description of the area click here .

Jidda is a newly created woreda (administrative district), with a population of about 60,000, and Sirti (its only town) is becoming its administrative centre. An existing clinic at Sirti (with two nurses) is being upgraded to a Health Centre. Of 13 health posts that will be required in the woreda 2 have been built and 7 are in various stages of construction or planning (November 2007).

SHAPE's aim is to work in partnership with the local communities and healthcare providers and we can see that when the current government plan (intended as an interim measure) is fully implemented there will be a need and an opportunity to provide additional support. However, SHAPE's initial plan is to help the community achieve access to a basic level of healthcare and health education under the current programme. We can then support future developments by building relationships with the local healthcare team.

Compared to the UK the cost of living in Ethiopia is low, as are things required for healthcare that can be provided locally (such as staff salaries and building work) but things that must be imported (such as most medical equipment and drugs) are expensive and hard to obtain by a nation that does not have many exports. A Health Post (from which two trained local women would work providing health education and simple treatments for about 5,000 people) would cost about £5,000 to build and equip, and about £1,000 per year to run, including salaries. Furniture, medical equipment and a stock of medical consumables for a Health Centre (serving at least 25,000 people) would probably be less than £20,000. SHAPE would also pay SUNARMA's costs in supporting us in the area.

To decide which gaps in provision we help fill first we need to discuss priorities with the local community and the healthcare staff.

The estimates of costs show how the amounts of money that could be raised by a concerted effort in local communities in the UK could make a huge contribution to healthcare in a community in Ethiopia, as could the medical skills and experience that healthcare professionals in Shropshire could contribute to the endeavour.

Next steps

We agreed with SUNARMA that it was unwise to engage in further contact with the community or local administration until we had raised sufficient funds to plan actions and discuss implementation. We are now close to that point and are meeting with SUNARMA UK to agree the next actions.