Background 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.

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

Child 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

Child 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

Child 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%

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%

diarrhea 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%

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

Nutrition Ethiopian Ministry of Health document shows that : 47% of under fives are stunted 8% are wasted 37% are underweight 15% 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

Health and health related indicators –MOH/2011 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%

Basic health indicators, MOH, 2011 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%

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

Essential Nutrition Action, program 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

Prevention of Mother to child transmission 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

Roll back malaria initiative Systematic data collection Vector control Insecticide treated nets Indoor residual spraying Integrated vector management Case management Support research

There is still great hope! The promised land! “ Let Ethiopia hasten to stretch out her hands to God” Psalm (68:31)

Thank you