Ethiopia is a country with 85% of its population living in rural areas. Between 70% and 80% of the diseases that affect its population are preventable by using simple methods. Despite this, Ethiopia previously had a health policy that focused on curative and urban-centered health services until the Government of the Federal Democratic Republic of Ethiopia launched its new health policy in 1993.

The new health policy gives much more emphasis on prevention and the health promotion components of healthcare that should be able to resolve most of the health problems of the population. The main features of this policy include a focus on decentralisation, expanding the PHC system, and encouraging partnerships as well as the participation of the whole community in health activities. The strategy of the policy has been to expand healthcare delivery at the grass roots level through the implementation of the Health Service Extension Programme (HSEP). The primary aim of the HSEP approach is to bring health service delivery to the rural community at family level where such a big percentage of the total population lives.

Currently, the health referral system of Ethiopia is a three-tier healthcare delivery system (Figure 8.1), which is organized into primary Health Care Units (PHCUs), General Hospitals and Specialized Hospitals. The PHCU is a health centre surrounded usually by five satellite health posts. Each health post serves approximately 5,000 people and the five together total 25,000 people who are looked after by each health centre.

Figure 8.1 The three levels of the current health care delivery system in Ethiopia.


The role of the health extension workers and practitioners is to work with the community and help them acquire the knowledge and skills that enables them to ensure their own health. In the following sections, you will study the principles of PHC that will help you to understand its impact on improving health throughout Ethiopia. As you see from the diagram the health post has direct communication with the immediate health centre in its catchment area.

Last modified: Tuesday, 28 February 2017, 7:05 PM