global health in ethiopia

Ethiopia is a country completely surrounded by land, and positioned in the northeast region of Africa. Formally known as Federal Democratic Republic of Ethiopia, it is the second most populated country in Africa. As of 2009 the population is estimated to be greater than 79. 2 million people, and ranked the tenth largest by area with 1,100,000 km per square inch. Sudan, Eritrea, Djibouti, Somalia, and Kenya are located on the outskirts of Ethiopia. There are eighty different languages used in Ethiopia.

Afar, Berta, Oromo, and Somali are the main languages used in this country, but Amharic is the language most spoken in Ethiopia (Britannica, 2010). The climate in Ethiopia is tropical with periods of heavy rainfall to dry desert weather. Elevated terrains have a temperature of 60 degrees and below while the lower terrains are approximately 80 degrees. Addis Ababa, the capital, has a yearly temperature of 60. 8 degrees Fahrenheit. During the night the temperature drops to 44-50 degrees Fahrenheit, so a light coat may be needed.

Ethiopia has three seasons: the dry season, called bega, is from September to February, although the coolest weather is in December or January. Next is a brief period of rain known as belg, which is from March to April. May is mostly arid then precedes a lengthy rain period during June, July, and August called the kremt (Britannica, 2010). Ethiopia is called a third world country because of its poverty rate. The economy relies on agriculture, which makes up 45% of the gross domestic product (GDP) and 85% of their employment.

Repeated droughts, deforestation, soil erosion, and overgrazing has affected terrains, however there is enough land for farmers to cultivate. Coffee is an important export and was sold oversees in 2006 for $350 million, but with the decreased prices cultivators are selling other crops to bring in money (Britannica, 2010). History Ethiopia is known for being one of the oldest self-governing countries in Africa to be occupied by people. It is believed that the Queen of Sheba and King Solomon’s son from the Bible created the Ethiopian kingdom.

The Christian religion was first introduced during the fourth century by missionaries from Syria and Egypt, but not long after the Europeans slowly severed the Ethiopians from their Christianity. In 1493 the Portuguese began to speak with the Ethiopians to persuade them to become Roman Catholic and to also reinforce their power over the Indian Ocean. Later on a disagreement between those for and against Catholicism resulted in the removal of all foreign missionaries. In the 1700s, no one was able to control Ethiopia for 100 years because of the competitiveness of the leaders.

This period finally ended in 1869 when the ruler Tewodros brought most of the leaders together. The uniting force enabled the successor Yohannes to overpower the Dervish and Sudanese attacks. Under the rule of Menelik II, Ethiopia was able to conquer Italy at the Battle of Adwa in 1869. This battle is the first triumph of an African country over a provincial command (Henze, 2000). In 1930 Emperor Haile Selassie governed the country, but in 1936 he was ostracized from his kingdom when the Italians attacked and inhabited Ethiopia.

Haile Selassie petitioned to the League of Nations, but no one responded and he had to escape to the United Kingdom (UK). He was not able to return to his empire until five years later when the Ethiopian patriotic resistance forces overpowered the Italians. Haile Selassie’s sovereignty ended in 1974 and a temporary committee of soldiers called the Derg took over and established a communist government with a militant approach. These soldiers killed fifty nine people of imperial descent-generals and ministers included. After two of his predecessors were killed, Major Mengistu took over as chief of state and Derg leader.

His autocratic ruling and tyranny, plus a food shortage for seventeen years helped in the demise of the Derg. Soon the people became rebellious and formed the Ethiopian Peoples’ Revolutionary Democratic Front (EPRDF) which allowed them to force Mengistu to escape to Zimbabwe. Meles Zenawi and affiliates from the Transitional Government of Ethiopia (TGE) formed a democratic party. In June 1994, 548 affiliates were elected, and later that December embraced the organization of the Federal Democratic Republic of Ethiopia. The very first legislative election was held the following year, and a government was created in August 1995 (Henze, 2000).

Political Structure The 1994 constitution led Ethiopia to become a federal republic nation led by a prime minister, the chief of administration, and a president. A president, council of Ministers, and Council of State are comprised in the executive branch. There are two legislatures; House of Peoples’ Representatives being the lowest chamber and the highest chamber is the House of the Federation. Affiliates from the higher and lower chamber are voted to serve a term of five years. The dominant party of the House of Peoples’ Representatives selects who will be the prime minister.

They also choose a nominee to be president, and the two legislative houses are obligated to vote. Each president carries out a term of six years. The current president of Ethiopia, Girma Wolde-Giorgis was elected in October 2001 and re-elected in 2007. Every district is governed by a president, and a chairperson governs the cities. Voting is allowed at the age of eighteen. Every ethnic group and country is given the opportunity to be a part of the government, and represented in the House of Federation (Britannica, 2010). The current government is somewhat successful in its stability.

Even though there are laws and regulations, people who disagree with the government’s decision tend to protest. The government and police waste no time in deescalating the protestors. Traditions/Health Practices that affect health care A tradition that is practiced in Ethiopia is female genital mutilation. It is a procedure that cuts or burns the woman’s genital area to protect her purity. Most of the time the procedure is done with little or no anesthesia and unsanitary tools like broken glass, blades, scissors, or knives may be used.

Genital mutilation can result in severe pain, heavy bleeding, and at times death. This practice is usually done when the child is young. According to the Ethiopian Demographic Health Survey, more than 74% of women between 15 and 49 years old have gone through some type of genital mutilation and cutting. This practice is against the law, but it seems that the people are so steeped in tradition that the law is ignored. Most people think this tradition will secure a woman’s virginity, and make for a respectable marriage (UNICEF, 2006). Health Care Model Health Care System/Nurses role/Nurse Education

Most of the health care facilities in Ethiopia are owned by the government. Due to the Derg period, the health care system experienced some drawbacks. Although the nursing schools are still producing medical professionals, the demand for healthcare workers is ever increasing. Most of the country’s medical physicians either moved abroad or left for school overseas and never came back. A common and constant issue is lack of proper equipment and medications. The country has adopted the use of conventional therapy such as minor surgical procedures, bone manipulation, and obstetrics.

Modern medicine was not introduced to the Ethiopians until Christian missionaries brought their religious values and knowledge of health to the country. The main dilemma this health system faces is the availability of medicine and medical doctors in Ethiopia (Britannica, 2010). Health care centers, hospitals and clinics make up the health care systems in Ethiopia. Most of the doctors and hospitals are located in major cities. Families that live in rural regions have basically no access to healthcare. Ethiopia has about 21 nurses and 3 doctors for every 100,000 people.

Globalization may affect the country, which is why medical personnel are leaving the country for better opportunities. The International Training & Education Center for Health (I-TECH) has a curriculum that helps students learn skills to become a nurse. Ninety-percent of the health care workers are nurses, but are not used as often because of their physician-based model of care. I-TECH has a HIV/ART nurse specialist program that trains nurses in caring for HIV/AIDs patients, and gives physicians assistance in lightening their work so they can focus on the more serious cases.

The classroom training is seven days a week with practicum for six days at five hospitals, and clinical mentoring for five days (I-TECH, 2009). The Ethiopian Nurses Association (ENA) is the oldest practicing institution to create a nursing service suitable for Ethiopia. ENA stands for all the nurses in Ethiopia, and its mission is to improve the country’s nursing and healthcare system. There are approximately eight nursing schools in Ethiopia, with two of them being ENA approved private nursing colleges. Nurse training begins after the student has completed the 12th grade, and train for a duration of 2 years.

During these years the Institute trains them to become public health nurses, nurse midwives, or clinical nurses. The first bachelor in science nursing (BSN) program was started in 1994 at Jimma University, and presently there are seven BSN Universities in Ethiopia. Students now have the opportunity to continue their education without going abroad. When students complete their training, the Ministry of Health of Ethiopia registers and license them to practice nursing in Ethiopia (ENA, 2007). Major Health Issues affecting Population

One of the major health problems affecting this country is infectious diseases due to unsanitary conditions and malnutrition. In February 2008 the ENA and the Ethiopian Public Health Association (EPHA) joined together and trained 23 nurses’ in ways to prevent infections. The training duration lasted five days, but this is taking a step towards a decrease in infections. Shortage of healthcare workers and facilities only worsen this problem. The Ethiopian people have a low life expectancy of 45 years. Infants have a high mortality rate, and are estimated to be about twice the world’s average.

Eight percent of infants die during or soon after childbirth, and complications like obstetric fistula affect these mothers also. Infant deaths are frequent in Amharic and Gambela areas with 92 to 94 deaths per 1,000 live births, and Adidas Ababa has the lower rate of 45 deaths per 1,000 live births. The lower death rate in Adidas Ababa is a prime example of health resources made more readily available in the city. A major concern is lower respiratory infections, HIV/AIDS, and diarrheal diseases which are on the rise. Although HIV prevalence is lower in Ethiopia when compared to other African countries, it is above the world’s average.

Most of the HIV is seen in cities and in younger women (Britannica, 2010). Although the economy of Ethiopia has grown a lot, hunger and poverty still remains prevalent. Many people have no supply of clean water, education, or healthcare. Organizations like UNICEF, Tropical Health and Education Trust (THET), Medecins San Frontieres (MSF), and other organizations have been a great help to this country. With donations and medical assistance from these organizations Ethiopia can make its way out of being a third world country.


Henze, P. (2000). Layers of Time, a History of Ethiopia. Christopher Hurst. London. Retrieved August 2, 2010 from http://www.ethioembassy.org.uk/fact%20file/a-z/history.htm Ethiopia. (2010).
Encyclopedia Britannica. Retrieved August 07, 2010 from http://www.britannica.com/EBchecked/topic/194084/Ethiopia

Ethiopian Nurses Association. (2007) History of ENA. Retrieved August 3, 2010 from http://www.ena.org.et/new/history.php

UNICEF. (2006) Battling an ancient tradition: Female genital mutilation in Ethiopia. http://www.unicef.org/infobycountry/ethiopia_34881.html

I-TECH. (2009). Ethiopia HIV/ART Nurse Specialist (HANS) Training Program Evaluation. Retrieved August 2, 2010 from http://www.go2itech.org/what-we-do/operations-research-and-evaluation/quality-improvement/qi-program-examples/ethiopia-hiv-art-nurse-specialist-hans-training-program-evaluation.

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