Official Name: Federal Democratic Republic of Ethiopia
Area: 1.1 million sq. km (472,000 sq. mi.)
Cities: Addis Ababa (pop. 5 million). Other cities – Dire Dawa (237,000), Nazret (189,000), Gondar (163,000), Dessie (142,000), Mekelle (141,000), Bahir Dar (140,000), Jimma (132,000), Awassa (104,000).
Terrain: High plateau, mountains, dry lowland plains.
Climate: Temperate highlands; hot lowlands.
Ethiopia is Africa's oldest independent country. It is the tenth largest country in Africa, covering 1,104,300 square kilometers (with 1 million sq km land area and 104,300 sq km water) and is the major constituent of the landmass known as the Horn of Africa. It is bordered on the north and northeast by Eritrea, on the east by Djibouti and Somalia, on the south by Kenya, and on the west and southwest by Sudan. Its geographical coordinates are between 8 00 N and 38 00 E.
Ethiopia is a country with great geographical diversity and its topography shows a variety of contrasts ranging from high peaks of 4,550m above sea level to a low depression of 110m below sea level. More than half of the country lies above 1,500 meters. The predominant climate type is tropical monsoon, with temperate climate on the plateau and hot in the lowlands. There are topographic-induced climatic variations broadly categorized into three: the "Kolla", or hot lowlands, below approximately 1,500 meters, the "Wayna Degas" at 1,500-2,400 meters and the “Dega” or cool temperate highlands above 2,400 meters.
The climate is temperate on the plateau and hot in the lowlands. In Addis Ababa, which ranges from 2,200 to 2,600 meters (7,000 - 8,500 ft.), temperature ranges between 26° C (80° F) to 4° C (40° F). The weather is usually sunny and dry with the short (belg) rains occurring February to April and the big (meher) rains beginning in mid-June and ending in mid-September.
People* (2009 estimates)
Urban population: 16%
Annual Growth Rate: 2.7%
Languages: Amharic (official), Tigrigna, Guaragigna, Oromigna, Somali
Literacy: 43% (total); 50% (male); 35% (female)
Health: infant mortality rate (IMR) – 77 per 1000 live births; total fertility rate (TFR) – 5.3 live births per woman; percent of population <15 – 43%; percent of population 65+ -- 3%; life expectancy at birth – 53 years
Workforce: agriculture – 85%; industry – 5%; services – 10%
With a highly diverse population of over 82 million people, Ethiopia is the second most populous sub-Saharan African country.
Projections from the 2007 population and housing census estimate the total population for the year 2010 to be 79.8 million.. Ethiopia is the home of a mosaic nations, nationalities and peoples varying in population size from more than 18 million to less than 1005 spread across the country and with more than 80 different spoken languages. According to 2007 census, the country is among the least urbanized country in the world with 83.6% living in rural areas whilst 16.4% of the total population living in urban areas. The largest city in the country is Addis Ababa, the capital, with 2.7 million people accounting for nearly 4% of the total population. The average size of a household is 4.7.
Most of its people speak a Semitic or Cushitic language. The Oromo, Amhara, and Tigreans make up more than three-fourths of the population, but there are more than 77 different ethnic groups with their own distinct languages. Some have as few as 10,000 members. In general, most of the Christians live in the highlands, while Muslims and adherents of traditional African religions inhabit the lowland regions. English, the most widely spoken foreign language, is taught in all secondary schools.
The major health problems of the country remain largely preventable communicable diseases and nutritional disorders. Despite major progresses have been made to improve the health status of the population in the last one and half decades, Ethiopia’s population still face a high rate of morbidity and mortality and the health status remains relatively poor. Figures on vital health indicators from DHS 2005 show a life expectancy of 54 years (53.4 years for male and 55.4 for female), and an IMR of 77/1000. Under-five mortality rate has been reduced to 101/1000 in 2010 and more than 90% of child deaths are due to pneumonia, diarrhea, malaria, neonatal problems, malnutrition and HIV/AIDS, and often a combination of these conditions. These are very high levels, though there has been a gradual decline in these rates during the past 15years. In terms of women health, MMR has declined to 590/100,000 though it still remains to be among the highest . The major causes of maternal death are obstructed/prolonged labor (13%), ruptured uterus (12%), severe pre-eclampsia/ eclampsia (11%) and malaria (9%) . Moreover, 6% of all maternal deaths were attributable to complications from abortion. Shortage of skilled midwives, weak referral system at health centre levels, lack of inadequate availability of BEmONC and CEmONC equipment, and under financing of the service were identified as major supply side constraints that hindered progress. On the demand side, cultural norms and societal emotional support bestowed to mothers, distance to functioning health centers and financial barrier were found to be the major causes.
Following changes of Government in 1991, the transitional Government produced the health policy which was the first of its kind in the country and was among a number of political and socio-economic transformation measures that were put in place. The translation of the health policy was followed by the formulation of four consecutive phases of comprehensive Health Sector Development Plans (HSDPs), the first phase of which was implemented starting in 1996/97. Both of the policy formulation as well as the development of the first HSDP have been the result of critical reviews and scrutiny of the nature, magnitude and root causes of the prevailing health problems of the country and the broader awareness of the newly emerging health problems in the country.
The core elements of the health policy are democratization and decentralization of the health care system, development of the preventive, promotive and curative components of health care, assurance of accessibility of health care for all segments of the population and the promotion of private sector and NGOs participation in the health sector.
Since the development of HSDP I which also paved the way for the subsequent HSDP II and HSDP III, the Federal Ministry of Health has formulated and implemented a number of policies and strategies that afforded an effective framework for improving health in the country including the recent addition of maternal and neonatal health. This include implementations of far reaching and focused strategies such as Making Pregnancy Safer (2000), Reproductive Health Strategy (2006), Adolescent and Youth Reproductive Health Strategy (2006) and the Revised Abortion Law (2005). Others include strategies on free service for key maternal and child health services (Health Care Financing Strategy), the training and deployment of new health workforce called all female HEWs for the institutionalization of the community health care services including clean and safe delivery at HP level, and deployment of HOs with MSc training in skills of Integrated Emergency Obstetric and Surgery (IEOS). In addition, the establishment of the MDG Performance Package Fund and the priority given to maternal health therein is expected to mobilize the much required additional funding opportunities.
HIV and AIDS
According to the Ministry of Health's Single Point HIV Prevalence Estimate, national adult HIV prevalence is estimated at 2.4% while the rate in urban areas is 7.7% for the year 2010 (MOH, 2007). Currently, there are an estimated 980,000 people living with HIV (PLHIV) in the country and an estimated 67,000 people have died from the disease. The Ethiopia DHS 2005 notes that the highest concentration of PLHIV is in urban areas, and as a result most new infections occur in cities and more populous towns. Furthermore, surveillance and epidemiological evidence reveal that sex workers, migrant laborers and other marginalized groups are the most at risk populations for acquiring HIV infection, and other research suggests these groups have some of the lowest rates of health knowledge and access to health services in the country. While we do not presently have current data to illustrate the variations in adult HIV prevalence and incidence, the data presented below (from 2005) demonstrates that there are vast differences by geography and sex.
Adult HIV prevalence (%) adult HIV incidence (%) by geographic location and by sex, Ethiopia, 2005
|Adult HIV prevalence (%)||Adult HIV incidence (%)|
|Addis Ababa Region||11.7||11.9||0||13.2||10.2||1.40|
|Dire Dawa Region||6.8||8.6||0.9||7.7||5.9||0.58|
Source: AIDS in Ethiopia 6th Report, 2005.