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ABSTRACT
Local community health care provision is very important for Ethiopia where 85% of the population live in small, widely scattered rural communities. In 2003 there were 1,936 physicians and 18,652 Community health Workers in Ethiopia – so most people will have their need for medical care provided by community health workers rather than physicians. The provision of further training, access to specialist opinions and diagnostic services for them are clearly important. This was recognised by the Government when in September 1993 a new National Health Policy was approved by the Council of Ministers in order to improve access to health-care services. This policy commits the government to the following:
(a) Decentralization of the health service management and delivery system;
(b) Development of the prevention of disease and promotion components of health care;
(c) Equitable distribution of health services;
(d) Intersectional collaboration;
(e) National self-reliance in health development;
(f) Accessibility of health care;
(g) Working closely with neighboring countries and regional and international Organizations;
(h) Development of appropriate capacity based on needs;
(i) Payment for health care according to ability;
(j) Participation of the private sector and nongovernmental organizations.
The decentralisation of medical services allows for flexibility in meeting local needs but health centres should be linked to larger academic medial units. In contrast to Ethiopia, in the UK there is increasing central control and less flexibility to meet local requirements.
Tertiary referral, academic units have an essential role in providing adequate training and support for those working in local Medical Posts and Health Centres.
Teaching Hospitals As centres of undergraduate teaching, postgraduate
training and research teaching hospitals set the standard for health care for the country. Not only should they be centres of medical excellence but it is also important that community medical officers are enabled to benefit from their high standard of medical practice. This means providing courses for them as well as making sure that expert opinions are available when needed. Research projects, particularly epidemiological, can be very effectively carried out with their assistance.
Community Health Centres These are the first line of medical care and often provide the only medical service that most people have. Encouragement and support for Community Health Officers is vitally important- particularly in the provision of basic medicines and diagnostic tests that do not require specialised equipment. Access to hospital services may be difficult but should be available as far as possible. Courses in specific areas of medicine, such as dermatology, not only improve their skills in diagnosis and treatment but also enable them to meet other medical workers. |
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