Ethiopia Aid effectiveness in the health sector - Action for Global ...

Ethiopia – Aid Effectiveness in the health sector
1. Country Overview
Ethiopia is currently the second largest country in Africa by population and has
one of the highest growth rates in the world at 3.21%. 1 Every year, the
population increases by more than 2 million people. Over 84% of Ethiopians live
in rural areas, 2 something which, in a big country with little infrastructure and an
extremely difficult topography, makes the task of delivering essential services
very difficult and heavily dependent on infrastructure and investment.
Ethiopia is among the poorest countries in the world. Despite robust economic
growth over the last five years (over 11% annually), 3 the country still features
169th out of 179 countries on the Human Development Index (HDI) ranking. 4 The
share of population living below the national poverty line has decreased over
the last few years, but still stands at 35%. At the same time, Gross Domestic
Product (GDP) per capita in 2007 was US$780, or just over US$2 a day, which
means a significant share of the population still lives below the World Bank’s
moderate poverty line (the latest figure available is 78%). 5
In the last few years, Ethiopia has gained significance as an aid-recipient
country. In 2001, Ethiopia received US$1 billion, two-thirds of which was
provided by multilateral agencies and with a strong emergency component. In
2007, the figure had risen to US$2.4 billion and slightly over half was provided by
Organisation for Economic Cooperation and Development-Development
Assistance Committee (OECD-DAC) donors. 6
However, at present, the biggest Development Partners (DPs), both in general
terms and in the health sector, are PEPFAR and the Global Fund to Fight AIDS,
Tuberculosis and Malaria (see page 9). While the arrival of these two donors has
boosted resources in the health sector, it has also unbalanced the distribution
of funds. Accordingly, one of the main challenges for AE in Ethiopia is to
increase the harmonisation of vertical donors.
Progress in the health sector
Ethiopia is also making progress in the health sector. Maternal mortality rates
have decreased from 871 deaths per 100,000 births in the 1990s to 673 per
100,000 in 2005/2006. Similarly, the national under-five mortality rates also went
down from 180 in 1992/1993 to 123 in 2004/2005. 7 In spite of the improvements,
Ethiopia still has a long way to go. Both maternal and under-five mortality rates
will have to decrease by half in order to meet MDGs 4 and 5 by 2015.
We have seen that most people in Ethiopia live in rural areas. As a
consequence, one of the main challenges for aid and the health sector in
Ethiopia is bringing health services to the population. This requires long-term
programmes, sustained aid and good coordination among DPs, the
Governments and Non-Governmental Organisations (NGOs) working in the
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