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Health Department
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General
Health Catholic Church Health Service Delivery Situational Analysis The Ethiopian health policy emphasizes the importance of achieving access, for all segments of the population, to a basic package of quality primary health care services, via a decentralized state system of governance. The HSDP I introduced a four-tier system for health service delivery. This is characterized by a primary health care unit (PHCU), comprising one health center and five satellite health posts; district hospital, zonal hospital and specialized referral hospital. A PHC-unit has been planned to serve 25,000 people, while a district and a zonal hospital are each expected to serve 250,000 and 1,000,000 people respectively. The health system in Ethiopia comprises the public sector (Federal MOH, regional health bureaus (RHBs), armed forces), the private sector, and NGO's. Currently, a total of 119 hospitals, 451 health centers, 2396 health stations (clinics) and 1432 health posts are functional. The FMOH runs four specialized hospitals, situated in Addis Ababa. Health services are also delivered at army and police based facilities at the federal level.1 A total of 79 hospitals, 426 health centers, 2013 health stations and 1432 health posts are administered by the 11 RHBs and city administrations. The regional health system comprises specialized referral hospital/s, zonal hospitals, district hospitals and PHCUs. In addition to the RHBs, the private sector and NGOs contribute a lot to the service delivery system in all the regions and cities. Some industries in region and city administrations also have their own health facilities that provide significant service to employees and their family members. The nine regional states of Ethiopia are: Tigrai, Afar, Amhara, Oromia, Somali, Benishangul-Gumuz, Southern Nations Nationalities and Peoples (SNNP), Gambella, and Harari City Administrations; its two city administrations are Addis Ababa and Dire Dawa. Disease Prevention Programs In addition to the mostly curative services delivered at the health facilities, the FMOH and RHBs that run several programs aim at prevention of the major public health problems, including blindness control malaria, HIV/ AIDS, TB, MCH, leprosy, onchosarciasis and Guinea worm. The Health Extension Program (HEP) is expected to fill the gap by raising the level of awareness of disease prevention at the grassroots level. Catholic Health Services in EthiopiaUnlike other African, Asian and South American Countries Ethiopia has not had such a long-standing presence of Missionaries in Health care services. One of the first recorded is the Franciscan Sisters of Calais; a French Congregation that founded a dispensary and school in Harar in 1897. When the Italians invaded in 1935, the Missionaries had to leave Ethiopia because of the war. These Sisters returned to Ethiopia in 1957 and are known as Franciscan Sisters of Our Lady. The Consolata Sisters were also here from 1924 to 1942. They returned in 1974. Daughters of Charity came to Ethiopia in 1927.Short History of Health Department of ECS The first department established at ECS then known as the Catholic Welfare office in 1965 was for Education followed in about 1968 by the Medical Department. Sr. Jutta, a Medical Mission Sister, established this Department. Ato Tekle Rosario followed her in 1971. He served the Department until 1996 (25 years) Ato Tekle took his leave of absence in 1996 and Ato Hagos Geshen relieved him for one year on a part-time basis. Unfortunately due to the political situation in the country Ato Tekle was unable to return to Ethiopia Prior to 1996 all health Institutions came directly under Ministry of Health and all agreements between Ministry of Health and Catholic Institutions were signed by the Cardinal on behalf of the Church All requests to build/open new Health Institutions were made by and followed through by the Head of the Medical Department. He represented the Catholic Church in all matters pertaining to health and was also present at the time of inspection of all Catholic Church Health Institutions; this also included requests to the Ministry of Health for places in training schools for Church personnel In times of emergency, the Medical Department worked closely with the Social Welfare and Development Office especially in times of famine of 1974 and 1984. The Department acted as Medical Advisors both to the Social Welfare department and the newly established JRP. 1983 to 1988 Sr./Dr.Maura O'Donohue MPH MMM joined Ato Tekle and helped in the co-ordination of famine relief. In 1988, the then Secretary General requested help with the management and distribution of the large supply of medicines in the ECS Store. Two Medical Missionaries came for about one year. They sorted and distributed all the medicines to all our health institutions. and made reports to donors. In 1994 the Secretary General again requested some help for Ato Tekle Rosario to manage the drug supply. Sr. Maria Goretti MMM came from the mission in Sidama and took charge of drug donation, distribution, reporting, preparing annual requests for drug donations from our Caritas partners and USA – CMMB and making appeals for emergency drug supplies in times of epidemics i.e. malaria, meningitis, measles, etc. When the Government policy changed, ECS was no longer allowed to import drug donation. The ECS’s role changed to one of purchasing drugs from PHARMED and other private companies on behalf of Catholic Church Institutions. This was a fairly satisfactory arrangement. However a further change in Government Policy required that each Health Institution should have its own medicine license. ECS was not entitled to hold such a license and the role again changed to one of a liaison between Federal Ministry of Health and the MOH Pharmacy Department. The Pharmacy Department at Ministry of Health later became the "Drug Administration and Control Authority" a Ministry in its own right. The Department has served under three different political regimes, its functions varied accordingly. The biggest changes came with Rationalization and the setting up of the Diocesan Secretariats. At Federal level the only authority still recognized in matters relating to Health is the Ethiopian Catholic Secretariat. It still holds responsible for obtaining accreditation for all missionary or volunteer Health professionals entering the country in the service of the Catholic Church. Since 1999 it is compulsory for all health professionals, both National and expatriate to renew registration every five years. This is also the responsibility of the Health Department. Distribution of Catholic Church Health Facilities in Ethiopia
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Ethiopian Catholic Secretariat
Natural Family Planning Natural Family Planning also known as the Billing’s Method is an individual technique of Natural Fertility regulation in which days of infertility, possible fertility and maximum fertility are defined by the pattern of vaginal discharges which are observed by the woman at the vulva. The Billings Ovulation Method of family planning has many advantages: Ø It is medically safe, Ø highly reliable, Ø morally acceptable, Ø easy to learn, Ø inexpensive, Ø highly versatile – it can be used at any stage of woman’s reproductive life Ø It precisely identifies the true days of fertility and infertility and Ø a valuable aid for couples who are having difficulty in achieving pregnancy Besides Natural Family Planning, the Unit works very closely with youth in and outside schools in collaboration with the Archdiocesan Catholic Secretariat (ACS) Youth coordinating Office and interested private and government schools. For school youth the Unit provides Teen S T A R (Sexuality Teaching in the context of Adult Responsibility) program. The main purpose of this program is to obtain a well informed, responsible and sexually mature youth at all levels. Within youth program, school dropout and unemployed youth are provided with various skills training and Income Generation Activities to employ themselves. In this regard, the unit has achieved good results, i.e. most of the skill trained youth have been employed and those engaged in Income Generation Activities are becoming profitable in the areas of their activities and as a result their life style is changing. Lessons Learned Ø The understanding of different actors about the practical application of the natural method is variable. Common understanding/interest is very important to a make difference Ø Youth programs are successful mainly because of cooperation obtained from concerned bodies (in particular the youth coordination office). Thus, cooperation is very essential to bring about changes. Follow-up actions Ø Continue to build the capacity of Diocesan Catholic Secretariats through training of Natural Family Planning and Teen STAR program. Ø Close follow-up and monitoring to consolidate the activities of Family Life Promotion Unit and that of the Diocese. Ø Networking with similar offices abroad and in the country to exchange information. Ø Conduct refresher courses for already trained NFP and Teen STAR teachers to enhance their activities. Ø Organize a forum where teachers of different Dioceses/ school share their experience and learn from one another. Ø Secure fund to provide technical and financial support to dioceses where the activities are not conducted due to financial problems. Address:
Ethiopian Catholic Secretariat
HIV/AIDS Prevention and Control
HIV/AIDS in Ethiopia The earliest evidence of HIV infection in Ethiopia was found in 1984. The first AIDS case was reported in 1986. Since 1984, a cumulative of 107,575 AIDS cases were reported to the Ministry of Health. Currently there are about 1.5 million people living with HIV/AIDS in Ethiopia, out of which 96,000 are children. The prevalence of HIV was relatively low in the eighties but with the onset of the nineties, the virus began to spread so rapidly that it began to pose socio-economic challenges such as increasing the child/infant mortality rate, reducing life expectancy, disrupting the economic and social basis of the family and the country by orphaning huge numbers of children, increasing the number of female headed house holds and by negatively affecting the quality of production and earnings.
Response of ECC to the HIV/AIDS Pandemic The Ethiopian Catholic Church, (ECC) has been involved in HIV/AIDS related activities since the onset of the epidemic in Ethiopia and has been increasingly operational in the rage of activities related to HIV/AIDS. Those affected by HIV/AIDS face loveless and unjust acts towards them. The Church believes that this is wrong and calls for compassion and love towards those infected and affected by HIV. Over the past years the Church has been giving services for treatment of STIs (Sexually Transmitted Illnesses), sharing information through IEC (Information, Education and Communication) programs, giving counseling and testing, providing blood safety and universal precaution, training counselors and care providers, giving pastoral care, creating income generating activities for PLWHA and their families and also providing care and support for orphans, the elderly and widow. Some of the ongoing activities within the Ethiopian Catholic Church § VCT is available in MMM/ST. Mary Laboratory, St. Luke hospital, Gambo rural hospital, and at Bushilo and Chire major health centers. § Home-based care is implemented by MMM (Addis Ababa), Daughters of Charity (Addis Ababa and Mekele), and Medhin social center (Addis Ababa) § Missionaries of Charity in Addis have a home for children living with HIV/AIDS and for those who have lost their family support due to HIV/AIDS. § Most local Catholic Parish churches also support PLWHA and their families in an informal way. § Care and support to HIV/AIDS infected and affected people: The Ethiopian Catholic Church is responding to the HIV/AIDS pandemic by educating people about AIDS, providing care and support to the infected and affected people, psychosocial counseling, and provision of health services and voluntary counseling and testing for HIV. The Catholic Church supports thousands of orphans through Catholic congregations, parishes and schools.
Challenges and limitations § There is a limited formal system of information sharing between institutions within the Catholic Church which creates gaps in institutional learning, information and experience sharing. § Most organized efforts of the ECC are located in the urban parts of the country.
Strategies of ECC towards the fight against HIV/AIDS § Behavioral Change Interventions (BCI) - promote abstinence or faithfulness to one partner through regular education about the disease. § Voluntary Counseling and Testing for HIV/AIDS § Blood Safety and Universal Precaution - ensuring a continuous supply of equipments and reagents for blood screening for transfusion purposes. § Prevention and Management of STIs Other than HIV/AIDS - the presence of STIs increases the likelihood of acquiring and transmitting HIV/AIDS for this reason the ECC promotes health care seeking behaviors for individuals during attacks of STIs § Prevention of Mother to Child Transmission of HIV/AIDS - includes programs which work towards prevention of HIV/AIDS infection among women of reproductive age, prevention of unwanted pregnancies, providing obstetric care, anti-retro-viral therapy and an alternative substitution to breast feeding. for HIV infected women § Care and Support to PLWHA and Their Families - providing mechanisms for alleviating the impacts of AIDS in the family and improving its traditional coping mechanisms. § Mitigating Institutional Impacts of the HIV/AIDS Epidemic - Formulate mechanisms to alleviate the impacts of AIDS on institutions. § Mainstreaming HIV and AIDS in Development and Emergency Response - mainstreaming acknowledges the magnitude of the AIDS epidemic and determines how each sector should respond. § Institutional Capacity Building - e.g. building skills in designing and setting up HIV/AIDS programs and building capacity to establish and maintain monitoring and evaluation systems. § Operational Researches - the ECC will participate in different researches regarding HIV/AIDS such as HIV/AIDS surveillances, researches on impacts of AIDS on children and Women etc. § Advocacy and influencing - since AIDS is also related to stigma and discrimination the church will be working at all levels to overcome this injustice. Address:
Ethiopian Catholic Secretariat |
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©2005 Ethiopian Catholic Secretariat |