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Background. Ethiopia: second populous country in Africa, 80 million - women and children constitute 72% of the population. - 49.7% of Ethiopia's’ population are female - TFR is estimated 4.8 - Maternal mortality rate is estimated at

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    1. Background • Ethiopia: second populous country in Africa, 80 million - women and children constitute 72% of the population. - 49.7% of Ethiopia's’ population are female - TFR is estimated 4.8 - Maternal mortality rate is estimated at 673 /100,000 live births.

    2. Background • Per capita expenditure on health $ 2.31 compared to India $ 9, S. Africa $ 100, U.K $ 1780 • Doctor to population ratio 1: 42,700 • Nurse to population ratio 1: 4,200

    3. Child health • Under 15 years constitute 44.7% of the population • Of which 40% are under five and 8% are under one year. • Infant mortality rate is 59/1000 live births • Under five mortality rate 88/1000 live births • Neonatal mortality rate 37/1000 live births

    4. Child health • 1/20 born alive die in their first month of life • 1/10 die before reaching their 1st birth day • 1/6 die before reaching their fifth birthday

    5. Child health • More than 70% of these deaths are due to the five diseases. • Pneumonia 28.9% • Malaria 21.6% • Diarrhea 12% • Measles 5% • 60% of these deaths are associated with malnutrition • Perinatal 22% • HIV/AIDS 11%

    6. Malaria • Prevalent in 75% of the country • 4-5 million are affected every year • 40 million are at risk • Morbidity and mortality is high in children • Only 20% of children under five who experience malaria visit existing clinics • The case fatality rate currently ranges from 17-35%

    7. diarrhea • One of the major causes of under five mortality and morbidity next to lower respiratory infection and measles • In a nationwide rural survey 12.5% of children 6-59 months had diarrhea in the past two weeks. • There is an estimate of 230,000 under five deaths each year due to diarrhea. • The median incidence of diarrhea is estimated to be 5 episodes/child/year. • Clean water coverage is about 31%

    8. HIV/AIDS (2001) • Prevalence rate 2.1% • Number of orphans – current report is 4 million • Prevalence in pregnant women 6%- 23% • 60,000 newborns infected through MTCT • 40% of infected children die before 1 yr of age • 50-75% die before 5th birthday

    9. Nutrition • Ethiopian Ministry of Health document shows that : 47% of under fives are stunted 8% are wasted 37% are underweight 15% are low birth weight • Malnutrition, underlying cause of death in >50% of deaths of under fives • In Ethiopia more than five out of ten under fives are chronically malnourished

    10. Health and health related indicators –MOH/2011

    11. Basic health indicators, MOH, 2011

    12. The way forward • The IMNCI strategy 1. Improve health worker skill 2. Improve the health system 3. Improve family and community health seeking behavior • ENA approach • PMTCT • Roll back malaria initiative – new drug introduced

    13. Essential Nutrition Action, program objectives • Additional feeding for pregnant and lactating mothers • Exclusive breast feeding for 6 months • Complementary feeding after 6 months of age • Extra feeding for the child during illness • Micronutrient supplementation • Immunization

    14. Prevention of Mother to child transmission of HIV • The four prongs: • Primary prevention • Prevention of unintended pregnancies in HIV infected mother • Prevention of mother to child transmission of HIV • Care and support to HIV infected women, their infants and families

    15. Roll back malaria initiative • Systematic data collection • Vector control • Insecticide treated nets • Indoor residual spraying • Integrated vector management • Case management • Support research

    16. There is still great hope! • The promised land! “ Let Ethiopia hasten to stretch out her hands to God” Psalm (68:31)

    17. Thank you