The health policy of the Federal Democratic Republic of Ethiopia has given due emphasis to promotive and preventive interventions coupled with basic curative services. Consequently, the Health Promotion and Disease Prevention General Directorate (HPDP-GD) has been established to achieve greater public satisfaction by engaging communities and families in the inception, implementation and evaluation of health programmes. Particular emphasis has also been given to halting common and easily preventable health hazards by transferring the necessary skills to empower communities to take charge and opt for healthy lifestyle.
Four major health programme areas have been integrated within the HPDP-GD:
- Maternal and Child Health
Ethiopia is one of the signatory countries that have committed to achieve the Millennium Development Goals (MDGs) by 2015. As such, the HPDP - GD strives to achieve the MDG 4 and 5 targets for maternal and child health by designing and executing various innovative approaches.
- Communicable Disease Prevention and Control
The HPDP – GD seeks to control and eliminate, whenever possible, communicable diseases by utilising the full potential of the Health Extension Programme (HEP), by accelerating the training of model families as well as availing proven interventions and services to the community.
- Hygiene and Sanitation
Ethiopia has made commitments to achieve universal sanitation coverage by 2012. Taking into account the tremendous progress made in the country over the last 4 years, Ethiopia is in pole position to achieving this target. This is due to the Health Extension Programme and the resultant social mobilisation and open-defecation-free movements taking place at the community level.
- Information, Education, Communication (IEC) and Advocacy
IEC and advocacy activities are strengthened by moving away from disease specific to all health-related risks. Comprehensive and holistic communication strategies are developed and aim at the major public health problems.
The above programmes, which were delivered in a separate and vertical approach in the previous health care delivery system are integrated and harmonised in the new Health Extension Programme. The HPDP-GD together with the Medical Services Directorate proposes to empower families and communities to be key players in the health development programmes along with the holistic support from the Government and development partners.
The Health Extension Programme (HEP)
The HEP is an innovative community based initiative introduced in 2003 during the Third Health Sector Development Programme (HSDP II). The HEP is aimed to create healthy environment and healthful living by making available essential health services at the grass roots level. The objective of HEP is to improve equitable access to preventive essential health services through community (Kebele) based health services with strong focus on sustained preventive health actions and increased health awareness.
The implementation of HEP involves deployment of two salaried Health Extension Workers (HEWs), predominantly females, at each Kebele, who are trained for a year at a Technical and Vocational Training and Education Centre (TVET). The HEP brings the health sector to Kebele level, whereby the HEW represents health sector in the local administration. The HEWs, elected members of the Kebele, agricultural development agents, and teachers constitute a Kebele council, which brings together a range of administrators and specialists. This ensures close linkages with interrelated areas and promotes inter-sectoral collaboration. So far 34000 HEWs have been trained and deployed. Some 3,400 urban and 950 Pastorialist HEWs have also been trained and deployed.
The Ministry has designed three types of HEP Agrarian (rural), Pastoralist and Urban HEP. Apart from some additions in the urban HEP (i.e. mental health, non communicable disease and violence injury prevention), the healthl,400th extension packages in the three types are more or less similar.
The FMoH has split the traditional "one-size" fits all vertical programme based health care delivery system into separate mechanisms to address the unique health needs of households and communities with different cultural and socio-economic background. As such, the all health programmes under HPDP-GD are organised within the Agrarian, Pastoralist and Urban Directorates to provide communities with client-oriented services.
Agrarian Health Promotion and Disease Prevention Directorate (AHPDPD)
This Directorate is responsible for the coordination of the health promotion and disease prevention packages and components implementation in four regions - Tigray, Amhara, Oromia and SNNPR. It is also tasked with the coordination of nationally identified tasks in the agrarian Health Sector Development Programme (HSDP) to reach key both national and MDGs targets.
Urban Health Promotion and Disease Prevention Directorate (UHPDPD)
The UHPDP carries out health programmes designed to tackle urban health problems in three major cosmopolitan cities of Ethiopia, Addis Ababa, Dire Dawa and Harari. The major responsibility of the Ministry is to provide support to regional and city health bureaus. Hence, the Urban HPDP directorate closely works with the above three cities to align the Ministry's plan with its regional counter-parts.
Pastoralist Health Promotion and Disease Prevention Directorate (PHPDPD)
This Directorate is established to coordinate health initiatives in four emerging regions - Afar, Somali, Gambela and Beneshangul-Gumuz. The Directorate provides special support to the above mentioned regions and work as a liaison office between the Ministry of Health and the Ministry of Federal Affairs. It also offers short and long term technical support by assigning experts of the Ministry in some of the districts.
Major Roles and Responsibilities of HPDP – GD
The health promotion and disease prevention strategic and annual plans as well as monitoring and evaluation activities are carried out in alignment with Policy, Planning and Finance General Directorate. As such, the HPDP-GD, based on the intended Health Sector Development Programme (HSDP) and the MDGs goals ensures:
- The development of strategic plans addressing programmatic and thematic areas
- Specific plans for each programme derive from the Ministry's annual plans
- All plans are in alignment with strategies of the regions, woredas and kebeles
Manual and Guideline Development
In collaboration with development partners, the General Directorate:
- Prepares and customises manuals, guidelines, and standards operating procedures (SOPs) as an output for the implementation of health promotion, disease prevention and basic curative health services at all levels in the health care delivery system
- Updates existing manuals, guidelines and standard operating procedures according to new global evidences and health developments
- Develops/adopts health promotion materials and job aids to the community and specific target groups
- Facilitates programme based pre-service and in-service trainings to health professionals to build their capacity and competence levels
- Collaborates with partners to develop and continuously update training materials
- Provides support for the effective implementation of community based training in alignment of the health extension programme
Monitoring and Evaluation
- Monitors the implementation process of all health programmes using the new Health Management Information System (HMIS)
- Conducts regular supportive supervisions and review meetings