Human Resource Development and Administration directorate
Ethiopia is one of the countries in the world with low health workforce density of 0.7/1000 population, which is far below the minimum threshold density of 2.3 health workers (MD, nurses & Midwives) per 1000 pop for countries to achieve essential services (a targeted 80% coverage rate for skilled birth attendance). In the African region, the average threshold is 1.6 of doctors, nurses & Midwives per 1000 pop (WHR, 2006).
In 2009 when the HR strategic plan has been drafted the level of doctor to Population ratio for Ethiopia was at 1 physician per 36,158 people of which 43% working in Addis Ababa, the national capital. Low production capacity, limited health workforce management systems, which include lack of adequate retention and motivation mechanisms, remain responsible in most. The consequence has been inadequate skill mix, geographical imbalances (urban/rural, interregional and M/F), as well as Mismatch between services requirement and education. The shortage of physicians is attributed to a combination of factors: 1) Limited number of medical schools, 2) Limited capacity of enrolling students, 3) Shortage of medical educators and faculty, and 4) Internal displacement and Brain-drain.
Since then the ministry of health through the human resource development and administrative directorate has been responding through a combination of factors, including, task-shifting, improved retentions schemes and through improved service organization and management of services and improved governance at the decentralized levels (FMOH, 2010). Focus has been given to the phased scaling up of the pre-service education capacities for the scarce health workforce and in line with the national health workforce development plan (HSDP IV/FMOH, 2010).
National health systems response included accelerated training of health officers in ten existing health science colleges in the country; training of integrated emergency surgery and obstetric officer in eleven universities and thirty affiliate hospitals, as well as training and deployment of government salaried female health extension workers. However, huge gap persisted for the key professional categories, such as medical doctors, midwives, and anesthesia.