Health Status

The health status of Oromia region is generally poor as it is true for the country as the whole compared to other low income countries, even within the sub-Saharan Africa. Widespread poverty along with low income level of the population, low educational level, inadequate access to clean water and sanitation facilities, high population growth, spread of HIV/AIDS and poor access to health services are among factors contributing to high burden to health services in the region.

Oromia Government has been constructing a number of health facilities over the past seven years with the objective of improving the health coverage of its citizens. Despite the efforts made by the government the health coverage of the region is still low exhibiting some improvement from its level of 41.4% in 1988 to 53% in 1997 computed on the basis of available health facilities.

Government pursues a health policy that emphasizes achieving access and basic package of quality primary health care services, which include preventive and basic curative service using a four tier system of health service delivery.

Health Facilities and Personnel

Over the last seven years, the Regional Government has made encouraging efforts in expanding health facilities, particularly focusing on hitherto forgotten areas. However, expansion of health facilities is not followed by commensurate increase in health coverage as the rate of population growth outstrips the increment in facilities and health personnel.

Health facilities and health manpower

i. Hospitals

In Oromia region there were 21 governmental and 4 non-governmental hospitals in 2003 G.C. There were also 4 other governmental (other than Ethiopian government) hospitals that make 29 the total number of hospitals in the region.

ii. Health Centers

According to the information obtained from Oromia Health Bureau, there were 153 governmental, 2 non-governmental and 20 governmental other than Ethiopian government health centers in 2003G.C. in Oromia State. Hence, the total number of health centers in the region is 175 in 2003/4.

iii. Clinics

In 2003 G.C., the total number of clinics in Oromia region was 2503 of which 768 were governmental, 80 were non-governmental and the rest were private clinics of different levels.

iv. Health Posts

In 2003 G.C. there were 414 governmental and 7 non- governmental health posts in Oromia Region. According to the data obtained from Oromia Health Bureau, most of these health posts have constructed since 1992 G.C.

v. Pharmacies

There were 65 special government pharmacies and 795 private rural pharmacies in Oromia Region in 2003 G.C. Thus, currently there are about 860 pharmacies all over the region.

vi. Health Professionals

In Oromia, there were 214 medical doctors, 1380 nurses, and 2133 health assistants in the year 2003 G.C. As the information from Oromia health Bureau proves it the number of health workers particularly the number of doctors goes on decreasing from year to year.

According to available data the region's hospitals to population ratio in 1994 is 1:846571 that is by far below the national average of 1:584522 and 1:5740 in the same order. Likewise the ratio of health center to population is 1:206121 in the region, which is again below the national level of 1:163155 and the WHO recommended level of 1:100000, implying the enormous effort that has to be made to catch-up with the national level and eventually reach the level stated in country's health policy.

Although the efforts made so far to improve health coverage in general are encouraging, yet much has to be done to further expand health facilities and equip existing ones so as to enhance service delivery.

Regarding health personnel, physician to population ratio was 1: 58834 in 1987 and 1:74075 in 1994 E.C indicating a declining trend, whereas the ratio of nurses to population has improved from 1:18855 in 1987 to 1:9911 in 1994. Both indicators are generally below the national level and WHO standard, of 1:28339 and 1:10,000 for medical physicians and 1:5236 and 1:5000 for nurses, respectively.

The above statistics show that the number of physicians has declined from 1987 to 1994, even in absolute terms, although the number of new graduates is adding into the supply which is supposed to improve the availability of physicians in the health facilities. The cause to the attrition of medical physicians from the region is possibly attributed to low salary scale paid by the government vis-à-vis the high market demand for the profession and/or poor handling. As the result, the availability of medical physicians in the region has become inadequate, seriously aggravating the poor delivery of health service. The situation is further exacerbated by high concentration of medical physicians and nurses in three godinaas (East Shewa, Arsi and Jimma), where 80% of specialized physicians, 50% of general practitioners, and 50% of nurses are stationed.

To alleviate this situation; firstly the government has to devise a special incentive arrangement to attract physicians into distant godinaas; secondly, design a mechanism whereby medical service delivery may be contracted out to health professionals; thirdly, consider increasing the supply of health professionals by enhancing absorbing capacity of higher institutions or make special arrangements with training institutions to upgrade the qualification of lower health professionals.

Major health indicators

EPI coverage declined from 69% in 1988 E.C to 52.61% in1994. On the other hand TT2 pregnant women coverage showed a little improvement increasing from 31% in 1988 to 33% in 1994, while TT2-non pregnant women coverage fluctuated, (increased from 6% in 1991to 14% in 1993 and declined to 11% in 1994). Infant and under-five mortality rate is as high as 116.2 and 193.8 per thousand live born children, respectively in 1994 in Oromia, which is still greater than the national average (112.9 and 187.8). When compared to other regions such as Amhara (112.4 and 183.4), Tigray (103.6 and 169) and SNNP (113.4 and 191.5) Oromia lagged behind all regions in under-five mortality rate.

Similarly, 600 mothers out of 100,000 die because of conditions related mainly to pregnancy and childbirth. Acute respiratory infection mainly causes mortality among under-five children in Oromia as well as at the national level. There was some increment in contraceptive prevalence rate (CPR), from 4.5% in 1991 to 11.5% in 1994. Antenatal and postnatal coverage also increased to some extent during the period of seven years.