Over the last decade, the committed leadership and proactive stance of the government of Ethiopia catalyzed efforts to improve RMNCAH results, particularly with regard to maternal and child health. The efforts of the government of Ethiopia notably impelled the achievement of Ethiopia’s MDG 4 target, which was reducing under-five mortality by two-thirds by 2012, three years ahead of the 2015 deadline. Despite such positive developments, profound economic and geographical inequities challenge the attainment of better RMNCAH results. For instance, “the proportion of births assisted by a skilled provider ranged from 10 percent in Affar to 86 percent in Addis Ababa” (DHS, 2014).
Ethiopia has strong existing systems for partner coordination led by the government and involving a wide range of national and international health (including RMNCAH) stakeholders. The Joint Consulting Forum is the highest governing body and serves as a joint forum for dialogue on sector policy and reform issues between the government, development partners, and other stakeholders and for oversight on the implementation of the International Health Partnership (IHP+), the Sustainable Development Goal performance fund, and other donor-supported projects. The Joint Core Coordinating Committee serves as the technical arm of the Joint Consulting Forum. The country plans to use these existing systems to serve as its platform for the GFF. This country platform will be supported by a technical working group, established to further focus on health financing.
Ethiopia’s transformative vision is outlined in a five-year costed plan, namely the Health Sector Transformation Plan (HSTP). RMNCAH investments are an integral part of the national HSTP, which proposes multisectoral interventions, including civil registration and vital statistics and nutrition, simultaneously targeting both users and providers, and further highlights the significant role of partnerships to mobilize and leverage support for accelerated and sustainable RMNCAH results.
Many partners—including the Department for International Development (DfID), the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Power of Nutrition trust fund, the U.S. Agency for International Development (USAID) and the World Bank—with resources from the International Development Association (IDA) and the GFF Trust Fund—are increasingly interested in aligning their financing in support of the RMNCAH scale-up in Ethiopia.
Health financing strategy
To support its plans for Universal Health Coverage, the government of Ethiopia is finalizing its health financing strategy to guide investments and mobilize domestic resources. It proposes to do so by (1) tapping into innovative financing including sin taxes and engaging non-state actors like the private sector; (2) increasing government spending on health and maximizing resource allocations; and (3) attracting complementary funding. Further, to prevent catastrophic out-of-pocket health spending, the Ethiopian health financing strategy includes a proposed rollout of a social health insurance scheme for the formal sector as well as expanding a community-based health insurance scheme for the informal sector.