The healthcare system of a country indicates the developmental stage of its population. Ethiopia, a third-world country, reflects its healthcare systems. Despite the country’s challenges, from poverty to high population and malnutrition, the country is determined to make changes and achieve universal health coverage (UHC) before 2030 (Debie et al., 2022). A deep dive into the country’s healthcare demographics, structure, and systems reveals their process towards a better future and the challenges the healthcare department struggles with to make changes. However, compared to the healthcare systems in the U.S, Ethiopia shows some differences and similarities but still has a long way to go before reaching a better healthcare operation.
Comparison between Ethiopian and American Healthcare Systems
Through the efforts of charity organizations and the government, Ethiopia has improved its healthcare system. However, it still has areas that require improvement. As a country, Ethiopia has primary health centers, hospitals, and clinics, whereby major cities have better healthcare than rural areas (Debie et al., 2022). Moreover, there is a limited number of physicians in Ethiopia due to the migration of well-trained doctors to other countries and poor training in the remaining ones. As a third-world country, Ethiopia has a high infant mortality rate and instances of communicable diseases.
Nonetheless, the government is putting more effort into improving healthcare for mothers, children, and vulnerable groups. Despite impediments from cultural practices, economic reasons, politics, and environmental factors, Ethiopia has improved its record. It has better healthcare than it did a decade ago as it works towards achieving universal health coverage (Assefa et al., 2020). Therefore, the country is offering more health education to the masses and working on educating doctors to handle better all healthcare situations in both rural and urban areas.
On the other hand, Ethiopia’s improvement does not surpass the development of the American healthcare system. The system is complicated and capitalistic, with private and public sectors as part of the mix. Healthcare facilities in America are owned and managed by the private sector. Healthcare services are possible due to the contributions of organizations, healthcare facilities systems, providers, and independent operators (Zieff et al., 2020). Despite the good record of having quality healthcare, American healthcare is expensive. Therefore, many people only afford it through insurance which can be private or public. Through the Affordable Care Act, the American government is insistent on Americans getting insurance to improve their access to quality services in public healthcare facilities. Therefore, around 300 million people have insurance, with 39% being in public insurance plans (Zieff et al., 2020). The number makes up 91% of the population, leaving around 31 million uninsured and likely to pay out of pocket for medical services (Zieff et al., 2020). Nonetheless, the American healthcare system is great compared to Ethiopia’s, but it still has to go.
Financing of Healthcare System in Ethiopia and America
The healthcare system of Ethiopia is highly different from that of America. Although they have made significant strides from the system in 2000, Ethiopia is still far from achieving the healthcare level of America (Butkus et al., 2020). One of the major issues limiting Ethiopia is poverty and the lack of sufficient funds to support a better and sustainable healthcare system. Three sources finance the Ethiopian healthcare system; off-budget donor assistance, on-budget donor support, and private out-of-pocket outlays. Over 40% of the total money used in healthcare is from donations and grants from different parts of the world, while 16% comes from the government and over 35% from out-of-pocket (Debie et al., 2022). The increase in out-of-pocket finance costs the population their health since those who cannot afford not to get quality healthcare and treatment. The Ethiopian government is aware of the problem and is working on ensuring that by 2030, Ethiopia will have universal health coverage (Debie et al., 2022). However, the current situation is different from that of America, which has better ratings when it comes to healthcare.
In America, the government is more involved in the healthcare system. Therefore, they grant public insurance plans that are funded by federal taxes. These programs are Medicare, CHIP, Medicaid, and military health insurance (Butkus et al., 2020). Furthermore, the introduction of the Affordable Care Act elevated the access to healthcare and the number of insured people. On the other hand, private insurance companies have a great American population since 67% of Americans use private programs (Butkus et al., 2020). Therefore, American healthcare is financed by the government, which helps many poor and underprivileged people, private insurers, and individuals who can afford healthcare services without nationwide insurance.
Differences between American and Ethiopian Systems
Ethiopia, though it has a struggling healthcare system, it has a less complicated organization compared to America. Furthermore, it has plans to reach universal health coverage by 2030, which America does not have in place. On the other hand, the American population has more people insured and access to healthcare services. In contrast, Ethiopia has no national insurance policy, which limits the number of people accessing healthcare services.
Elements Influencing the Development and Distribution of Healthcare Services
Politics
In Ethiopia, certain aspects influence healthcare, its cost, and access by vulnerable groups. These elements include politics, culture, economic background, history, and environmental factors. Politics controls legislation; therefore, they dictate healthcare systems, payment plans, and the spread of healthcare (Shiferaw et al., 2018). Hence, many people access healthcare and pay using out-of-pocket means because of the limited insurance programs. The situation is limiting to older people without employment or retirement benefits.
Furthermore, the donations and grants are more focused on maternal health, and children forget the mentally ill, which makes them neglected and likely to suffer (Argaw et al., 2019). On the other hand, politics influence access to healthcare since the leadership in Ethiopia has yet to establish better infrastructure and education systems to help people living in rural areas. Hence, quality healthcare is limited to people in the urban center, which comprises young people, while the elderly live in rural areas (Shiferaw et al., 2018). The limited access applies to expectant mothers and children, increasing mortality rates. With limited education, the country has a shortage of qualified healthcare providers underequipped to handle psychological issues.
Culture
Cultural issues affect people’s perception of healthcare. In Ethiopia, many people from different places practice different cultures. It is a country with both Christians and Muslims. People in Ethiopia believe in polygamy and early marriage. Therefore, many cases of HIV/AIDS affected families because of multiple partners within the polygamy string (Argaw et al., 2019). According to statics, 61% of people with HIV in Ethiopia are women, and the rest are men and children, indicating that the virus spread is high among women (Argaw et al., 2019). More so, only 3.3% of the population has had a test for the virus since the rest has reservations about healthcare, and there is still a stigma associated with the virus (Argaw et al., 2019). On the other hand, early marriages lead to a high population, making it impossible for the government and families to support the healthcare cost of the country’s population.
Economic Background
Another issue affecting access to quality and affordable healthcare is economic background. Many people in Ethiopia live below the poverty line, making it hard for them to cope with basic needs, let alone afford healthcare. Moreover, due to a lack of stable insurance and the government struggling with donations and grants, it is hard to ensure that every person can afford healthcare when needed (Argaw et al., 2019). Therefore, many families prioritize the health of their children and young people over that of the old and mentally ill people. Furthermore, the government can only afford to focus on mothers, children, and people with chronic illnesses, not the older population.
History
Ethiopia did not have a good start in matters dealing with healthcare. The country’s educated healthcare providers opted to work abroad because of the lack of opportunities in their home countries. In addition, the country continued to suffer from bad leadership, and it was in the late 1980s, they decided to work on improving their healthcare system (Kiross et al., 2021). Its history concerns poverty, religious dogmas, a toxic culture, and poor leadership, which all hindered development and influenced the country’s healthcare system.
Environmental Factors
Ethiopia’s environmental health is below the standard, limiting the community’s well-being. The country’s population of about 120 million people continues to grow (Woldemichael et al., 2019). Therefore, they are using more land for farming to sustain the population and water. As a result, they have occupied most of the land and are limiting the environment from rejuvenating and developing (Argaw et al., 2019). These issues affect their healthcare since the water in urban areas is not enough to support the population. Many people in towns live squeezed and share resources like latrines which are room for spreading diseases and developing digestive issues. On the other hand, the food from farming is insufficient to support the population, which means older people and young children rely on fast food or food without a balanced diet to survive (Argaw et al., 2019). Living in poor conditions affects their health and exposes them to diseases that require healthcare they cannot afford.
Women and Maternal Child’s Health
The Ethiopian government and the ministry of health understand the importance of protecting the health of mothers and their children. Therefore, the government is working towards improving their health through working with different organizations. Through the efforts of the government and private organizations, Ethiopia has managed to reduce its mortality rates and only records 44- 67 deaths per 100,000 births which is a good score (Kiross et al., 2021). In addition, community health centers cater to mothers and their children and educate women about better healthcare. The government is working towards eradicating the practice of early marriages to avoid complications during birth and the deaths of the baby or/and mother, which would improve women’s and children’s well-being.
Additionally, USAID has made important strides towards better healthcare in Ethiopia. The organization offers education about better healthcare practices and living and encourages more people to care about their health and those around them (Woldemichael et al., 2019). Therefore, their collaboration with the Ethiopian Ministry of Health has led to more immunization of children at birth and during developmental stages, improved testing for HIV, counseling, and education on nutrition, and encouraged prenatal care (Woldemichael et al., 2019). Therefore, the overall health of women, mothers, and children in Ethiopia has improved in the last decade.
However, poverty and malnutrition are issues that impede better health for mothers, women, and children. High poverty levels limit access to healthcare by pregnant mothers and ill children. Furthermore, due to poverty, many children lack a proper meal to sustain their development (WHO, n.d). It exposes them to illnesses due to a weakened immune system and leads to poor health or under-development. A report by USAID states that 44% of children in Ethiopia have chronic malnourishment and 28% of children’s deaths yearly are because of the same (Kiross et al., 2021). Therefore, the government, to salvage the situation, has a National Nutrition Plan to help improve nutrition for children and the population of Ethiopians (Kiross et al., 2021). Once in motion and proven successful, the plan can save the country millions per year.
Management of Communicable and Non-Communicable Diseases
There are several communicable diseases in Ethiopia. These include HIV/AIDS, TB, malaria, measles, pneumonia, and parasitic infections (WHO, n.d). The best way the government manages them is by encouraging the national immunization program to eradicate issues like measles and polio (Shiferaw et al., 2018). Furthermore, the Ethiopia Public Health Institute works closely with CDC to identify and contain communicable diseases, the recent being Covid-19. The CDC has helped Ethiopia be more sensitized and active in testing surveillance, and preventing these infections.
On the other hand, the management process of non-communicable diseases is different from that of communicable ones. Non-communicable diseases in Ethiopia are cardiovascular diseases, diabetes, chronic respiratory issues, digestive diseases, and neoplasms (Jung et al., 2021). Hence, the best management strategy for these issues is education about better living and lifestyle changes. The non-communicable diseases are brought about by excessive consumption of alcohol, poor diet, minimal physical activity, and substance abuse. Therefore, the government is working on providing healthier foods to its population and creating better legislation against tobacco and alcohol consumption to protect its people from further healthcare issues (WHO, n.d). However, the bigger decision lies with the people and their willingness to change.
Theory and Practice of Health Promotion
Ethiopia hopes to achieve Universal Health Coverage. Therefore, their way of promoting healthcare ensures they reach a point where all healthcare services are accessible. They promote health by educating the masses about better healthcare practices (WHO, n.d). The key to promoting health in Ethiopia lies in eradicating ignorance and encouraging people to seek medical attention. Furthermore, people need to understand their role in ensuring their well-being and work on improving themselves for the better of the community (WHO, n.d). Hence, the practice is constructing more healthcare facilities to access and train more healthcare providers to ensure quality healthcare services. The education is done through community outreach programs that target people in rural areas and vulnerable groups (Jung et al., 2021). These measures can promote and change the healthcare operations of Ethiopia.
Lifestyle and Behavioral Factors that Affect Health
The behavior and conduct of people affect their health and capacity to get illnesses. In Ethiopia, these factors include alcoholism, substance abuse, and poor diet. Alcohol affects vital organs and damages them, which lowers the life expectancy of the alcohol consumer (Jalu et al., 2019). They work like drugs that damage the body and compromise a person’s psychological health. Therefore, substance abuser is at risk of developing mental health issues and deteriorating their physical health through exposing them to toxic materials.
On the other hand, using drugs makes a person has impaired judgment, which means they are less likely to protect themselves or others if they have a communicable disease (Jalu et al., 2019). Poor dieting affects the development of the body and its strength to fight diseases. Instances of substance abuse and poverty lead to poor dieting, which contributes to poor health. On another spectrum living a life of inactivity and in an unclean environment can lead to contracting diseases like respiratory and cardiovascular diseases, diabetes, high blood pressure, cholera, malaria, and diarrheal illnesses (Kiross et al., 2021). Therefore, a person’s behavior and lifestyle can change their health or lead to more serious conditions.
Comparison with America
Healthcare in America is lacking in the same way Ethiopia needs improvement. However, America has made more accomplishments by making healthcare accessible in the rural area. The Obamacare strategy has led to more people getting insurance which has improved healthcare in America (Butkus et al., 2020). Furthermore, America is keen on the health of vulnerable people like the mentally ill, disabled, children, and the old. Therefore, they have more facilities for the mentally unstable and ensure older people.
More so, nursing homes are common in America because they ensure the well-being of the old. These are things that are limited or unheard of in Ethiopia. For instance, there are no insurance systems specifically targeting the old in Ethiopia, and the country is still struggling to establish healthcare in rural areas (Assefa et al., 2020). Nonetheless, the two countries populations struggle with poor lifestyle choices that lead to non-communicable diseases, and they are working on eradicating them.
Conclusion
The government, health facilities, healthcare providers, and the community have roles to play in ensuring healthcare improvement in their country. America’s system is more improved but different from the approach of Ethiopia, but one could learn something from the other and improve its strategies. As such, America can put more effort into ensuring universal health coverage for its population, which means finding a means to make healthcare less expensive. On the other hand, Ethiopia needs the means to prioritize insurance to improve access to healthcare services and seek more funding in preparation for UHC.
References
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