Health services are given in Eritrea through a three-tier system. The primary level constitutes community health services, health stations, health centers and community hospitals. The secondary level includes regional referral hospitals and first contact hospitals while the tertiary level covers national referral hospitals.
The delivery of health service has always been guided by the National Health Policy. Since 2000, the health policy has been implemented through cycles of five year strategic plans and annual operational plans, which started at program level and in 2012 developed to a sector- wide Strategic Development Plan (HSSDP). At the moment the country is implementing its HSSDP II, which covers the period 2017-2021. The HSSDP provides the medium term strategic directions that guide the health sector in facilitating the attainment of the Eritrean health aspirations, contributing appropriately to the national development and global health agenda.
The positive achievements in the health sector are not being realized in isolation. They are getting a boost from other activities, which can be described as ‘collateral gain’ from other development endeavors. These include a government that is committed to national development, a strong local government structure that stretches from the top all the way up to the village, the ending of the no-war-no-peace situation and the lifting of the unjust and unfair sanctions as well as the heralding of lasting peace and all rounded cooperation with Ethiopia, strong organizational capacity, highly responsive and responsible patriotic population, dedicated health workforce (both health service providers, managerial, administrative and technical support staff), collateral gains with improved road network; access to potable water; power supply to rural areas; and infrastructure for health etc…, wide distribution of health services in rural and remote areas and pre-service and on-going in-service training activities.
The 2030 Agenda for Sustainable Development represents an unprecedented undertaking of the global community to eradicate poverty and achieve sustainable development worldwide by 2030. Implementation of the actions needed to attain SDG-3 and its health targets including UHC calls for countries to adopt new, and in many instances innovative, approaches to addressing their health needs.
In Eritrea, as is the case with other countries in Africa, the nature and focus of required health services has evolved significantly. While communicable diseases continue to be a major problem, additional challenges are emerging to which changes in policy are needed to be able to address them urgently. Reductions in mortalities associated with many high priority diseases like HIV and Malaria is improving the overall survival rates. Globalization and changing lifestyles are leading to more risky health behaviors that are fuelling a rise in non-communicable diseases and injuries. This burden is particularly related to four major non-communicable diseases, which include heart disease and stroke, diabetes, cancer, and chronic lung disease, which share four common risk factors that include tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol.
The emerging complex issues consist of, but are not merely limited to, demographic, epidemiologic, socio-economic, health security and environmental changes that are influencing health.
The major challenges that continue to affect the country that were identified in the Eritrea National Indicative Development Plan (NIDP) 2014-2018 include improving and sustaining social progress, environmental stability, capacity development, accelerated inclusive growth and food security, gender and youth empowerment and human welfare and social protection. Within the NIDP, the Government has proposed to implement a series of people-centered policy initiatives against the challenges across the different sectors.
Two interrelated challenges, the “need of more money for health”, which means the need for ensuring adequate investment, and the “need of more health for the money”, which emphasizes the need for minimizing wastage and ensuring efficiency, are identified as challenges requiring special attention for creating and sustaining an enabling environment in the health sector.
The 2019 Eritrean National Health Policy (NHP) draft is the result of a critical assessment of the nature, magnitude and root causes of the prevailing health problems in the country and an awareness of newly emerging health problems. It accords appropriate emphasis on the needs of the less privileged rural population, which constitute the overwhelming majority of the population, as well as the more vulnerable population groups that include mothers and children.
The policy proposes realistic goals and the means for attaining them based on the fundamental principle that health, which constitutes physical, mental and social wellbeing, is a prerequisite for the enjoyment of life and for optimal productivity.
The government gives health a prominent place in its priorities, and it is committed to the attainment of the healthcare policy goals.
Strengthening an effective and efficient health system will require new approaches such as ensuring a capable and motivated health workforce. Coordination will also be needed across the wide range of topic-specific initiatives that will all share the benefits of improved health systems.
The policy will build on the achievements already made to provide guidance to tackle current challenges and emerging and re-emerging challenges. The policy shall also provide guidance on maximizing the benefits gained from the enabling factors and opportunities in the health sector.
The health sector’s goal and objectives cannot be met without making substantial progress on UHC. Hence, achieving UHC lies at the center of the policy priorities. The UHC aims to ensure that the country is able to (a) identify and plan to make available the full range of essential health and related services that the population requires, (b) progressively increase coverage with these essential health and related services by addressing access and quality of care barriers, and (c) progressively reduce the financial barriers that populations are facing when accessing these essential health and related services until there is equity and financial risk protection in the financing of services.
Achieving UHC will, in turn, require strengthening health system to deliver effective and affordable services to prevent ill health and to provide health promotion, prevention, treatment, rehabilitation and palliation services. The strengthening of a Health system requires a coordinated approach involving improved health governance and financing to support the health workforce and access to medicines and other health technologies in order to ensure delivery of quality services at the community and individual levels. As part of this, health information systems will be vital in informing decision-making and monitoring progress. Investments in these areas, financial and otherwise, should seek to increase responsiveness, efficiency, fairness, quality and resilience based on the principles of health service integration and people-centered care. To strengthen the health sector and help attain its goals and objectives, the policy identified policy priorities in four action areas — inputs and process, outputs, outcomes and impact levels. These four priority action areas are rooted in an integrated approach toward the strengthening of the system and appropriate sequencing of actions for the best possible outcomes.
The health sector will endeavor to respond to the Eritrean National Vision which is “to become a nation that is economically, politically, socially, culturally and psychologically well developed”.
The 2019 National Health Policy vision is to ensure improved health status, wellbeing, productivity and quality of life of the Eritrean people by promoting and providing high quality, effective, efficient, acceptable, affordable and accessible preventive, curative, palliative and rehabilitative health care services to all the Eritrean people. The ultimate goal of the NHP is guaranteeing “HEALTHY LIVES AND WELLBEING FOR ALL ERITREANS AT ALL AGES”. This is the overall goal of healthcare Eritrea is committed to achieve by 2030.
Good health will enhance the long term economic growth and development of Eritrea. Higher standards of living as a result of economic growth will also enhance the physical, mental and social wellbeing of the people of Eritrea.