The mid-term review of Eritrean Health Sector strategic and development plan HSSDPII

As part of its ongoing efforts, the Ministry of Health (MoH) conducted a three-day mid-review workshop from 3 to 5 December on the progress of the five-year strategic plan of the health sector. The workshop, which was held at Hotel Asmara Palace, was attended by the Minister of health, directors at the Ministry of Health, director generals, and representatives from UN and WHO.

In her opening address, Ms. Amina Nur-Hussen, Minister of Health, said that the objective of the three-day workshop of the mid review of the Health Sector Strategic and Development plans — HSSDP II — is to critically analyze the progress made and identify the challenges with a view to attaining the objectives of the plan.

The mission of the national health policy of Eritrea is to provide up to date and efficient health service to the public. And the HSSDP II was developed to address the challenges of non-communicable and communicable diseases and injuries that are major causes of mortality and to take the health sector to a higher level of efficiency and quality, added Ms. Amina Nur-Hussen.

Regarding progress made by the health sector, Minister Amina went on to say that commendable achievements have been registered including the reduction of death rate of infants and children under five years of age and the increase in life expectancy of nationals. Although the results are encouraging, more concerted efforts of all concerned bodies are expected to promote the health sector to a higher level.

On the occasion, Dr. Martins Ovberedjo, representative of World Health Organization (WHO) in Eritrea, congratulated the minister of Health for the achievements in the health sector. Mr. Ovberedjo also said that he had witnessed the progressive accomplished in the heath sector and the demonstrated determination of the government and the leadership of the MoH to consolidate and improve the scope, coverage and quality of health services across the country, including political commitment to improve health services at hard to reach areas and nomadic communities.

Mr. Ovberedjo also expressed his admiration of the progress and achievements recorded in key programmes, including maternal and child health services, TB, HIV/AIDS, and immunization including the recent national vaccination of Meningitis A and Vitamin A supplementation campaign that targeted an estimated population of 2.8 million under 30 years of age.

Mr. Martin Ovberedjo promised that “WHO will remain committed to support implementation of strategic sector priorities and recommendations of the midterm review.”

At the workshop, presentations on the progress made in the health sector were made on sustainable improvement in life expectancy, maternal mortality reduction, infant mortality reduction, under 5 mortality, expansion of health services and control of communicable disease.

Over the past few years, Eritrea has witnessed significant improvements in life expectancy and in some of the key health impact targets, in particular adult mortality, infant mortality and child mortality, and maternal mortality. Life expectancy at birth has significantly improved from 49 years in 1995 to 64.7 years in 2015, a rate higher than the African region average. Non communicable diseases are the main contributors to all-cause mortality, responsible for 51.7% of all deaths. Maternal mortality, on the other hand, has gone down significantly, from 998/100,000 in 1995 to 486/100,000 in 2010, with an estimated annual rate of reduction of 4.6%. Commendable progress has also been attained in child survival, with an annual rate of reduction of under 5 mortality between 1990 – 2013 at 4.8%. Looking at specific contributors to disease burden, there have been improvements in the incidence, prevalence and mortality due to HIV TB and Malaria. There are also successes in other areas of service provision, like reduction of Female Genital Mutilation.

Regarding the current situation of communicable and non-communicable diseases, Dr. Andebrhan Tesfatsion, director general of Public Health, said since 2012 cardiac diagnoses have been made on over 9 thousand students in 80 elementary schools and as a result of the sustainable awareness raising campaigns 70 villages in the sub-zones of Asmat and Habero have become free from practicing harmful practices. Also, regarding the control of communicable diseases, 60% decline in TB incidence, prevalence and mortality over a 25 year period, 54% decline in HIV/AIDS prevalence over a 10 year period and 91% of reduction in malaria incidence have been registered by the Health sector.
Parallel to the progress in health care, the government of Eritrea has been making efforts to improve the stock of health workers for the attainment of health targets in the HSSDP II objectives. As a result, the number of health workers has been increasing by 4%-5% annually, reaching 10,361 by 2019.

Beside the achievements, some major challenges were also presented and discussed. They include the emerging dual burden of communicable and non-communicable diseases, low TB case detection at 60% against WHO set target of 70%, low skilled birth attendances as opposed to ANC services, and incapable to design any form of a pre-payment mechanism to protect people from financial difficulties.

As stated by WHO, Eritrea is making progress in several health fronts. However, there is a need to look forward and focus on relevant institutional reforms, consolidation and documentation of achievements, promotion of one health approach through multisectoral collaboration, and alignment of interventions in key strategic areas ( further reduction in maternal and child mortality, reduction in communicable and non-communicable diseases, health security) to address and reduce further the burden of disease on the population; and tracking of progress using essential health status indicators and promoting data quality and data use for evidence-based decision making.

Finally, as the Minister of Health recommended, although remarkable achievements have been made, still continuous focus and efforts are needed to fully achieve the HSSDP II plan in the remaining two years’ time.