Ethiopia Health Infrastructure Program

Ethiopia’s 74 million people have among the lowest per capita access to healthcare facilities in the world. Many health centers are in a poor state of repair and do not adequately support existing services, much less take on management services for HIV and other chronic diseases. The government of Ethiopia has embarked on a health system expansion program with the goal of increasing the number of government standard health centers from approximately 630 in 2009 to 3,153 by the end of 2012.

IRD will create highly visible improvements to the Ethiopian health sector in five regions that experience high HIV prevalence, and where USAID and the President’s Emergency Plan for AIDS Relief (PEPFAR) have contributed to the provision of healthcare services. The program will address public health infrastructure, with a focus on the following activities:

• Construction of sustainable and context-appropriate new health centers and ancillary infrastructure, such as warehousing facilities
• Enhancement of existing infrastructure to preserve and protect prior investments
• Participatory planning that incorporates the needs and constraints of communities, gender issues, and the environment
• Incentives for communities to make use of the health facilities

Ethiopia faces numerous challenges in reaching this objective, primarily shortages of technical capacity, funding, and human resources. Through collaboration with local construction firms, IRD will oversee the construction of approximately 85 government-standard health centers and 9 regional warehouses, and will renovate approximately 300 health centers with high antiretroviral therapy (ART) patient loads in areas of high HIV prevalence. The construction and rehabilitation will be primarily performed by subcontractors, and IRD is providing monitoring and supervising physical works, certifying the quality of completed works, and evaluating impacts.

While expediency is desirable, the objective of this program is to build safe, high-quality buildings for the long term. The work plan reflects the realities of constructing new buildings in rugged, remote areas, as well as renovating existing facilities with multiple deficiencies. Successful completion of program objectives will require time, local community buy-in, and rigorous construction supervision.

The Ethiopia Health Infrastructure Program (EHIP) is implemented by IRD with funding from USAID.