Millennium Goals – A Journey of Partial Success for Ethiopia
Helen Taye, 23, has been married for six years and is expecting her first child, Fortune met with her while she was in Kirkos Sub-city Health Office Gotera Massalecha Health Centre to get antenatal care services (ANC). This marked her second visit since she found out she was pregnant two months ago.
“Since this is my first child I have no idea what to expect during my pregnancy but the service has shed light for me in this aspect as well as taking care of me and my baby’s health,” stated Helen.
The centre gives care for 45 days after the birth of the child starting from post pregnancy period including child delivery services. All these services are given free of charge.
Since the centre was established in 2012, it has given 613 antenatal care services, 93 delivery services starting from last year and had transferred 34 cases that is beyond its provision to hospitals. The centre has a yearly plan to give 355 antenatal care and 337 deliveries. Through the years it never recorded either a child or maternal mortality.
This story is also reflected at the national level as Ethiopia is among the six countries in Africa, including Egypt, Liberia, Malawi, Tanzania and Tunisia that achieved one of the Millennium Development Goals (MDGs)-reducing child mortality by two-thirds in 2012, according to “Assessing progress in Africa toward the Millennium Development Goals, 2014” report by UN Economic Commission for Africa, the African Union, the African Development Bank, and UNDP.
In 1990, the under-five mortality rate in Ethiopia was one of the highest in the world at 204/1,000 live births; by 2012, this rate had been slashed to 68/1,000 live births. The expansion of health infrastructure and the successful implementation of Health Extension Package (HEP) are believed to have contributed to the achievement of the goal, according to UNDP Ethiopia. This includes focus on delivering an essential package of care that is most related to the diseases affecting children and the poor; a push to improve coverage and delivery of health services in rural areas; and a major effort on vaccination, which has been particularly successful.
However, challenges remain in reducing the maternal mortality ratio to three-quarters in 2015 (Goal 5). This is considered to be one of the goals that the country might not be able to achieve. Progress on reducing maternal mortality has been slow since 2005 when the country managed to reduce maternal mortality rate (MMR) to 510 per 100,000 births from 700 per 100,000 births in 2000. Achieving Goal 5 requires the country to reduce MMR to 175 per 100,000 births by 2015 from 420 per 100, 000 births in 2014, which seems to be an insurmountable task, explained UNDP Ethiopia. Early pregnancy and childbirth, low level of deliveries attended by skilled health personnel, and low nutritional status are some of the major challenges to reach this goal, according to UNDP Ethiopia.
In an effort to give a kick to the maternal mortality reduction program the UN Country Team, in collaboration with the Ethiopian government has developed a joint programme, stated UNDP Ethiopia. After an extensive consultation between the government and the UN Country Team a MDG Acceleration framework for achievement of Goal 5 in pastoral areas was designed as well as Accelerated Action Plan for reducing maternal mortality, which is already under implementation, according to UNDP Ethiopia.
A nurse explaining about the physical as well as biological changes pregnant women might experience, what they mean and which sings warrant a visit to the centre.
The Ethiopian government had also allocated around 5.5 million Br for the health sector starting from 2012 to 2014 which helps pregnant mothers like Helen to get antenatal care in a nearby location. Pregnant women pass trough physical examinations such as blood pressure, weight measurements, etc to track the mother’s health record and to keep it at a medically advisable level as well as HIV counselling and test, according to Tigist Fantaye, a nurse at Kirkos Sub-city Health Office Gotera Massalecha Health Center.
Additionally, necessary medication based on the physical diagnosis, training on sanitation, childcare and nutrition are given at the centre. The antenatal care goes in fixed four schedules at 0-16 weeks, 24-28 weeks, 30-32 weeks and 36-40 weeks, according to Tigist. But if there is a “danger sign”, which the mothers are taught on their first visit that can be a symptom of health disturbance of the mother or the child, the centre is open 24/7. But it is still shocking to see mothers in the city who come to the centre injured and bleeding, while they try to give birth without the attendance of skilled health personnel, stated Tigist. This calls for a better awareness creation in the community, she suggested.
Beside these two goals, substantial progress was observed in Ethiopia in terms of achievement of MDGs. Ethiopia is on course to achieve eradicating extreme poverty, which targets to halve the proportion of people whose income is less than one dollar a day in 2015, achieving universal primary education, promoting gender equality and empowering women with a target to eliminate gender disparity in primary and secondary education, by 2005 and in all levels of education no later than 2015, combating HIV/AIDS and Malaria, ensuring environmental sustainability and developing a global partnership for development. UNDP Ethiopia attributes the success achieved in Ethiopia to political will and government commitment and close collaboration between government and development partners. The remarkable economic growth that the country has achieved is also credited with the progress that the country made in achieving MDGs. However, achieving gender equality and women empowerment is lagging behind along with the reduction of maternal mortality.
As a result of the massive investment in basic education, most countries have achieved universal primary enrolment (Goal 2) in Africa and the continent as a whole is expected to achieve Goal 2 , according to Assessing progress in Africa toward the Millennium Development Goals, 2014 report. The Ethiopian government had allocated around five million Birr, which is out of the total of 50 million Br allocated for the execution of MDGs project in order to carry out new schools construction and expansion projects between 2012 and 2014.
The government had the goal of building 929 primary, secondary, preparatory and vocational schools but only 473 schools have been built. It achieved 60pc of its goal regarding school expansion projects. The projects have faced problems such as delay of imported equipment for furnishing the school, especially to the vocational school construction, as well as lack of road access, explained Samuel. But as a whole, Ethiopia is on track to achieve universal primary education, he added. The Net Enrolment Ratio (NER) for primary education (Grade 1–8) increased from 40.4pc in 2000 to 91pc in 2014.
By 2025, Ethiopia has set out to be one of the middle income countries in the world taking eradication of poverty as its core objective of development plan. Ethiopia is among six countries such as Swaziland and Uganda, which are less than five percentage points away from reaching the target. While countries like Ghana, Angola, Malawi and Rwanda have already achieved the target in 2013.
Ethiopia targets to reduce people whose income is less than one dollar a day to 27.8pc in 2015 from 55.61pc in 2000. The Ethiopian government takes the construction of roads as a core element in the mission to eradicate poverty as roads are believed to play a major role in strengthening the economic network in the country as well as assisting the business sector to flourish, explained Samuel.
Even though the end of the MDG-2015 may not achieve some of the goals, we cannot deny how far we have come considering where we started, stated Haji Ibsa, PR at the MoFED. One criticism of the MDG plan is that its extra emphasis on the gap between current levels of performance and actual, neglecting the effort exerted to reach the current level of performance in the first place, according to Assessing Progress in Africa toward the Millennium Development Goal, 2014 report.
“By the end, some goals might be achieved while others might not be achieved. Whatever the outcome is, it does not mean that the Goals become less relevant. Even goals that will be achieved by the 2015 deadline will still be important. Achieving Goal 1 (halving the number of people living in poverty, for example) does not make the poverty reduction goal any less relevant. Given this, there is a global consensus that successor Goals be designed to succeed the MDGs,” says a statement from the UNDP Ethiopia.
The MDGs, which intend to improve the lives of the world’s poorest people, have faced different criticism over the years. General criticisms include a perceived lack of analytical power and justification behind the chosen objectives. Also, lack of national government commitment, which drives from the mechanism used to introduce local change through external innovations supported by external financing are among many.
Despite the aforementioned criticisms, the 2010 MDG review summit called for thinking about the successor to the MDGs. The UN Secretary General established an intergovernmental Open Working Group to design Sustainable Development Goals (SDGs), which are successors to the MDGs. The Open Working Group recommended 17 Goals and 169 targets. The Ethiopian government will also work on strengthening the achievement made focusing further not only on the quantity but also on the quality of the goals, stated Haji. The MDGs are expected to be endorsed at the September 2015 session of the UN General Assembly.