Designing a Resilient National Health System in Ethiopia: The Role of Leadership

What is a Resilient Health System? The Ethiopian Experience Successes Remaining Challenges Reasons for Success References The global community has recently agreed on a number of health targets in line with the United Nations’ Sustainable Development Goals adopted in 2015 to be achieved by 2030. Among the most important of these are achieving universal health coverage, ending preventable child and maternal deaths, ending the HIV/AIDS epidemic, and controlling the emergence of chronic diseases, most notably cardiovascular diseases, diabetes, and mental illness. The recent Ebola outbreak affected Guinea, Liberia, and Sierra Leone in many aspects. Not only did thousands of people, including hundreds of health workers, lose their lives but the economies of the region took a nosedive and the costs to the rest of the world for controlling this epidemic were astronomical. The devastation of the Ebola epidemic exposed the lack of resilience of the health systems in these countries and the need for strong leadership. It also highlighted the potential for similar crises from infectious disease outbreaks in other settings where systems are weak. Security from global health threats is now reaching a level of importance on par with security from military threats throughout the world. Hence, resilient health systems and effective leadership are needed now more than ever to meet the challenges that lie ahead over the next decades. For Ethiopia, this will require continuing to improve our primary health care system by: expanding services provided by health extension workers (HEWs) at the community level; establishing higher-trained personnel at primary health centers; and improving access to basic and essential surgical services at first-level referral hospitals.