In 2015, life expectancy for Ethiopia’s population was only 61.5 years.
The infant mortality rate is very high at 44.5 deaths per 1000 live births, compared with 4.7 for Canada and 4.4 for Great Britain. The maternal mortality rate is 490 per 100,000 live births, compared with 11 in Canada and 8 in Great Britain.
Twenty-five percent of Ethiopian children under the age of five are underweight. The risk of dying from infectious disease is very high.
Ethiopia ranks 173rd of the 187 countries on the 2014 United Nation’s Human Development Index.
The introduction of Family Medicine in Ethiopia is a way to improve these adverse health outcomes and reduce healthcare costs for Ethiopia’s 99,500,000 people.
Addis Ababa University (AAU) in Ethiopia’s capital is a state university with an enrolment of close to 50,000 undergraduate and graduate students. In 2011, when this project took place at AAU’s School of Medicine, the specialty of Family Medicine did not exist in Ethiopia. However, its development was seen as an important step toward improving health outcomes, managing healthcare costs, and providing more equitable access to care.
Many health problems in Ethiopia result from preventable communicable diseases such as malaria, pneumonia, and tuberculosis. Addressing the high incidence of these diseases requires a strong system of primary care, including physicians with enhanced training to lead programs of prevention and treatment before ailments advance to a stage requiring the care of specialists.
In 2011, a team from University of Toronto’s Department of Family and Community Medicine undertook a needs assessment that included the design of a curriculum for a new post-graduate specialization in Family Medicine at AAU’s School of Medicine. Jane Philpott and Katherine Rouleau began the study in February 2011. In May and June 2011, three additional volunteers, Eileen Nicolle, Kevin Bezanson, and Marc Abbyad, along with five graduate students from AAU’s program in Public Health, completed the first part of the research, a time-motion study that provided information about the current practices of general practitioners in Ethiopia.
The second part of the study, a stakeholder survey of what should be included in the curriculum for the new program, was conducted in January 2012.
The feedback from the graduate students in the Public Health master’s program has been invaluable in making adjustments to the project to ensure its success.
– Eileen Nicolle, Volunteer
In countries around the world, the Family Medicine specialty has been shown to provide a valuable contribution to the improvement of health systems. Rather than taking a disease-by-disease approach to health care, Family Medicine focuses on people and populations. Family Medicine physicians are well trained specialists in general medicine who can lead primary care teams that deliver coordinated, comprehensive, and cost-effective healthcare. The development of Family Medicine practitioners will help address Ethiopia’s overwhelming health concerns.
Please do not lose the momentum on this important project.
– Ethiopian doctor at AAU Family Medicine meeting
- Recruitment and retention of generalists
- Improvements in physicians’ technical, surgical, and emergency skills
- Improved health systems, producing better health outcomes and lower costs
- Skilled leadership of inter-professional primary care teams
Ethiopia’s first training program in Family Medicine was launched on February 4, 2013, at Addis Ababa University’s School of Medicine, which had previously had no postgraduate training program for general practitioners. In 2015, the residency program had 18 students. Graduates of the Family Medicine program will be highly skilled comprehensive-care doctors, providing much-needed care in both urban and rural areas of Ethiopia.
Date: 2011, 2012
- Marc Abbyad, M.Sc., Project Manager and Software Engineer, Medic Mobile
- Kevin Bezanson, M.D., Lecturer, Department of Family and Community Medicine, University of Toronto and family physician, Palliative Care, Temmy Latner Centre for Palliative Care, Mount Sinai Hospital, Toronto, Ontario
- Eileen Nicolle, M.D.C.M., Faculty Physician, Health for All Family Health Team, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario
- Jane Philpott, M.D., Cabinet Minister, Canadian Government; past Chief, Family Medicine, Markham Stouffville Hospital, Markham, Ontario and Assistant Professor, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario
- Katherine Rouleau, M.D.C.M., Assistant Professor, Department of Family and Community Medicine, University of Toronto and Staff, Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, Ontario