Ethiopia: A Community-Driven Revolution Against Disease
Twenty years ago, Ethiopia’s health system was under-resourced and under pressure, facing critical workforce and infrastructure gaps. The country grappled with a heavy burden of infectious diseases – including HIV, TB and malaria – and elevated maternal and child mortality rates. A substantial portion of the population lacked access to essential primary health care services.
As part of a comprehensive strategy to tackle these challenges, the government of Ethiopia launched the Health Extension Program in 2003. The program focused on training and deploying over 40,000 salaried health extension workers – primarily women – who deliver lifesaving services that prevent disease, improve maternal and child health, and treat common illnesses directly within communities.
Domestic financing has been crucial, covering core costs such as salaries, training and health post operations, reflecting strong national ownership. This commitment has been complemented by donor support, including from the Global Fund.
Investments from the Global Fund have helped equip health extension workers with essential commodities such as medications, diagnostic tools, insecticide-treated nets and other vital supplies.
Global Fund catalytic funding through initiatives like the Africa Frontline First Catalytic Fund and the Digital Health Impact Accelerator have also played a key role. These funds have supported the deployment of digital tools that simplify data collection and enable real-time reporting, as well as flexible training programs that update health extension workers’ skills to meet evolving health challenges. These investments help keep health extension workers connected to the national health system, enhancing supervision and resource allocation.
Ethiopia’s Health Extension Worker program has been central to dramatic health improvements over the past two decades. Its large scale, strong government ownership and sustainable integration into the national health system make it a global benchmark for effective community-based primary health care.