Ethiopia - Country Commercial Guide
Healthcare
Last published date: 2022-07-21

Health care is one of the best prospect service sectors in Ethiopia. The information below provides a market overview and trade data.  

Overview  

The Government of Ethiopia (GOE) is working to strengthen the healthcare system to align it with the Sustainable Development Goals. Ethiopia has a large, predominantly rural and subsistence agriculture population with poor access to safe water, housing, sanitation, food and health service. The government has made significant investments in the public health sector that have led to improvements in health outcomes. Nevertheless, communicable diseases like HIV/AIDS, TB, malaria, hepatitis B&C, respiratory infection, leprosy, and diarrhea remain a serious challenge in Ethiopia. Premature death, suboptimal quality of life, and nutritional diseases constitute a major health challenge. With a growing middle class, the GOE is facing an increase in non-infectious diseases such as cancer, diabetes, heart diseases, and high blood pressure. Mental health and eye problems are also becoming major issues in Ethiopia.   

 

Ethiopia Food and Drug Authority (EFDA) is being strengthened to provide increased regulatory oversight for the registration, importation and quality of medicines, supplies and equipment into the Ethiopian market.  EFDA has a mandate to regulate practices, facilities, professionals and products in the health sector.  The agency is responsible for promoting and protecting public health by ensuring the safety and quality of products and health services through registration, licensing and inspection of health professionals, pharmaceuticals and health institutions, as well as the provision of up-to-date regulatory information.  The GOE is implementing a plan to transform EFDA to make its operations more efficient with the aim of ensuring 100% availability of vital and essential drugs at all levels of the healthcare delivery system without stock shortages.  Currently, EFDA is trying to implement a “zero backlogs” strategy for medicine registration and licensing activities.  EFDA has digitized the importation and registration of health commodities to Ethiopia using the below listed programs:  

 

  • i-Register: is used by importers for application of market authorization and product registration (new products, request registration exceptions and renew existing registrations).    

  • i-Import: is an online application used by importers to apply for and receive permits to import all health commodities. Ethiopia Pharmaceuticals Supplies Agency (EPSA) also has access to this application as they are participating in procurement activities.  

  

EPSA is the public procurement agency responsible for purchasing pharmaceuticals, medical supplies, and equipment throughout Ethiopia.  EPSA has developed the below listed applications for ensuring proximity of EPSA distribution hubs to health facilities across Ethiopia and to establish efficient systems for inventory, fleet and information management. These improvements are targeted to increase efficiencies and improve the availability of commodities throughout the public sector.   

 

  • Vitas: A platform designed to support logistics management information, and warehouse management and inventory control.  It functions at the central warehouse and 18 regional hubs throughout Ethiopia.  

  • Dagu: A platform designed to support logistics management information and inventory control at service delivery points by using systematic record keeping. This application provides service at more than 700 sites all over the country.  

  • MBrana: A platform integrated with Vitas and other programs in EPSA that it uses to manage inventory from beginning to end.   

  

EPSA has developed a list of medical devices to procure that are categorized as products, which are durable capital equipment and non-capital items.  Based on this, the agency plans to design different procurement modalities to enhance the efficiency of the procurement process. EPSA plans to procure and store the non-capital items in its warehouse and distribute immediately when the demand arises in the country.  This also helps the agency reduce the amount of lead time required to procure medical equipment and supplies.  

  

The GOE encourages private sector participation in the area of quality of care and quality of service. The government is also working with the private sector to build advanced tertiary care hospitals to meet domestic demand that would otherwise be met through outbound medical tourism. The Ethio-American Hospital, which is under construction, and the recently announced Roha Group medical center, which will be built with a cost of $300 million in Addis Ababa are examples of the government’s commitment to developing major new healthcare facilities. These projects also demonstrate the government’s commitment to encouraging foreign investment in the sector through public private partnership (PPP) arrangements.    

  

Standardization and expansion of hospitals located in different regions is also the main focus under health infrastructure development in the country.   

 

The following health care facilities are available in Ethiopia:  

Health Posts:  17,699 available and 391 under construction  

Health Centers: 3,777 available and 113 under construction  

Hospitals: 367 available and 67 under construction  

Private Clinics: 3,867  

Private Hospitals: 43  

  

In addition to increasing the number of healthcare facilities in the country, the MOH is working to improve services to reduce health related burdens. Cancer is a leading healthcare challenge in Ethiopia. The MOH is working to establish cancer diagnosis centers at different hospitals. To address this significant burden, MOH has continued to work on radiation therapy expansion programs and access to chemotherapy services. Cancer chemotherapy services were provided in a limited number of health centers.   

Some of the upcoming priorities in the health care sector are:  

  • Prevention and containment of COVID19  

  • Prevention and control of communicable diseases and neglected tropical diseases  

  • Prevention and control of non-communicable diseases and mental health  

  • Improving medical services such as clinical services, emergency and critical care, blood transfusion and laboratory services  

  • Improve regulatory framework  

  • Improve health system infrastructure  

  • Enhance private sector engagement in the healthcare sector   

  • Improve the management of human and infrastructural resources  

  • Improve resource mobilization  

  • Improve research and evidence-based decisions and enhance the use of technology and innovation by supplementing with the deployment of appropriate information systems  

  • Facilitate the procurement of and access to drugs, supplies and equipment   

  • Increase patient satisfaction and address good governance  

  • Work on an early warning system, risk assessment and multi-sectorial coordination mechanisms that can improve response time for epidemics  

  • Procurement of medical equipment from quality providing companies and considering after sales maintenance service as part of contract package  

  

MOH has signed with Mastercard to launch Wellness Pass in Ethiopia which is the first program in the country and the second in Africa. In Ethiopia, the purpose of deploying Wellness Pass technology is to strengthen the public health responses by enabling secure Covid-19 vaccination tracking and offline portability of health records. The first phase of this project focuses on Covid-19 vaccination tracking. Phase two will scale up to the deployment of the program to apply across multiple health care programs.  

  

The GOE have started to address the high out of pocket costs for health services through the introduction of community-based health insurance (CBHI) and social health insurance (SHI) for the informal and formal segments of society, respectively.   

  

Challenges in the healthcare sector in Ethiopia include:  

  • Lack of available forex for the private sector to import the necessary equipment and supplies  

  • Price sensitivity of the market and lack of expertise/awareness to differentiate between product qualities  

  • Import of medical equipment and supplies is highly dominated by Chinese companies  

  • Bureaucracy in the government  

  • Lack of manpower capacity in the regulatory bodies  

  • Lack of manpower capacity and technology in healthcare service providers  

  • Delays in the bidding process  

  • Poor data management and reporting for proper decision making  

   

   

Healthcare Market (‘000)   

 Unit: USD ‘000  

2020  

2021  

2022  

(estimated)  

2023  

(estimated)  

  

Total Market Size  

27,372  

122,193  

134,412  

147,853  

  

Total Local Production  

  

22,500  

  

24,750  

  

27,225  

  

29,947  

  

Total Exports  

  •   

  •   

  •   

  •   

  •   

Total Imports  

4,872  

97,443  

107,187  

117,905  

  

Imports from the United States  

592  

682  

750  

825  

  

Exchange Rate  

44.38  

51.00  

51.75 

-  

  

  

Source: National Bank of Ethiopia   

 (total market size = (total local production + imports) - exports)  

  

Leading Sub-Sectors  

  • Equipment and services to new hospitals and health centers  

  • Construction of modern hospitals, blood banks, warehouse for pharmaceuticals and health care facilities  

  • Pharmaceuticals and supplies  

  • IT support  

  • Cold storage facilities  

  • Knowledge and skill transfers  

  

Opportunities  

The GOE is keen to acquire services, equipment, supplies, information management systems, and knowledge and skill transfers to improve the quality of the healthcare system. This is an opportunity for U.S. companies that are providing equipment and supplies, hospital furniture, ambulances for emergency, pharmaceuticals, vaccinations, and other services.   

  

Resources