Essential Health Services Package of Ethiopia 2019

Essential Health Services
Package of Ethiopia
November 2019
Addis Ababa
Ethiopia
© Copyright Ministry of Health of Ethiopia
The material in this publication is covered by the provision of the copyright Act
Year 2019
Title: Essential Health Services Package of Ethiopia
ii
Table of contents
Contents
Table of contents .................................................................................................................. iii
List of Tables ........................................................................................................................ v
List of Figures ...................................................................................................................... vi
List of Abbreviations and Acronyms ................................................................................... vii
Foreword.............................................................................................................................. ix
Executive Summary .............................................................................................................. x
Chapter 1: Introduction ......................................................................................................... 1
1.1. Background............................................................................................................. 1
1.2. Demographic and socioeconomic situation .............................................................. 2
1.3. Health status: mortality and morbidity ..................................................................... 3
1.4. Ethiopia’s disease burden ...................................................................................... 10
1.5. Health service utilisation ....................................................................................... 11
1.6. Ethiopia’s health system........................................................................................ 12
Chapter 2: Rationale, objectives and scope .......................................................................... 15
2.1. Rationale for revising Ethiopia’s EHSP ................................................................. 15
2.2. Values and guiding principles for Ethiopia’s EHSP ............................................... 15
2.3. Objectives of the EHSP ......................................................................................... 15
2.4. Scope of Ethiopia’s EHSP ..................................................................................... 16
Chapter 3: Development process of the EHSP ..................................................................... 17
3.1 Defining the scope of the EHSP revision ............................................................... 17
3.2 Selecting the EHSP interventions .......................................................................... 17
3.3 Estimation of costs and fiscal space analysis ......................................................... 23
3.4 Deliberation process .............................................................................................. 24
Chapter 4: Components of the EHSP ................................................................................... 27
4.1 Reproductive, maternal, new-born, child health and nutrition interventions ................ 27
4.2 Major communicable diseases .................................................................................... 38
4.3. Non-communicable diseases (NCDs) ........................................................................ 40
4.4. Surgery and injury care ............................................................................................. 48
4.5. Emergency and critical care ...................................................................................... 55
4.6. Neglected tropical diseases ....................................................................................... 56
4.7. Multi-sectoral interventions: hygiene and environmental health ................................ 58
iii
4.8 Health education and behavioural change communication .......................................... 59
4.9. Multi-sectoral interventions: nutrition interventions .................................................. 61
Chapter 5: Implementation strategies of the package ........................................................... 66
5.1. Key and strategic priority areas ................................................................................. 66
5.2. Institutional arrangement .......................................................................................... 75
Chapter 6: Monitoring and evaluation framework ....................................................................... 78
6.1. Monitoring ................................................................................................................ 78
6.2. Evaluation................................................................................................................. 79
6.3. Indicators to measure the progress of ESHP .............................................................. 79
Annexes .............................................................................................................................. 83
Annex I: Costs and fiscal space for EHSP implementation ............................................... 83
Annex II: Interventions by level of delivery and payment mechanisms ............................ 90
iv
List of Tables
Page
Table 1: Indicators related to maternal, neonatal and child health (MNCH) 5
………...
Table 2: Indicators related to major immunisation …………………………… 5
Table 3: Status of the indicators of major communicable diseases in Ethiopia … 7
Table 4: Status of non-communicable disease–related indicators ……………… 9
Table 5: Nutrition-related indicators for Ethiopia, 2016 ………………………… 10
Table 6: Cause of death and injury and percentage contribution to the total
11
DALY in Ethiopia 2017 ……………………………………………
Table 7: Current health workforce in Ethiopia for Ethiopia’s Fiscal Year 2010 … 14
Table 8 Essential RMNCH interventions in Ethiopia ……………………………
Table 9 Essential HIV/AIDS, tuberculosis, and malaria interventions …………. 39
Table 10 Essential NCD interventions for Ethiopia ……………………………..... 41
Table 11 Essential surgical intervention Ethiopia 49
Table 12 Essential emergency and critical care interventions for Ethiopia
Table 13 Essential NTD intervention for Ethiopia ……………………………… 57

Table 14 Essential multi-sectoral hygiene and environmental health interventions
for Ethiopia ……………………………..………………………………. 59
Table 15 Essential health education and behavioural communication interventions
for Ethiopia ……………………………..……………………………… 61
Table 16 Essential multi-sectoral nutritional interventions for Ethiopia ………… 63
Table 17a Improvement/change in burden of disease as measured by Age-
standardised death rate and DALYs ……………………………………… 77
Table 17b Improvement/change in quality UHC service coverage ………………... 78
Table 17c Financial risk protection core indicators for the monitoring and
evaluation of EHSP ………………………………………………. 79
Table 18 Assumptions for simplified budget expansion scenarios......... 86
Table 19 Components of the ESHP for Ethiopia by programme area, level of
delivery and payment mechanisms …………………………………… 90
v
List of Figures
Page
Figure 1 Outpatient department visit per capita by region in 2010 EC …………… 11
Figure 2 Admission rate per 1,000 population by region in 2010 EC ………….. 12
Figure 3 Financial arrangement for Ethiopia’s EHSP ……………………………. 70
Figure 4 Theory of change for the monitoring and evaluation of EHSP 79
Figure 5 Figure 5. Required resources for the implementation the EHSP over 83
(2020-2030) …………………………………………………
Figure 6 Required resource needs (USD per capita) for implementation of the 84
EHSP (over 2020-2030) (low, medium and high variant) …………
Figure 7 Per capita total health expenditure projections, 2020-2030 (low, 85

medium, and high available scenario)........................................................
Figure 8 Total Health Expenditure (USD per capita) projected with low, medium, 87
and high variant scenarios ………………………………………………
Figure 9 Required resources compared with expected available resources for 88

EHSP implementation, per capita USD (2020-2030)
vi
List of Abbreviations and Acronyms
ACER Average Cost-Effectiveness Ratio

AIDS Acquired Immunodeficiency Deficiency Syndrome
ANC Antenatal Care
ART Antiretroviral Treatment
ASRH Adolescent Sexual and Reproductive Health
BCC Behavioural Change Communication
BEOC Basic Emergency Obstetric Care
BI Budget Impact
BMI Body Mass Index
BoD Burden of Disease
CD Communicable Disease
CEA Cost-Effectiveness Analysis
CEOC Comprehensive Emergency Obstetric Care
CHEERS Consolidated Health Economic Evaluation Reporting Standards
CMNNDs Communicable, Maternal, Neonatal and Nutritional Diseases
CMR Child Mortality Rate
DALY Disability-Adjusted Life Year
DCP Disease Control Priorities
DCP-E Disease Control Priorities – Ethiopia
DHIS 2 District Health Information System 2
DRS Developing Regional States
ECEA Extended Cost-Effectiveness Analysis
EDHS Ethiopian Demographic and Health Survey
EFY Ethiopian Fiscal Year
EHSP Essential Health Services Package
EPI Expanded Programme of Immunisation
FMOH Federal Ministry of Health
FRP Financial Risk Protection
GBD Global Burden of Disease
GCEA Generalised Cost-Effectiveness Analysis
GM Growth Monitoring
HALY Healthy-Adjusted Life Year
HC Health Centre
HEP Health Extension Programme
HEW Health Extension Worker
HIV Human Immunodeficiency Virus
HLY Healthy Life Years
HMIS Health Management Information System
HP Health Post
HRIS Human Resources Information System
HSTP Health Sector Transformation Plan
vii
ICER Incremental Cost-Effectiveness Ratio
IEC Information, Education and Communication
IMR Infant Mortality Rate
MDG Millennium Development Goals
MMR Maternal Mortality Ratio
MTR Mid-Term Review
NCDs Non-communicable Diseases
NCDIs Non-Communicable Diseases and Injures
NMR Neonatal Mortality Rate
NTDs Neglected Tropical Diseases
OOP Out-Of-Pocket
OPD Outpatient Department
ORS Oral Rehydration Solutions
PHC Primary Health Care
PHCU Primary Health Care Unit
PMTCT Prevention of Mother to Child Transmission of HIV
PNC Postnatal Care
QALY Quality-Adjusted Life Year
RHB Regional Health Bureau
SARA Service Availability and Readiness Assessments
SCMS Supply Chain Management Systems
SDGs Sustainable Development Goals
SPA Service Provision Assessment
STI Sexually Transmitted Infections
TT Tetanus Toxoid
UHC Universal Health Coverage
UNICEF United Nations Children’s Fund
VAS Vitamin A Supplementation
WB World Bank
WHO World Health Organization
viii
Foreword
The Essential Health Service Package, launched in November 2019, aims to provide access to
quality health services without any financial challenges regardless of age, ability to pay and
economic status, and geographic location for the population in Ethiopia. I believe strengthening
the health system and introducing new initiatives are vital to the achievement of universal
health coverage (UHC). The government of Ethiopia continues to develop critical strategies
that potentially lead to Universal Health Coverage. However, I also believe that we cannot
progress towards UHC without clearly identifying the most pressing health problems and the
essential and affordable interventions to address health problems.
Defining the Essential Health Service Package (EHSP) of the country and identifying priority
health interventions is, therefore, one of the critical strategies. In the EHSP, we identified the
most pressing health challenges and interventions that were deemed appropriate, affordable,
and equitable to address health problems. For the preparation of the EHSP, we compared both
health problems and health interventions. Consequently, interventions were selected and
prioritized based on the essential health needs of the population.
I believe any health policy, strategy, and program designing require the full participation of
every citizen. Since the inception of ESHP revision, we have involved all public
representatives, health service providers, professional associations, and individual experts.
Besides, our partners have been instrumental in the revision process.
Every individual reading this EHSP document, whether a program manager, an implementing
partner, a health professional, or a donor, has a vital role to play in translating this document
into reality by focusing their approaches, actions, and resources towards the high priority
interventions identified in the package. In doing so, I am confident that the revised EHSP will
improve the efficiency of the entire health system and health services delivery in Ethiopia.
Successful implementation of the EHSP needs integration within different building blocks of
the health systems and integration across different sectors. It is my full confidence that we will
prevail in meeting the Essential Health Service Package by the unwavering commitment of our
government, ownership of the health programs by the community, enthusiastic service by
health workers, and entrusted support of our development partners.
Amir Aman (MD, MPH)

Minister of Health
Ethiopia
ix
Executive Summary
Ethiopia’s investment in health in the last two decades has resulted in substantial improvements
in the health condition of its population. For example, life expectancy has increased from 56.8
years in 2005 to 65.9 years in 2017 [1]. Three consecutive Ethiopian Demographic and Health
Surveys (EDHS) (2005, 2011 and 2016) have indicated declining trends in neonatal, infant,
under-five and maternal mortality.
Despite great progress, Ethiopia is still facing a high burden of disease (BoD). Thus, the
development of the Essential Health Services Package (ESHP), which defines appropriate
priority health services, represents a major strategy to maximise the benefits from the
demographic dividend by improving the health status of the Ethiopian population [2]. The
Ministry of Health initiated a process to revise the EHSP in July 2019, and as a result, this
document presents the revised EHSP of Ethiopia and the main elements underlying the
revision. This EHSP document not only acts as a guide for the development of other important
strategic and operational documents that can improve health services delivery in Ethiopia but
also serves as a guiding framework to progressively realise universal health coverage (UHC)
in the country.
The values and guiding principles of Ethiopia’s EHSP draw from the values reflected in the
national health policy and other strategic plans. These include value for money, priority to the
worse-off, enhanced equity, financial risk protection (FRP), poverty reduction, creation of a
resilient health system, achievement of UHC, cost-effectiveness, affordability, improved
quality, building institutional capacity and sustainability of health interventions.
The main objectives of the EHSP are as follows:
 To reduce ‘high BoD in Ethiopia’ by availing affordable, high-priority interventions.

 To protect the population against catastrophic health expenditures and provide FRP.
 To increase equitable access to health services and interventions.
 To increase the efficiency of the health system.
 To increase public participation and transparency in decision-making in the health
sector.
The EHSP was developed through a participatory approach, with frequent appraisal and
feedback before decision-making. A roadmap document that guided and informed the overall
x
process and each step of the revision process was prepared, presented to the management of
the Federal Ministry of Health (FMOH) and approved. A technical working group, composed
of 30 senior experts on various health system dimensions was established. Several consultative
technical workshops were convened to define the scope of the revision, develop a complete list
of health interventions, develop prioritisation criteria, gather evidence and compare and rank
health interventions according to a range of criteria.
Seven prioritisation criteria were selected, mostly based on the review of the national health
policy, the review of relevant strategic documents of the health sector and several rounds of
consultations with global and local experts, public representatives and a professional
association. These criteria are as follows:
1. Size of the disease burden
2. Cost-effectiveness
3. Budget impact
4. Equity
5. FRP
6. Public acceptability
7. Political acceptability
The major components of the EHSP of Ethiopia are classified based on the BoD of Ethiopia.
Interventions chosen to address the major causes of death and disease are detailed for the key
health service sub-components falling under each major component. The major components of
the EHSP of Ethiopia are organised into the following nine components:
1. Reproductive, maternal, neonatal, child and adolescent health

2. Major communicable diseases
3. Non-communicable diseases
4. Surgical and injury care
5. Emergency and critical care
6. Neglected tropical diseases
7. Hygiene and environmental health services
8. Health education and behaviour change communication services
9. Multi-sectoral nutrition interventions
The implementation of the EHSP of Ethiopia requires a sound implementation strategy that
enables proper planning, accurate measurement of performance and tracking of the progress as
xi
well as impact of the EHSP. Accordingly, the following ten key strategic priority areas are
proposed.
1. Enhance community participation in the planning, implementation, monitoring and
evaluation of the EHSP
2. Enhance stakeholder engagement
3. Improve health service delivery
4. Improve the availability, competency and capacity of human resources for health
(HRH)
5. Ensure sustainable health financing and a clear and viable payment mechanism
6. Strengthen the logistics and supply chain management system to ensure access to
essential medicines and equipment
7. Improve data utilisation for decision-making at all levels of the health system
8. Continuous improvement of leadership and management
9. Enhance partnership and coordination with other sectors
10. Create interface and integration with other national strategies, initiatives and strategic
priorities
The progress in the availability of EHSP will be monitored and evaluated using selected key
indicators that can be tracked using the routine health information system and surveys. The
core indicators are grouped into three: service coverage indicators, FRP indicators and
mortality and morbidity impact indicators.
xii
Chapter 1: Introduction
1.1. Background
In 1993, the health policy of Ethiopia was formulated with an emphasis on increasing access
to a basic package of quality primary health care services to all segments of the population.
Since the formulation of the policy, Ethiopia has developed and implemented four successive
health sector development plans (HSDP) followed by the Health Sector Transformation Plan
(HSTP) [3]. The commitment and efforts of the government in designing innovative and
evidence-based high-impact interventions have significantly improved the health outcomes.
However, the selection of high-impact interventions has never been an easy task and demands
systematic priority setting. Priority setting in health is critical for governments that seek to
promote equitable access to essential packages of health services. To prioritise health services
for the equitable delivery of packages of health interventions, Ethiopia developed and
published the first Essential Health Services Package (EHSP) in 2005. The goal of the 20051
Ethiopian EHSP was to focus on the delivery of priority health interventions that can improve
the equitable coverage of efficient and quality health services that the country can afford. These
services encompass the delivery of a comprehensive range of health services appropriate to the
primary level of care.
In the last 15 years, since the development of the 2005 EHSP, revision of the package has not
yet been addressed. Cognizant of this fact, the Ministry of Health initiated a process to revise
the EHSP. This document presents the revised EHSP of Ethiopia and the main elements
underlying the revision. This EHSP document not only serves as a guide for the development
of other important strategic and operational documents that can improve health services
delivery in Ethiopia but also serves as a guiding framework to progressively realise universal
health coverage (UHC) in the country. UHC is one of the core targets among the Sustainable
Development Goal for Health (SDG3) (Target 3.8: ‘Achieve universal health coverage,
including financial risk protection (FRP), access to quality essential health care services and
access to safe, effective, quality and affordable essential medicines and vaccines for all [by the
year 2030]’) [4].
1
In Gregorian calendar.
1
In summary, Ethiopia’s EHSP constitutes a set of affordable, promotive, preventive, curative
and rehabilitative key health interventions that can be offered at all levels of the Ethiopian
health system in an equitable, acceptable and sustainable manner as a path towards UHC. This
document summarises the EHSP revision process and is structured in the form of the following
eight chapters:
 Chapter I: presents the context (demographics, socioeconomic situation, health status

including, mortality and morbidity, burden of disease (BoD) and overall health system
indicators for Ethiopia)
 Chapter II: specifies the scope, objectives, values and guiding principles of the EHSP
revision
 Chapter III: describes the EHSP revision process and techniques of the revision
 Chapter IV: summarises the main components of the EHSP
 Chapter V: proposes the implementation strategy for the EHSP
 Chapter VI: presents the monitoring and evaluation approach along with key indicators
 Chapter VII: presents the costing and budget envelope required for EHSP
implementation
 Annexes: present the selected health interventions by service delivery level (i.e. health
posts, health centres, primary, hospital, general hospital and tertiary hospital) and the
payment mechanism (i.e. free of charge, cost-sharing and cost-recovery).
1.2. Demographic and socioeconomic situation
Ethiopia has a total population of about 109 million (as of 2018) [5]. About 80% of the
population lives in rural areas and is mainly dependent on subsistence agriculture [6]. The
population of Ethiopia is characterised by a rapid population growth and a young age structure.
The 2017 age pyramids have a relatively narrow base owing to the ongoing demographic
transition caused by the combination of declining trends in mortality and fertility. The ongoing
change in the age structure of the Ethiopian population is expected to offer a chance for the
country to earn the benefits of the demographic dividend with a conducive policy environment.
Thus, the development of ESHP, which defines appropriate priority health services, can be a
major strategy to maximise the benefits from the demographic dividend by improving the
health status of the Ethiopian population [2].
2
The Ethiopian government aspires to reach a middle-income status by 2035. The economic
system has seen a substantial growth over the past decades. Expansion of the services and
agricultural sectors accounts for most of this growth, while the performance of the
manufacturing sector was relatively modest. While about 55% of Ethiopians lived in extreme
poverty in 2000, this figure had been reduced to about 34% in 2011, as measured based on the
international poverty line of less than US$ 1.90 per day. Ethiopia has a wide socioeconomic
development gap between the rural and urban areas in terms of access to education, health and
other social services. Nevertheless, the substantial expansion of the economic system is
gradually narrowing this gap and is bringing positive trends in terms of poverty reduction in
both urban and rural regions.
1.3. Health status: mortality and morbidity
Ethiopia’s investment in health has resulted in improvements in the health condition of its
population. For example, life expectancy has increased from 56.8 years in 2005 to 65.5 years
in 2016 [1]. Three consecutive Ethiopian Demographic and Health Surveys (EDHS) (2005,
2011 and 2016) have indicated declining trends in neonatal, infant, under-five and maternal
mortality. Ethiopia has met the Millennium Development Goal (MDG4, reducing under-five
mortality) three years in advance of the agenda (2015). This is in part attributable to the
implementation of the National Neonatal and Child Survival Strategy (2015–2020) to further
reduce under-five mortality to below 30 deaths per 1,000 live births by 2020 [7].
The recent improvements in the health outcomes in Ethiopia can also be attributable to rapid
socioeconomic developments in general, including large economic growth and introduction of
innovative health policy strategies such as the Health Extension Programme (HEP) [8,9]. The
HEP has certainly contributed to the increased access and coverage of high-impact public
health interventions in the country. Improved public health interventions such as malaria
control efforts, access to safe drinking water, improved toilet facilities and vaccination against
childhood diseases are some of the factors behind the improved health outcomes in Ethiopia.
Despite such progress, a large burden of preventable mortality and morbidity persists in
Ethiopia, including non-communicable diseases, child and maternal conditions, neonatal
diseases, HIV/AIDS, tuberculosis (TB) and injuries [10].
However, improvements are not uniform. Some Ethiopian regions have high under-five
mortality rates (U5MR), Afar having the highest U5MR. Likewise, data from the Health
Management Information System (HMIS) shows that there is significant inequality in the BoD
3
across the country. For instance, based on the EFY 2010 growth monitoring and nutrition
screening data, there is a very high burden of child under-nutrition in Somali and Afar. A brief
summary of the level of interventions coverage, mortality and morbidity, from the available
sources of evidence, for major programmatic areas is presented below.
Reproductive, maternal, neonatal and child health

Ethiopia has made progressive improvements in areas of reproductive, maternal, neonatal and
child health (RMNCH). Maternal mortality has been reduced by 39%, from 676 in 2011 to 420
in 2016 per 100,000 live births. The use of modern family planning methods among
reproductive women has increased from 6% in 2000 to 35% in 2016. Demand for family
planning increased from 45% to 58% in the same period. However, there are still huge gaps in
terms of providing optimal RMNCH health services and the health care need [11, 12].
According to the maternal death surveillance and response (MDSR) data, among the estimated
total maternal deaths in 2010 EFY, 72% were at health facilities (i.e. 65% in hospitals and 7%
in health centres). The remaining 11% deaths occurred on the way to the health facilities and
13% deaths occurred at home. The leading cause of maternal death, according to the MDSR
report, was haemorrhage (41%). The other common causes of death are hypertensive disorders
of pregnancy (19%), anaemia (18%) and obstructed/ruptured uterus (10%).
Similarly, Ethiopia has made major improvements regarding neonatal and child health.
According to the 2016 EDHS, the national neonatal, infant and under-five mortality rates are
29, 48 and 67 per 1,000 live births, respectively. A summary of key RMNCH-related indicators
is presented below (Table 1).
Table 1: Indicators related to maternal, neonatal and child health (MNCH)
Indicator Values Source

MMR (per 100,000 live births) 420 EDHS 2016
Infant mortality rate (per 1,000) 48 EDHS 2016
Neonatal mortality (per 1,000) 29 EDHS 2016
Under-five mortality (per 1,000) 67 EDHS 2016
Contraceptive acceptance rate (Percentage) 70 HMIS2
ANC 4+ coverage (Percentage) 72 HMIS
Deliveries attended by skilled health personnel (Percentage) 66 HMIS
Early postnatal coverage (Percentage) 77 HMIS
2
FMOH (2018): Annual Health Sector Performance Report, EFY 2010 (2017–2018)
4
Pregnant women counselled and tested for PMTCT (Percentage) 92 HMIS
Pregnant women tested positive for HIV who received ART to prevent 60 HMIS
MTCTH (Percentage)
Immunisation services
With the progressive introduction of new vaccines, the total number of antigens in the routine
immunisation programme of Ethiopia has currently reached 12 (i.e. including HPV vaccine
targeting adolescent girls). The 2018 Service Availability and Readiness Assessment (SARA)
survey shows that the mean availability of tracer items required to provide the child
immunisation service was only 54% (Table 2). The routine health information shows that in
2010 EFY, the national pentavalent-3, measles and fully vaccination coverages were 94%, 88%
and 86% respectively. Similarly, the national pentavalent-1 to measles dropout rate has
increased from 10% in 2009 to 13% in 2010 EFY.
Table 2: Indicators related to major immunisation
Indicators Values (2010 EFY) Source of data

National coverage of pentavalent-3 vaccination 94% HMIS
National coverage of measles vaccination 88% HMIS
National coverage of fully vaccination 86% HMIS
National pentavalent-1 to measles dropout rate 13% HMIS
Mean availability of tracer items required to provide 54% SARA 2018
child immunisation services
Major communicable diseases
Mortality and morbidity owing to HIV/AIDS, TB, and malaria markedly decreased in the last
decade. The EDHS documented that HIV prevalence among women and men aged 15–49 years
has continued to decline from 1.5% in 2011 to 0.9% in 2016. The new HIV infection dropped
by 90%, and mortality rate dropped by more than 50% among adults. Similarly, HIV/AIDS-
caused age-standardised death rate declined from 177 per 100,000 in 2005 to 19 per 100,000
in 2017. In addition, Ethiopia has been recognised as one of the few sub-Saharan African
5
countries that achieved rapid decline of mother-to-child transmission of HIV, with a reduction
by 50% of new HIV infections among children between 2009 and 2012. Yet, there is significant
variation in mortality and morbidity of HIV by sex, age, demographic characteristics and
geographic areas.
Similarly, the country has achieved several of the targets set for TB prevention and control.
For example, in the last decade, mortality and prevalence owing to TB had declined by more
than 50% and the incidence rate is significantly falling. Age-standardised death rate owing to
TB declined from 191 per 100,000 in 2005 to 76 per 100,000 in 2017.
In the same way, mortality and morbidity owing to malaria declined with a significant decrease
in the admissions and deaths of under-five children. Age-standardised death rate owing to
malaria declined from 29 per 100,000 in 2005 to 3 per 100,000 in 2017. Furthermore, a
generalised malaria outbreak has not been reported for the last decade.
Although the leprosy elimination target of less than 1 case per 10,000 people has been achieved,
the notification of new cases has remained the same for the past 10 years. According to the
2010 EFY Annual Health Sector performance report, 2633 new leprosy cases were detected.
Therefore, interventions targeting leprosy are yet vital in Ethiopia.
A summary of the key indicators for the major communicable diseases is presented below
(Table 3).
Table 3: Status of the indicators of major communicable diseases in Ethiopia
Indicators Values Sources

HIV-related indicators
Adult HIV prevalence 0.9% EDHS 2016
Adult HIV prevalence (women) 1.2% EDHS 2016
Adult HIV prevalence (men) 0.6% EDHS 2016
Urban adult HIV prevalence 2.9% EDHS 2016
Rural adult HIV prevalence 0.4% EDHS 2016
613, 825 2018 Spectrum
Total number of HIV positive population
Estimate
15,898 2018 Spectrum
New HIV infection in 2010 EFY
Estimate
Currently on ART among total PLHIV 74.6% HMIS, 2010 EFY
Coverage of viral load testing 60% HMIS, 2010 EFY
6
Suppression of viral load 87.6% HMIS, 2010 EFY
Estimated total number of HIV positive population 613, 825 HMIS, 2010 EFY
Percentage of PLHIV who knows their HIV status 78.5% EDHS 2016
Percentage of people who are currently on ART 82.9% HMIS, 2010 EFY
Percentage with viral suppression rate 80.2% HMIS, 2010 EFY
TB and leprosy
Annual incidence of TB per 100,000 population in 2016 151 WHO 2019 report
TB mortality rate per 100,000 population in 2018 22 WHO 2019 Report
Prevalence of leprosy per 10,000 population 0.3 WHO 2017 Report
Number of all forms of TB cases reported in 2010 EFY 110, 675 HMIS
TB case notification rate per 100,000 population (2010EFY) 115 HMIS
TB treatment coverage (2010 EFY) 65% HMIS
TB treatment success rate for bacteriologically confirmed 94% HMIS
pulmonary TB cases for 2010EFY
TB cure rate for 2010 EFY 83% HMIS
Number of patient rifampicin resistance (RR)/multi-drug HMIS
resistance (RR/MDR) 741
Patients put on second line drugs
Total number of new leprosy cases detected in 2010 EFY 3218 HMIS
Proportion of Grade II disability among new leprosy cases for 7.9% HMIS
2010 EFY
Malaria
Total number of malaria cases in 2010 EFY as confirmed by 1, 206, 892 PHEM report
laboratories
Proportion of confirmed malaria cases either by microscopy or 88% HMIS, 2010 EFY
rapid diagnostic tests (RDTs)
Case fatality of malaria in 2010 EFY 0.01% HMIS, 2010 EFY
Non-communicable diseases (NCDs)
In Ethiopia, approximately half of all deaths are attributable to NCDs and injuries. Ethiopia has
a large and diverse burden of NCD risk factors such as tobacco, alcohol and Khat. While the
overall prevalence of obesity is low in Ethiopia, it is about six times higher in the wealthiest
quintile than the other socioeconomic groups. Hypertension, low physical activity, raised
plasma cholesterol and high fasting plasma glucose are also associated with the wealthier
socioeconomic groups. The national prevalence of hypertension is 16%; there has also been an
7
increase in the prevalence rates of stroke and myocardial infarction. The prevalence of raised
blood glucose ranges from 3% to 8% [13].
Mental and substance-use disorders are among the leading NCD disorders in terms of disease
burden. One out of five persons will be affected by mental disorders at some point in their life.
According to a large community-based study conducted in a predominantly rural area of
Ethiopia, mental illness was found to comprise 11% of the total BoD, with schizophrenia and
depression included in the top ten most burdensome conditions [14]. The estimated prevalence
of common mental illness is estimated to be 22% and 36% in the general population and among
patients with comorbid conditions, respectively. The prevalence of substance-use disorder is
reported to be 6%, 5% and 2% for alcohol, Khat and marijuana, respectively [15]. The most
common neurological disorder, epilepsy, is estimated to affect 1%–2% of the general
population [15].
The rate of rheumatic heart disease ranges from 17 to 38 cases per 1,000 school children and
young adults, which is much higher than African regional estimates and disproportionately
affects the poor. Regarding cancer, 65,000 new cancers are estimated to occur each year,
affecting females twice as often as males predominantly in the form of breast and cervical
cancers [16]. Injuries, digestive diseases such as cirrhosis of the liver, eye health problems such
as cataract, surgical conditions and musculoskeletal disorders are other causes of morbidity and
mortality from NCDs. A summary of key indicators for NCDs is presented below (Table 4).
Table 4: Status of NCD-related indicators
Indicators Values Source

Mortality owing to NCD 52% GBD 2016 report
Disease burden owing to NCD as measured by DALYs 46% GBD 2016 report
Prevalence of hypertension in adult population 16% 2015/16 STEPs survey
Prevalence of diabetes in adult population 3% 2015/16 STEPs survey
Prevalence of alcohol consumption 41% 2015/16 STEPs survey
Prevalence of Khat consumption 16% 2015/16 STEPs survey
Average daily salt intake of the population 8.3 g3 2015/16 STEPs survey
The prevalence of substance-use (alcohol) disorder 6% GBD report 2016
The prevalence of substance-use (Khat) disorder 5% GBD report 2016
3
Higher than the WHO recommended intake of less than five grams per day
8
The prevalence of substance-use (marijuana) disorder 2% GBD report 2016
Women who are thin (body mass index (BMI) < 18.5) 22% EDHS 2016 report
Percentage of children age 6-59 months who are anaemic 57% EDHS 2016 report
Percentage of anaemic women 24% EDHS 2016 report
Percentage of anaemic men 15% EDHS 2016 report
Percentage of non-pregnant adolescent girls who are 36% EDHS 2016 report
undernourished (BMI < 18.5)
Nutritional problems
Nearly four in ten (38%) under-five children in Ethiopia are stunted, 10% of the children are
wasted and 24% of the children are underweight [10]. On the one hand, 22% of women have a
body mass index (BMI) of <18.5; on the other hand, recently, obesity has become the number
one risk factor for NCDs in Ethiopia with about 8% of women being overweight or obese (BMI
≥ 25.0). Women in urban households are five times more likely to be overweight or obese than
rural women (i.e. 21% in urban vs. 4% in rural). Overweight or obesity has increased from 3%
in 2000 to 8% in 2016. Among men, one-third of them have BMI < 18.5 and only 3% are
overweight or obese (BMI ≥ 25.0).
In 2016, 57% of children aged 6–59 months were anaemic. Anaemia among women has
slightly decreased from 27% in 2005 to 24% in 2016. Among men, anaemia has slightly
increased from 11% in 2011 to 15% in 2016. Amongst non-pregnant adolescent girls, 36% of
them have BMI < 18.5 and 13% of them are anaemic. A summary of key nutrition-related
indicators is presented below (Table 5).
Table 5: Nutrition-related indicators for Ethiopia, 2016
Nutritional indicators Values Source

Percentage of children who are stunted 38% EDHS 2016
Percentage of children who are wasted 10% EDHS 2016
Percentage of children who are underweight 24% EDHS 2016
Vitamin-A supplementation (VAS) coverage among children aged 59% HMIS
6–59 months
9
1.4. Ethiopia’s disease burden
To define Ethiopia’s EHSP, characterising the current BoD of Ethiopia and its trends over time
is important. Recent estimates show that Ethiopia is experiencing a double BoD. According to
the 2017 Global Burden of Disease (GBD) study estimates, communicable, maternal, neonatal
and nutritional diseases (CMNNDs); NCDs and injuries account for 60%, 33% and 8%,
respectively, of the total disability-adjusted life years (DALYs) in the country.
In 2017, the leading 20 diseases, based on GBD’s level-4 classification, accounted for 75% of
total mortality and disability in Ethiopia. Neonatal diseases, diarrheal diseases, lower
respiratory infection, TB, ischemic heart disease, stroke, HIV/AIDS and diabetes, respectively,
were the top leading causes of age-standardised DALY rates per 100,000 population. The top
ten diseases caused 42% of DALYs. Overall, child and maternal malnutrition, unsafe water
and sanitation, air pollution, dietary risks, high fasting plasma glucose, high systolic blood
pressure and alcohol use, respectively, were the leading risk factors of BoD in age-standardised
DALY rates for Ethiopia.
Based on level-2 GBD classification (Table 6), the top ten causes of death and injury were
responsible for 75% of DALYs. This means that if the Ethiopian health system focuses on the
top causes of diseases and injuries, it would gain maximum health gains.
Table 6: Cause of death and injury and percentage contribution to the total DALY in Ethiopia,
2017 (Source: 2017 GBD)
Rank Causes of death or injury Percentage Cumulative
(Level-2 GBD) contribution to percentage
total DALYs (%) contribution (%)
1 Maternal and neonatal disorders 18 18
2 Respiratory infections and TB 12 30
3 Enteric infections 11 41
4 Other infectious diseases 7 48
5 Other NCDs 5 54
6 Nutritional deficiencies 5 59
7 HIV/AIDS and sexually transmitted infections 4 63
8 Cardiovascular diseases 4 67
9 Neoplasms 4 71
10 Mental disorders 4 75
11 Unintentional injuries 4 78
12 Digestive diseases 3 81
13 Neurological disorders 3 84
14 Self-harm and interpersonal violence 2 86
10
15 Musculoskeletal disorders 2 88
16 Diabetes and kidney diseases 2 90
17 Neglected tropical diseases and malaria 2 92
18 Skin and subcutaneous diseases 2 94
19 Sense organ diseases 2 96
20 Transport injuries 2 98
21 Chronic respiratory diseases 2 99
22 Substance-use disorders 1 100
1.5. Health service utilisation
Health service utilisation refers to both outpatient and inpatient services. The number of
outpatient visits per capita per year measures outpatient service utilisation. The Ethiopian
health system is tracking the outpatient service utilisation based on outpatient department
(OPD) visit per capita per year and the admission rate for inpatient service utilisation as part
of the eight health service quality indicators tracked through the HMIS. Although WHO
recommended 2.5 visits per capita per year, the national average OPD visit per capita per year
in 2010 EC was only 0.9. The 2010 EFY performance showed 21% increment from the 2009
EFY performance. Regional OPD visit performance ranges from 2 in Tigray to 0.2 in the
Ethiopian Somali region, and the performance of all of the developing regional states (DRS) is
below the national average for the year (Figure 1).
2.5
2
2
1.5 1.5
1.5 1.4
1.2
1.1
1 0.9
0.8
0.7
0.5
0.5 0.3
0.2
Figure 1: Outpatient department visit per capita by region in 2010 EC (Source: HMIS).
The national admission rate average per 1,000 population is 13 and ranges from a high 108 in
Harari to a low 8 in Afar. The admission rate reflects the interaction between demand and
11
supply of inpatient care. Similar to outpatient services utilisation, the admission rate is
inversely related to certain barriers that may be physical (distance), economic (the cost for the
patient), cultural (low awareness and health care seeking behaviour) or technical (poor quality
of health care).
120
108
100
80
60
43
39
40
24 24
20 15 13 13 11 10 10 8
Figure 2: Admission rate per 1,000 population by region in 2010 EC (Source: HMIS).
1.6. Ethiopia’s health system
The Ethiopian health sector has introduced a three-tier health care delivery system. The primary
level of care comprised a primary hospital (covering 60,000–100,000 people), health centres
(covering 15,000–25,000 people) and their satellite health posts (covering 3,000–5,000
people). The urban and rural health services arrangements differ as there is no health post in
the urban areas. The secondary level of care is a general hospital covering a population of 1–
1.5 million. This is the next referral centre for the primary level of care. Tertiary level of care
is a specialised hospital covering a population of 3.5–5 million.
Referral system
The referral can be vertical as in the hierarchical arrangement of the health services (from the
lower end of the health tier system to the higher end). It can also be horizontal between similar
12
levels of facilities in the interest of patients for cost, location, needs and other reasons. Referrals
can also be diagonal when a lower level health facility directly refers patients to a specialised
facility without necessarily passing through the hierarchical system. The Ethiopian guideline
for the patient referral system stipulates that referrals can be among public, private, community-
based and other traditional and alternative medicine practitioners and sometimes social service
providers.
Health financing system
The financing of the Ethiopian health system is mixed; about 30% of the money is from the
government, 33% from household’s out-of-pocket (OOP) expenditure, 33% from donors, and
1% from private employers and others sources. Within the last 20 years, the share of domestic
health financing has increased from 50% to 64%. The share of spending by ‘the rest of the
world’ (bilateral and multilateral donors and private philanthropists) has fallen from 50% in
2010/11 to 36% in 2013/14. Although the per capita health expenditure has significantly grown
over the past two decades (from US$5 in 1995/96 to US$29 in 2013/14), the 6th National Health
Accounts [17] study indicates that Ethiopia’s per capita health expenditure is very low.
As a pooling mechanism, community-based health insurance and social health insurance

schemes were established. While community-based health insurance is under implementation,
social health insurance has not been implemented yet. Expanding both of these schemes is
expected to expand service coverage, FRP and equitable access to available health services.
Human resources for health
To address the critical shortage and misallocation of health workers, in parallel with the
construction of health facilities, investment in human resource development and management
has been scaled up in the last 20 years. According to the HSTP document, Ethiopia has major
human resource management challenges including shortage, urban/rural and regional
disparities, poor motivation, retention and poor performance. Owing to limited efforts to
modernise human resource (HR) functions as a strategic resource in the health sector, there is
limited investment into capacity development. Evidence shows that the existing staff in HR
management and leadership has limited technical skills and experience, the HR structure and
staffing at all levels is inadequate and the capacity and practices in strategic and operational
HR planning and budgeting are limited. The human resources information system (HRIS) is
not fully functional to support HR planning and development, supportive supervision,
13
performance monitoring and improvement. Major gaps also exist in performance management
and accountability. Robust systems and practices are required to link performance
planning/goal setting with monitoring and improvement along with regular performance
appraisal. The size of the current health workforce in Ethiopia is presented below (Table 7).
Table 7: Current health workforce in Ethiopia for EFY 20104

SN Type of health workforce In hospitals and agencies In Overall
Male: Female: Total Regions total
N (%) N (%) N
1 Health extension workers 0 (0) 0 (100) 0 36635 36635
2 Anaesthetists 177 (64.6) 9 7 (35.4) 274 710 984
3 Biomedical engineers 51 (73.9) 18 (26.1) 69 191 260
4 Health officer 184 (72.2) 71 (27.8) 255 9735 9990
5 Medical doctors-GP 446 (66.5) 225 (33.5) 671 2956 3627
6 Medical doctors-specialists 2015 (82.4 430 (17.6) 2445 463 2908
7 Medical doctors-sub-specialists 101 (79.5) 26 (20.5) 127 60 187
8 Laboratory technologists 1242 (58.8) 870 (41.2) 2112 7619 9731
9 Midwifery professionals 469 (57.8) 343 (42.2) 812 12206 13018
10 Nurses 3026 (43.2) 3975 (56.9) 7001 49006 56007
11 Pharmacy professionals 800 (69.7) 348 (30.3) 1148 5564 6712
12 Radiology 70 (68.6) 32 (31.4) 102 152 254
Total 8581 (57.2) 6435 (42.8) 15016 125297 140313
Governance of the health system
The governance of the healthcare system in Ethiopia mirrors and is defined within the wider
context of Ethiopia’s political system. The FMOH is mandated to formulate national policies
and strategies and develop standards in consultation with regional health bureaus (RHBs). The
governance includes administrative decentralisation to RHBs and district-level health offices.
The governance comprises consultation forums and joint decision-making processes. The
governance of Ethiopia’s health system comprises institutional frameworks that coordinate and
provide stewardship in the implementation of the programmes and health sector initiatives.
4
EFY (Ethiopian Fiscal year): 2010 EFY corresponds to September 2017–October 2018.
14
Chapter 2: Rationale, objectives and scope
2.1. Rationale for revising Ethiopia’s EHSP
Revising Ethiopia’s EHSP, which was initially developed in 2005, is crucial for three reasons.
First, the population’s demand for health services has substantially increased, mainly because
of the implementation of the Health Extension Programme (HEP), increasing literacy rate and
reduction of poverty. Second, health services practices have evolved, including the addition of
interventions that were not part of the initial 2005 EHSP. These changes were to some extent
driven by the recent demographic and epidemiological transition in the country. However,
rolling out health interventions without a clear understanding of their impact on health, cost,
cost-effectiveness, health benefits offered to the worse-off and FRP might lead to the inclusion
of inappropriate interventions. Third, in the last two decades, Ethiopia has gone through
tremendous demographic and epidemiological changes, which brought up a double BoD.
Therefore, revising Ethiopia’s EHSP is essential to ensure UHC to Ethiopian citizens.
2.2. Values and guiding principles for Ethiopia’s EHSP
The values and guiding principles for Ethiopia’s EHSP draw from the values reflected in the
country’s health policy and other strategic plans [18]. The following are the values and guiding
principles:
 Value for money

 Priority to the worse-off
 Enhance equity
 Reduce poverty
 Creation of a resilient health system
 Achievement of UHC
 Cost-effectiveness
 Affordability
 Improve quality
 Building institutional capacity
 Sustainability of health interventions
2.3. Objectives of the EHSP
15
The main objectives of the EHSP are as follows:
 To reduce high BoD in Ethiopia by availing affordable high-priority interventions

 To protect the population against catastrophic health expenditures and provide FRP
 To increase equitable access to health services and interventions
 To increase the efficiency of the health system
 To increase public participation and transparency in decision-making in the health
sector
2.4. Scope of Ethiopia’s EHSP
The revision of Ethiopia’s EHSP has been undertaken in the context of the national health
policy as well as by drawing from other policy documents that are relevant to the health sector
considering the country’s income level and its global commitment (e.g. SDG). The revised
EHSP also attempts to respond to the health needs of Ethiopia’s population across the life
course and across all levels of services delivery. The revised EHSP is meant to be delivered for
the next five years (i.e. 2020–2025), with subsequent regular updates. Therefore, the revised
EHSP shall be part of Ethiopia’s national development programme and its health sector’s long-
term strategic plans.
The EHSP outlines the types of services to be delivered within the framework of the existing
health care delivery system of Ethiopia. The EHSP should be available to all Ethiopians
irrespective of income, gender and place of residence. The promotive, preventive, curative and
rehabilitative interventions included in the EHSP are considered the minimum that people can
expect to receive through the various health care delivery mechanisms and facilities within
their reach.
16
Chapter 3: Development process of the EHSP
The methods for designing health benefit packages vary from country to country. Ethiopia’s
EHSP was developed through a participatory approach, with frequent appraisal and feedback
before decision-making. A roadmap document that guided and informed the overall process
and each step of the revision process was prepared, presented to the FMOH management and
approved. A technical working group, composed of 30 senior experts on various health system
dimensions and thematic areas was established. Several consultative technical workshops were
convened to define the scope of the revision, develop a complete list of health interventions,
develop prioritisation criteria, gather evidence and compare and rank health interventions
according to a range of criteria. This section provides a brief summary of the steps followed
during the revision of EHSP.
3.1 Defining the scope of the EHSP revision

Setting up an explicit national health benefits package has contributed to the improvement of
health outcomes in many countries. A national health services package is redefined by
following several steps, including, most importantly, frequent discussions and engagement of
a variety of stakeholders. Stakeholders were involved from the beginning of the EHSP revision
process. Therefore, inception meetings were held from June to August 2019 to launch the
EHSP revision work. The aim of these inception meetings was to define the end goals and
scope of the revised EHSP and to achieve a common understanding across all stakeholders for
the revision process. As a result, a detailed EHSP preparation plan was presented at these
inception meetings and an agreement was reached with stakeholders about the goals and scope
of the EHSP (see Chapter 2).
3.2 Selecting the EHSP interventions

Uptake of the EHSP will depend not only on the type and quality of evidence used for defining
the package but also on how transparent and deliberative the revision process is. Here, we
briefly present the conceptual framework and analytical steps applied to define Ethiopia’s
EHSP (i.e. identifying and selecting a comprehensive list of health services). Hence, the
following key steps were applied: identification of all relevant health interventions, selection
of the prioritisation criteria, evidence synthesis, calculation of the ‘priority scores’ and ranking
of interventions.
17
3.2.1 Identification of all relevant health services
Preparation of a complete list of health interventions is a key step in the EHSP revision process.
As much as possible, all promotive, preventive, curative and rehabilitative interventions
relevant for low- and middle-income countries were considered in a primary list of
interventions, including but not limited to communicable diseases, maternal health, child
health, NCDs, injures, surgery and neglected tropical diseases (NTDs). In addition, other
system-wide interventions, such as health education and communications, laws and
regulations, were considered.
An exhaustive search of the Ethiopian health sector’s plans, strategies and national
publications, along with the WHO data repository [1], WHO-CHOICE [19] database, Disease
Control Priorities 3rd edition (DCP3, www.dcp-3.org) and Tufts Global Health Cost-
Effectiveness Analysis Registry (Tuft-registry,
http://healtheconomics.tuftsmedicalcenter.org/orchard) was conducted. Furthermore, a two-
day workshop focusing on selecting the interventions eligible for inclusion into the EHSP was
conducted with about 80 experts from different programmatic areas, primary health care
practitioners, doctors and specialists to identify all the health services relevant to the Ethiopian
context. Therefore, in the first ‘universal list’ of interventions, a total of 1749 relevant
interventions were included. This initial list was further cleaned to avoid duplication and
merged to provide a total of 1442 interventions.
3.2.2 Setting prioritisation criteria and evidence synthesis
General and specific criteria for the prioritisation of health services drew from Ethiopia’s core
values [16] and built on the recommendations from the WHO’s Consultative Group on Equity
and Universal Health Coverage [20], consistent with important scholarly works [21,22].
Notably, these criteria encompassed maximising the total health gains for a given investment,
giving priority to health services that target or benefit the worse-off and providing FRP
particularly to the poor [20,23]. Such a prioritisation approach is broadly based on three
elements: data, dialogue and decision. Seven prioritisation criteria were selected based on the
review of the national health policy, the review of relevant strategic documents of the health
sector and several rounds of consultations with global and local experts, public representatives
and professional associations.
18
The application of these criteria varied according to the availability of current evidence and the
characteristics of the specific criteria. BoD was used to identify the relevant conditions and risk
factors of particular importance in the Ethiopian context. The cost-effectiveness criterion was
used to quantitatively rank and compare health interventions according to how much health
gains they would yield per Birr spent. The equity and FRP criteria were used to further compare
health interventions, give higher values to health benefits for the worse-off and provide
protection against catastrophic out-of-pocket (OOP) health expenditures – expenditures
surpassing a certain threshold of consumption expenditures. Budget impact, public
acceptability and political acceptability were also taken into account through the qualitative
deliberative process and through a dialogue with policymakers. A brief description of each
criterion is presented below.
Criterion 1: Burden of disease
The BoD is the size of a health problem (or underlying risk factor) as measured by mortality,
morbidity or a combination of the two. In a low-income country, such as Ethiopia, BoD can be
quantified in terms of summary measures such as disability-adjusted life years (DALYs), which
aggregate both mortality and morbidity outcomes. By design, DALYs account for age at death,
disability and prevalence of the disease. Therefore, all diseases and conditions were ranked and
compared based on DALYs. Using the recent BoD estimates for Ethiopia (year 2017), all high
BoD, conditions and risk factors were listed and their corresponding health interventions were
then solicited from the comprehensive list of health interventions available. In addition, the
targeted health interventions were matched with the actual country-level BoD. Data sources
included HMIS and the Global Burden of Disease Study 2016 data
(http://www.healthdata.org/gbd).
Different directorates of the FMH then commented on the intervention list, and further linkage
with BoD and cleaning was done for 1442 interventions. Removing the interventions that were
unmatched with BoD, the number of interventions was then reduced to 1223. Finally, the health
interventions were regrouped and reorganised, yielding 1001 interventions ready for evaluation
and comparison based on the other criteria.
Criterion 2: Cost-effectiveness
Economic resources are finite while population health demands are vast. Therefore, resource
allocation is a central part of the decision-making process in any health care system. Ethiopia
19
is a highly resource-constrained country. Hence, comparison of the costs of including
additional health interventions with the health benefits they can provide is central to decision-
making. Cost-effectiveness analysis (CEA) is a form of economic analysis that compares the
relative costs and health outcomes of different courses of action with the implementation of
specific health interventions [22]. The cost-effectiveness of an intervention can be expressed
as an incremental cost-effectiveness ratio (ICER) – the ratio of the difference in intervention
incremental cost to the difference in its incremental health effects [24].
Because of continuous increases in costs and budget constraints in many countries, cost-
effectiveness has become an important guiding principle in priority setting. Some health
economists and ethicists proposed the ‘cost-effectiveness’ criterion as an important criterion
because the opportunity costs of ignoring this criterion – in terms of health benefits forgone –
could be potentially high [22]. In the EHSP revision, WHO’s generalised cost-effectiveness
analysis (GCEA) – a form of CEA for comparing interventions with a ‘doing-nothing’ scenario
– was applied [25].
In this EHSP revision, cost-effectiveness evidence was extracted using both WHO-CHOICE’s
One Health Tool (OHT) and a review of the published literature. For about 190 interventions,
GCEA average cost-effectiveness ratios (ACER) were generated by the OHT based on local
input data. For about 600 interventions, CEA evidence from the literature was used after
applying appropriate contextualisation to the Ethiopian context using general transferability
criteria based on the Consolidated Health Economic Evaluation Reporting Standards
(CHEERS) 10 points checklist [26,27]. Reviewers appraised studies, and the studies considered
to meet a minimum standard of quality and the transferability criteria were accepted for
inclusion in the evidence base. In addition, for cost information from other settings, the
currency difference was adjusted for the appropriate exchange rate. All unit cost information
was inflated to USD 2019 using GDP deflator.
For CEA, the provider perspective was adopted; the currency year was USD 2019. All costs
were discounted at 3% per year. Healthy life years (HLY) gained, DALYs averted or quality-
adjusted life years (QALYs) gained were used as the main health outcome measures and were
discounted at 3% per year.
Criteria 3: Equity
20
Equity arises from the policy commitment of the government and local social values to create
a fair and just society and a pro-poor health system in Ethiopia. The equity criterion was applied
in a way that would give higher priority to health gains from interventions targeting the
diseases, conditions and risk factors that mainly affect the worse-off.
The ‘worse-off conditions’ in the Ethiopian context are defined as the conditions and diseases
concerning children less than five years of age, pregnant women, the economically poor and
the populations who live in remote areas. This typically includes childhood diseases,
complications around birth, NTDs (e.g. leishmaniosis, schistosomiasis, lymphatic filariasis and
podoconiosis), malaria and TB. Therefore, health interventions targeting these groups were
scored high.
Using a Delphi technique, a panel of experts was surveyed to give a score (from 1 to 5) to a
range of interventions, where 5 indicated interventions targeting the worse-off and 1 indicated
interventions without a particular equity impact. Therefore, in addition to cost-effectiveness,
health interventions were compared based on their equity score and assigned higher priority if
they benefitted the worse-off.
Certain health services had a social value that was not appropriately captured in a cost per
DALY framework; these included palliative care, family planning, in-vitro fertilisation (IVF),
legal abortion and some diagnostic procedures (where health information by itself may have
value). Hence, there may be additional ethical reasons why these may require a special
consideration of higher priority.
Criterion 4: Financial risk protection (FRP)
FRP is defined as households’ ability to receive health services without financial hardship.
Large OOP medical payments owing to illness can cause financial hardships in Ethiopia [28].
Health services that incur large OOP expenditures to patients and households could be given
high FRP weights and considered as priority interventions.
A simple analytical framework for valuing FRP in the context of revising Ethiopia’s EHSP was
similarly applied using the Delphi method. Using the Delphi method, a panel of experts gave
a score of 1 to 5 to the interventions, where 5 indicated interventions providing high FRP to
the individuals seeking the interventions or their families while 1 indicated interventions which
could only provide minimal FRP.
21
Criterion 5: Budget impact
The cost of implementation and scale-up of health services can severely impact the health
sector budget. For some interventions, cost-effectiveness might be low but the actual delivery
of the intervention to the targeted population might have substantial budget implications.
Therefore, in addition to cost-effectiveness, each intervention and/or group of interventions
was assessed in terms of the implied cost incurred via their actual implementation and scale-
up. Interventions with a high budget impact may need strong additional justification to be
included in the EHSP. Therefore, among cost-effective, equitable and FRP-enhancing
interventions, the EHSP revision core-team conducted a budget impact analysis. Together with
the FMOH management committee, the team examined the budget impact of each intervention
and proposed the interventions to be included and those to be on the waiting list.
Criteria 6: Public acceptability
The voice of the public has been directly accounted for in the revision process as well as in the
critiques and deliberation on the final list of the health interventions to be included in the EHSP.
The voice of the public has been further included through a series of meetings and workshops.
Groups from the public that have been represented include public representatives, professional
associations, patient organisations and patient unions. Furthermore, the public has been
engaged through mass media.
Criterion 7: Political acceptability
Priority setting is a highly political process because it involves an agreement between the
government and citizens to determine the type and mix of health services to be delivered.
Therefore, the politically designated body in the country must approve and ratify the final
EHSP. In the revision of EHSP, the Ministry of Health is delegated to be the main body
responsible for developing the EHSP and therefore, the FMOH management committee has
given the authority to make the final decision on both individual interventions and the overall
package document.
3.2.3 Compute ‘priority score’ and ranking of interventions
To compute the ‘priority score’ for a given intervention, the cost-effectiveness ratio was
adjusted with the equity and FRP weights by assigning a relative value of DALYs averted
22
based on the scores assigned through the Delphi method described above. The overall weights
were equal for equity and FRP: the equity and FRP scores ranged from 1 (lowest) to 5 (highest).
Therefore, all interventions were ranked in descending order based on their priority score, and
the most cost-effective, equitable and financially protective health interventions were extracted
and included into the EHSP to maximise health gains along with equity and FRP benefits per
budget expenditure, consistent with extended cost-effectiveness analysis (ECEA) [29].
3.3 Estimation of costs and fiscal space analysis

In comparing the health interventions, trade-offs between what is affordable and what is ideal
challenge the Ethiopian government’s current financial and technical capacities. The gap
between aspirational targets and actual available financial and physical resources is a limiting
factor for the implementation of quality essential benefits packages in many countries. The set
of services to be made available will likely be determined by the available funds. Therefore,
conducting a costing exercise for the entire EHSP and per health intervention, in particular, is
an important step. The costing and fiscal space analysis includes scenario analysis to provide
information for the final decision of the package. The interventions that should be included in
the EHSP were revised/updated based on the cost estimation and fiscal space analysis.
Costing of the EHSP

Costing of the Ethiopian EHSP was computed using the OHT [30]. OHT is a costing tool that
allows users to create a plan for scaling up the EHSP at a national and sub-national level. The
OHT was used to compute the resource requirements for implementing the interventions
included in the EHSP. A bottom-up costing approach was applied. The BoD, clinical guidelines
and practices, service provision modalities and current and target coverages by 2030 were used
as input for the estimation of the costs year by year. In addition, the required resources for
infrastructure, health resources for health (i.e. training, deploying and retaining health
workers), availing medicines and supplies and health system management (i.e. including
equipment, logistics, health information, health care financing and governance) were
accounted for in the health systems’ costing.
The OHT default data on the cost of drugs and supplies and the default population model for
Ethiopia were used. The tool also provided many other default assumptions on personnel time
needed, number of drugs needed, etc. In addition, we used expert judgments when other sources
23
of data were not available. Unit costs from appendices to DCP-3 publications were also applied
[31].
The number of interventions the health system needs to provide, and thus the budget impact,
depends on both the number of individuals in need and the intervention coverage. The
population in need was estimated from the total number of individuals affected by the condition
and the proportion of those who needed the appropriate intervention. We used estimates of
prevalence and incidence data from national level estimates (DHS, GBD, etc.) [1,11].
Fiscal space analysis

A fiscal space analysis for the years 2020–2030 for the EHSP was conducted to predict the
expected available resources. In the fiscal space, all potential sources of resources for health
were explored by comparing the estimated resource needs with projections of the resources
available. The fiscal space analysis was performed based on the current proposed reforms to
the health financing structure and discussions on innovative funding options/sources with the
Ministry of Finance and Economics Cooperation (MOFEC).
A conceptual framework developed by the World Bank for fiscal space analysis was used in
this study. The five key dimensions were explored to assess the potential to increase fiscal
space for health.
1. Macroeconomy: how will macroeconomic conditions affect resource levels for health?
Including external debt return.
2. Re-prioritisation of the health sector: how much fiscal space could be generated by
increasing the health sector’s share of the government budget?
3. Health sector-specific resources: can additional taxes and other revenue sources be
implemented and earmarked for health? ‘Innovative’ health financing strategies?
4. Foreign aid: how will future foreign aid flows affect the resource envelope for health?
5. Efficiency gains: can the fiscal space for health be increased through more efficient use
of current and future financial resources?
In addition, future fiscal space analysis should attempt to explore the potential source of the
resource that can be availed from other sectors for health via the Ministry of Health’s
engagement of other sectors using a multi-sectoral approach.
3.4 Deliberation process
24
The design of the EHSP should be participatory and include all relevant stakeholders [32-34].
The revision of Ethiopia’s EHSP has followed a participatory deliberation process involving
numerous and various stakeholders. A roadmap that has been approved by the management of
the FMOH was developed by a team of experts, and technical inputs on the roadmap were
received from various organisations including WHO and other international and national
experts. The roadmap was then presented to the management committee of the FMOH and
endorsed. The core team and technical work group (TWG) were established to provide overall
technical guidance in the revision process. The TWG members were tasked with providing
overall technical guidance in the revision process. TWG workshops and a series of consensus
building meetings were conducted to discuss the concept of EHSP, roadmap for the revision,
scope, criteria and methodological approach. The full list of interventions to be considered for
Ethiopia’s EHSP was prepared by organising consultative workshops: first a TWG workshop
and then a technical consultative workshop. A complete/long list of interventions was first
prepared by the TWG members by collecting evidences from national guidelines and
documents (e.g. 2005 EHSP of Ethiopia, various guideline and manuals) and international
documents (e.g. DCP3 list of interventions; Tufts University CEA registry; WHO’s CHOICE).
After a long list of interventions was prepared, the data were cleaned and shared with the
relevant directorates of the FMOH for further comments, inputs and feedback. To further
collect feedback and review the long list of interventions, a workshop was conducted with
selected high-level experts. This provided the opportunity to further refine and validate the list.
A consultative workshop was conducted with public representatives and professional
associations to receive feedback and inputs on the criteria to be used for enlisting interventions
in the EHSP of Ethiopia.
The draft of the EHSP was prepared through a collaborative and participatory approach by
involving a number of key experts. The contents of the package were shared with key experts
for further inputs. Subject-matter experts contributed and provided technical inputs and
resources. In collaboration with WHO headquarters, a four-day cost-effectiveness workshop
(28–31 January, 2019) was conducted to help the national experts use the WHO-CHOICE cost-
effectiveness tool; WHO CHOICE tool in priority setting and decision-making; and critical
appraisal and contextualisation processes for existing cost-effectiveness studies. A consultative
workshop was conducted to deliberate on the FRP and equity criteria.
25
Different methods of communication with stakeholders to cross-check and validate the process
as well as the EHSP outputs were applied. Means to ensure maximum public participation,
address political concerns and ensure commitment of the government were considered. In the
deliberation process, mechanisms were designed to synchronise the EHSP with the national
health insurance package and address concerns from private health care providers, disease-
specific interest groups, professional associations, patients and providers’ unions. Intensive
deliberation meetings were held with RHBs’ EHSP teams from 23 to 25 May, 2019 with an
objective of defining the levels of delivery, payment mechanism, implantation strategies and
monitoring and evaluation plans.
26
Chapter 4: Components of the EHSP
The major components of the EHSP of Ethiopia are classified according to the BoD of Ethiopia.
Interventions chosen to address the major causes of death, risk factors and diseases are detailed for key
health services sub-components falling under each major component. The major components of the EHSP
of Ethiopia are organised into the following nine components:
1) Reproductive, maternal, neonatal, child and adolescent health services
2) Major communicable diseases
3) NCDs
4) Surgical care
5) Emergency and critical care
6) NTDs
7) Hygiene and environmental health services
8) Health education and behaviour change communication services
9) Multi-sectoral interventions
The draft interventions were discussed and the feedback was solicited, analysed and incorporated.
Members of the public wing and associations and relevant stakeholders participated in the series of
consultations. The full list of interventions is attached in Annex I.
4.1 Reproductive, maternal, neonatal, child health and nutrition interventions

In this sub-section, 337 essential promotive, preventive, curative and rehabilitative sexual and
reproductive health, maternal health, neonatal health, child health and adolescent health services are
presented, along with their assessed priority rankings. Among these, 133 interventions are essential
nutrition health services for all age cohorts.
Table 8: High, medium and low priority essential RMNCH and nutrition interventions in Ethiopia
IC Sub-program Essential RMNCH and nutrition interventions Priority
1 Family Planning Outreach Family planning services Medium
2 Family Planning Counselling on family planning High
3 Family Planning Provision of male condoms High
4 Family Planning Provision of female condoms High
5 Family Planning Provision of oral contraceptive High
6 Family Planning Provision of injectable contraceptives High
7 Family Planning Provision of emergency contraception Medium
8 Family Planning Provision of implants High
9 Family Planning Provision of intrauterine devices (IUD) High
10 Family Planning Female sterilization service Medium
11 Family Planning Male sterilization service Medium
27
12 Family Planning Provision of monthly vaginal ring or patch low
13 Family Planning Diaphragm Low
14 Family Planning Lactational amenorrhea Low
15 Family Planning Provision of post-partum family planning High
16 Infertility management Identification and management of infertility High
17 Infertility management Psycho social counselling for individuals and couples medium
18 Comprehensive abortion Safe abortion services: MVA and D&C High
care
19 Comprehensive abortion Safe abortion services: Medical abortion High
care
20 Comprehensive abortion Post abortion case management (management of unsafe High
care abortion complications including E&C, sepsis management,
etc.)
21 Comprehensive abortion Post abortion follow up Medium
care
22 Comprehensive abortion Ectopic pregnancy case management high
care
23 Prevention and treatment of Education on menstrual hygiene and cycle Medium
gynaecological problem
24 Prevention and treatment of Treatment of menstrual problems and irregularities High
25 Prevention and treatment of Cervical cancer screening High
26 Prevention and treatment of Clinical breast examination (Screening) Medium
27 Prevention and treatment of Diagnosis and treatment of syphilis High
28 Prevention and treatment of Diagnosis and treatment of gonorrhoea High
29 Prevention and treatment of Diagnosis and treatment of chlamydia Low
30 Prevention and treatment of Diagnosis and treatment of trichomonas’s Low
31 Prevention and treatment of Diagnosis and treatment of Pelvic inflammatory disease (PID) High
32 Prevention and treatment of Diagnosis and treatment of Urinary tract infection (UTI) High
33 Prevention and treatment of Provision of HPV vaccine High
34 Sexual health issues Comprehensive sexual health education Low
35 Sexual health issues Adolescent sexual and reproductive health Low
36 Sexual health issues Age appropriate comprehensive sex education Low
37 Sexual health issues Provide adolescent friendly contraceptive services, scaling up High
modern contraception
38 Sexual health issues Expand access to and promotion of the use of condoms and High
other contraceptives, behavioural intervention to reduce the
incidence of HIV transmission
39 Gender based violence Comprehensive health education about GBV High
40 Gender based violence Conduct community dialogue about GBV High
41 Gender based violence Investigation, diagnosis, and reporting of GBV Low
42 Gender based violence Pregnancy test (HCG) for GBV High
28
43 Gender based violence HTC at least 3 times (initial 6 weeks and 6 months) Medium
44 Gender based violence Emergency treatment of life-threatening conditions due to GBV High
45 Gender based violence Surgical treatment for physical trauma Medium
46 Gender based violence Treatment for burn due to GBV Medium
47 Gender based violence Medical treatment for infection due to GBV Medium
48 Gender based violence Treatment of trauma due to GBV High
49 Gender based violence Tetanus anti-toxoids High
50 Gender based violence Hepatitis B vaccination for GBV victims Medium
51 Gender based violence Comprehensive abortion care for GBV victims High
52 Gender based violence Provision of psychiatric treatment for GBV victims Medium
53 Gender based violence Provision of psychosocial support for GBV victims, Hospital High
intervention to reduce injury recidivism
54 Gender based violence Post exposure prophylaxis for HIV for rape victims Low
55 Harmful traditional practice Health education and community advocacy against HTP High
(HTP)
56 Harmful traditional practice Family planning for child marriage High
(HTP)
57 Harmful traditional practice Special care for teen pregnancy High
(HTP)
58 Harmful traditional practice Psychiatric treatment for abduction Medium
(HTP)
59 Harmful traditional practice Counselling and management of female genital mutilation Medium
(HTP) victims
60 Harmful traditional practice Infibulation and surgical correction for female genital Medium
(HTP) mutilation victims
61 Prenatal care Folic acid supplementation/fortification Medium
62 Antenatal care Comprehensive health education about early ANC, skilled High
delivery, postpartum care, family planning, nutrition, maternal
waiting services
63 Antenatal care Focused ANC follow up High
64 Antenatal care Antenatal corticosteroids for preterm labour High
65 Antenatal care Foetal growth restriction detection and management Low
66 Antenatal care Gestational diabetes case management High
67 Antenatal care Antibiotics for prom High
68 Antenatal care Management of pre-eclampsia (antihypertensive, induction of High
labour, ultrasound to asses foetal growth)
69 Antenatal care Management of eclampsia (MgSO4) High
70 Antenatal care Hypertensive disorder case management High
71 Skilled delivery care Labour and Delivery Management High
72 Skilled delivery care Induction of labour for pregnancies lasting 41+ weeks High
73 Skilled delivery care Active management of the third stage of labour High
74 Skilled delivery care BEmONC High
75 Skilled delivery care CEmONC High
76 Skilled delivery care Pre-referral management of labour complications High
77 Postnatal care Maternal sepsis case management High
78 Postnatal care Clean postnatal practices High
79 Postnatal care Mastitis management Medium
80 Postnatal care Treatment of postpartum haemorrhage High
81 Postnatal care Chlorhexidine High
82 New-born care Comprehensive new born care Medium
29
83 New-born care Detection of congenital anomalies (cleft lip, palate, imperforate High
anus, club foot, meningeal, spina bifida, dysmorphism,
microcephaly)
84 New-born care Screening for congenital hypothyroidism and management Low
85 New-born care Screening for congenital heart diseases and management High
86 New-born care Parental chromosomal screening: amniocentesis (antenatal) for Low
chromosomal screening
87 New-born care Screening for retinoblastoma Low
88 New-born care Kangaroo mother care High
89 New-born care Voluntary new-born male surgical circumcision High
90 New-born care Early infant diagnosis for HIV (DBS) High
91 Intensive neonatal care Essential new born care High
(specialized neonatal care)
92 Intensive neonatal care Identification and treatment of new-born sepsis High
93 Intensive neonatal care Prevention of neonatal infections Low
94 Intensive neonatal care Premature sick new-born care: incubator and nutritional High
95 Intensive neonatal care Phototherapy and exchange transfusion Low
96 Intensive neonatal care Prolonged intravenous antibiotics for sever neonatal infection Low
97 Intensive neonatal care Treatment of birth trauma Medium
98 Intensive neonatal care Management of perinatal asphyxia High
99 Intensive neonatal care Management of thermoregulation: radiant warmer therapy High
100 Intensive neonatal care Nutrition: breastfeeding and feeding other than breast milk High
101 Intensive neonatal care Management of neonatal tetanus High
102 Intensive neonatal care Management of NEC High
103 Intensive neonatal care Management of neonatal jaundice Low
104 Intensive neonatal care Management of metabolic disorder Low
105 Intensive neonatal care Management of meconium aspiration syndrome High
106 Intensive neonatal care Management of neonatal seizure High
107 Intensive neonatal care Management of neonatal hematologic problems Medium
108 Intensive neonatal care Management of birth trauma High
109 Intensive neonatal care Management of fluid and electronic imbalance High
110 Intensive neonatal care Management of shock in neonates Low
30
111 Intensive neonatal care Parenteral feeding for premature babies High
112 Intensive neonatal care Management of neonatal acute emergency surgical conditions High
113 Intensive neonatal care Prevention of respiratory distress syndrome in neonates using High
(specialized neonatal care) surfactants
114 Intensive neonatal care Management of neonatal respiratory distress with continuous Low
(specialized neonatal care) positive airway pressure (CPAP)
115 Intensive neonatal care Early developmental stimulation Medium
116 Immunization and Promotion and counselling on immunization High
vaccinations
117 Immunization and Provision of HBV: at birth High
vaccinations
118 Immunization and Provision of BCG: at birth High
vaccinations
119 Immunization and Provision of OPV: at birth, 6, 10, 14 weeks High
vaccinations
120 Immunization and Provision of PCV: at 6, 10, 14 weeks High
vaccinations
121 Immunization and Provision of Rota Virus Vaccine: at 6 and 10 week High
vaccinations
122 Immunization and Provision of HepB: at Birth High
vaccinations
123 Immunization and Provision of DPT-HepB-Hib (Pentavalent): at 6, 10, 14 weeks high
vaccinations
124 Immunization and Provision of 1st dose of measles vaccine at 9 month High
vaccinations
125 Immunization and Provision of 2nd dose of measles vaccine: at 15-18 months or High
vaccinations first contact after 15 months
126 Immunization and Provision of Tetanus Toxoid (TT) Vaccine High
vaccinations
127 Immunization and Provision of 1st doses of IPV High
vaccinations
128 Child health: iCCM Integrated community case management of New-born & High
childhood illness (iCCM)
129 Child health: IMNCI Vitamin A for treatment of measles High
130 Child health: IMNCI Treatment of severe measles High
131 Child health: IMNCI Vitamin A Supplementation for treatment of xerophthalmia High
132 Child health: IMNCI ORS - oral rehydration solution High
133 Child health: IMNCI Treatment of severe diarrhoea (children) high
134 Child health: IMNCI Antibiotics for treatment of dysentery High
135 Child health: IMNCI Zinc for treatment of diarrhoea High
136 Child health: IMNCI Oral antibiotics for pneumonia High
137 Child health: IMNCI Treatment of severe pneumonia High
138 Child health: IMNCI ACTs - Artemisinin compounds for treatment of malaria High
139 Child health: IMNCI Treatment of severe malaria High
140 Child health: IMNCI SAM - treatment for severe acute malnutrition High
141 Child health: IMNCI MAM - treatment for moderate acute malnutrition High
142 Child health: Deworming Deworming every 6 months High
143 Vitamin A supplementation Provision of Vitamin A every 6 months High
31
144 Child health: curative care Paediatric HIV point-of-care CD4 testing strategy High
145 Child health: curative care Paediatric Palliative care Medium
146 Child health: curative care Paediatric end of life care & support Medium
147 Child health: curative care Management of Pharyngitis/Tonsillitis/Sinusitis Medium
148 Child health: curative care Management of eye infections: trachoma, High
149 Child health: curative care Management of ear infections: Otitis media High
150 Child health: curative care Management of Croup Syndrome (laryngitis, trachealis, Low
epiglottitis)
151 Child health: curative care Management of paediatric asthma Low
152 Child health: curative care Management of paediatrics bronchiolitis Medium
153 Child health: curative care Management of aspiration syndrome: foreign body, near Medium
drowning
154 Child health: curative care Management of Congenital Heart Diseases in paediatrics Low
155 Child health: curative care Management of infective endocarditis (Antibiotics) High
156 Child health: curative care Management of rheumatic fever/ Rheumatic heart diseases High
157 Child health: curative care Management of congestive heart failure Medium
158 Child health: curative care Management of shock in paediatrics High
159 Child health: curative care Management of Hypertension in paediatrics low
160 Child health: curative care Management of Hepatitis/Jaundice in paediatrics Low
161 Child health: curative care Management of Liver failure in paediatrics Low
162 Child health: curative care Management of ascites, Insertion of Trans jugular Intrahepatic Low
Portosystemic Shunts
163 Child health: curative care Management of malabsorption Low
164 Child health: curative care Management of gastro intestinal bleeding Low
165 Child health: curative care Management of acute abdomen High
166 Child health: curative care Management of Haemolytic-Uremic Syndrome Low
167 Child health: curative care Management of Nephritis Low
168 Child health: curative care Management of Nephrotic syndrome Low
169 Child health: curative care Management of Renal Failure Low
170 Child health: curative care Management of Urinary Tract Infections (Lower) with High
antibiotics
171 Child health: curative care Management of Pyelonephritis Medium
172 Child health: curative care Management of Wilms’ Tumour (Nephroblastoma) Medium
173 Child health: curative care Management of Ambiguous Genitalia Low
174 Child health: curative care Management of Pyomyositis Low
175 Child health: curative care Management of Septic arthritis Medium
176 Child health: curative care Management of Osteomyelitis Medium
177 Child health: curative care Management of juvenile rheumatoid arthritis Low
178 Child health: curative care Management of Impetigo Low
179 Child health: curative care Management of Dermatitis/Eczema High
180 Child health: curative care Management of Scabies High
181 Child health: curative care Management of Fungal skin infections (ringworms) Medium
182 Child health: curative care Management of Meningitis high
183 Child health: curative care Management of Encephalitis Medium
184 Child health: curative care Management of Seizure disorders High
185 Child health: curative care Management of Cerebral palsy Medium
186 Child health: curative care Management of raised intracranial pressure Medium
187 Child health: curative care Coma Management High
188 Child health: curative care Management of Poisoning High
189 Child health: curative care Management of Diabetes Mellitus High
32
190 Child health: curative care Management of Hypothyroidism Low
191 Child health: curative care Management of Hyperthyroidism Low
192 Child health: curative care Management of Anaemia medium
193 Child health: curative care Management of Septicaemia Medium
194 Child health: curative care Management of Haemophilia Low
195 Child health: curative care Management of Idiopathic Thrombocytopenic Purpura (ITP) Low
196 Child health: curative care Management of Leukaemia Medium
197 Child health: curative care Management of Lymphoma Low
198 Child health: curative care Prevention and management of Child Abuse Low
199 Child health: curative care Paediatric social services Low
200 Child health: curative care Management of Chromosomal anomalies in paediatrics Low
201 Child health: curative care Management of Down’s Syndrome in paediatrics Low
202 Child health: curative care Management of Edward’s Syndrome in paediatrics Low
203 Child health: curative care Management of autism Low
204 Nutrition: Pregnant women Promote one extra meal and rest during pregnancy, multiple High
micronutrient supplementation for pregnant women
205 Nutrition: Pregnant women Promote on healthy eating, diversified meal Low
206 Nutrition: Pregnant women Promote ITN use for malaria endemic areas High
207 Nutrition: Pregnant women Promote early initiation ( colostrum feeding) and exclusive High
breast feeding
208 Nutrition: Pregnant women Nutritional screening and weight gain monitoring during High
pregnancy
209 Nutrition: Pregnant women Link pregnancy mothers to supplementary feeding program High
(Productive Safety Net Program (PSNP) and other programs)
210 Nutrition: Pregnant women Treat malnourished pregnant mothers with therapeutic foods Medium
211 Nutrition: Pregnant women Iron-folic acid supplementation High
212 Nutrition: Pregnant women De-worming during pregnancy (2nd trimester) High
213 Nutrition: Pregnant women Promote family members (husband, grandparents and other High
HH members) involvement to provide nutritional care for
pregnancy women
214 Nutrition: Pregnant women Behaviour change communication on maternal nutrition ( High
215 Nutrition: Pregnant women Promote use of iodized salt High
216 Nutrition: Pregnant women Promote use of fortified foods High
217 Nutrition: Pregnant women Promote personal hygiene, environmental sanitation and Medium
infection prevention measures
218 Nutrition: Pregnant women Provide outreach nutrition services High
219 Nutrition: Pregnant women Promote use of time and labour saving technologies High
220 Nutrition: Pregnant women Promote use of reproductive health services after delivery High
221 Nutrition: Pregnant women Promote gender equity and economic empowerment High
222 Nutrition: Pregnant women Calcium supplementation for prevention and treatment of pre- Medium
eclampsia and eclampsia
223 Nutrition: Pregnant women Nutritional care and support for HIV+ pregnant women Medium
224 Nutrition: Pregnant women Anaemia diagnosis and treatment High
225 Nutrition: Pregnant women Counsel on two extra meals and rest during lactation High
226 Nutrition: Pregnant women Counsel on optimal breast feeding practices on, proper High
positioning and attachment, exclusive breast feeding and
feeding on demand)
227 Nutrition: Pregnant women Promote healthy eating, diversified diet during lactation, medium
universal strategy of brief dietary intervention for primary
prevention in primary care
33
228 Nutrition: Pregnant women Nutritional screening and counselling during lactation High
229 Nutrition: Pregnant women Counsel on exposing infants to sun light High
230 Nutrition: Breastfeeding Promote continued use of iron folate (to complete 90 tabs) High
mothers
231 Nutrition: Breastfeeding Measure birth weight, length and head circumference in the High
mothers first 1 hour
232 Nutrition: Breastfeeding Link Breastfeeding mothers to supplementary feeding program High
mothers (PSNP and other programs)
233 Nutrition: Breastfeeding Treat malnourished Breastfeeding mothers with therapeutic High
mothers foods
234 Nutrition: Breastfeeding Promote family members (husband, grandparents and other High
mothers HH members) involvement to provide nutritional care for
Breastfeeding women
235 Nutrition: Breastfeeding Promote shift in food taboos using religious leaders and High
mothers influential community members
236 Nutrition: Breastfeeding Promote access to reproductive health services High
mothers
237 Nutrition: Breastfeeding Strengthen women economic control and equitable decision High
mothers making role to improve nutrition
238 Nutrition: Breastfeeding Nutritional care and support (HIV+ pregnant and Breastfeeding Low
mothers women), nutrition intervention with oxandrolone
239 Nutrition: Non-pregnant and Promote adequate intake of diversified food High
non-Breastfeeding women
240 Nutrition: Non-pregnant and Nutritional care and support for HIV+ women Medium
non-Breastfeeding women
241 Nutrition: New-born and Early initiation of breast feeding within one hour High
infants (0-5 months)
242 Nutrition: New-born and Feeding of colostrum High
243 Nutrition: New-born and Avoidance of pre-lacteal feeding High
244 Nutrition: New-born and Promote exclusive breast feeding up to 6 months (Breast High
infants (0-5 months) feeding on demand and day and night and empty one breast at
a time)
245 Nutrition: New-born and Demonstrate proper positioning and attachment High
246 Nutrition: New-born and Promote appropriate feeding options for infants born to HIV High
infants (0-5 months) infected mothers
247 Nutrition: New-born and Promote Kangaroo mother care for pre-term and LBW infants High
248 Nutrition: New-born and Monthly growth monitoring and promotion (measure weight High
infants (0-5 months) and age, record, interpret and counsel accordingly)
249 Nutrition: New-born and Continued breast feeding during illness and recovery High
250 Nutrition: New-born and Zinc and ORS for diarrheal treatment High
251 Nutrition: New-born and Early detection and management of acute malnutrition High
252 Nutrition: New-born and Establish BFHF Initiative in all public and private health facilities High
34
253 Nutrition: New-born and Enforce international code of marketing for breast milk High
infants (0-5 months) substitutes
254 Nutrition: New-born and Promote enactment of maternity leave according to High
infants (0-5 months) international labour organization convention No. 183
255 Nutrition: New-born and Promote designated breast feeding rooms in all service High
infants (0-5 months) providing institutions
256 Nutrition: New-born and Support breast feeding working mothers to breast feed until 6 High
infants (0-5 months) months
257 Nutrition: New-born and Provide age appropriate immunization services High
258 Nutrition: Infant and young Nutrition screening and counselling in health facility and High
child nutrition (6-23) community
259 Nutrition: Infant and young Counsel on optimal complementary feeding practices (age High
child nutrition (6-23) appropriate amount, frequency and diversity of feeding,
responsive feeding)
260 Nutrition: Infant and young Timely initiation of complementary feeding at 6 months High
child nutrition (6-23)
261 Nutrition: Infant and young Continued breast feeding until 24 months and beyond High
262 Nutrition: Infant and young Promote feeding of sick child during illness and recovery High
263 Nutrition: Infant and young Zinc and ORS for diarrheal treatment High
264 Nutrition: Infant and young Vitamin A complementation biannually High
265 Nutrition: Infant and young Zinc supplementation Medium
266 Nutrition: Infant and young Detect and manage Acute Malnutrition High
267 Nutrition: Infant and young Link malnourished children to supplementary food support High
child nutrition (6-23) (B/TSFP, PSNP,
268 Nutrition: Infant and young Promote micronutrient powder in areas where iron deficiency High
child nutrition (6-23) is > 20%
269 Nutrition: Infant and young Promote enforcement of minimum standard nutritional High
child nutrition (6-23) services for young children in special situations (refugee
camps, orphanage, day care centres, PSNP public work sites
etc.)
270 Nutrition: Infant and young Promote local production of enriched complementary foods High
271 Nutrition: Infant and young Demonstrate preparation and utilization of diversified High
child nutrition (6-23) complementary foods
272 Nutrition: Infant and young Promote key actions for diversification and utilization of High
child nutrition (6-23) complementary foods at household levels
273 Nutrition: Infant and young Promote production and utilization of bio fortified foods High
274 Nutrition: Infant and young Promote food technologies (powder meat, etc.) High
275 Nutrition: Infant and young Identify and treat anaemia High
35
276 Nutrition: Infant and young Support local food processing factories to participate in High
child nutrition (6-23) production of ready to use therapeutic food and
supplementary food
277 Nutrition: Infant and young Provide free medical treatment to malnourished children High
278 Nutrition: Infant and young Support food for care takers whose children admitted to High
child nutrition (6-23) Stabilization Centre
279 Nutrition: Infant and young Promote hygiene and sanitation and access to safe and clean High
child nutrition (6-23) water
280 Nutrition: Infant and young Promote hand washing at critical times with soap High
281 Nutrition: Infant and young Promote use of household water treatment practices High
282 Nutrition: Infant and young Promote safe and hygienic preparation, storage and handling High
child nutrition (6-23) of food
283 Nutrition: Infant and young Promote safe and clean household environment (in relation to High
child nutrition (6-23) poultry, small ruminants, household waste management, etc.)
284 Nutrition: Infant and young Construction and use of pit latrine and safe water supply Medium
285 Nutrition: Infant and young Link food insecure households with children under two to High
child nutrition (6-23) social protection services and nutrition sensitive livelihood and
economic opportunities
286 Nutrition: Infant and young Integrate early childhood care and development stimulation High
child nutrition (6-23) with existing community and facility based nutrition programs
287 Nutrition: Infant and young Promote use of ITN High
288 Nutrition: Infant and young Promote prevention of food taboos and mal-feeding practices High
289 Nutrition: Infant and young Promote family members involvement during child feeding High
child nutrition (6-23) practices
290 Nutrition: Child nutrition (24 De-worming on biannual basis High
- 59 months)
291 Nutrition: Child nutrition (24 Promote enforcement of minimum standard nutritional High
- 59 months) services for young children in special situations (refugee
camps, orphanage, day care centres, chronic infections, PSNP
public work sites etc.)
292 Nutrition: Child nutrition (24 Demonstrate preparation and utilization of diversified foods High
- 59 months)
293 Nutrition: Child nutrition (24 Promote key actions for diversification and utilization of High
- 59 months) diversified foods at household levels
294 Nutrition: Child nutrition (24 Promote home or kitchen gardening and small scale food High
- 59 months) production that support a diverse range of nutrient dense
foods (small animals, cows,
295 Nutrition: For school age Promote nutrition education for young children in schools Low
children (5-10 years)
296 Nutrition: For school age Promote nutrition in schools using teachers and parents High
children (5-10 years) association and schools nutrition clubs
297 Nutrition: For school age Demonstrate and promote food diversification through school High
children (5-10 years) gardening nutrition clubs
298 Nutrition: For school age Initiate home grown school feeding program for school age High
children (5-10 years) children
36
299 Nutrition: For school age Promote access to safe potable water and sanitation in schools High
children (5-10 years) and at home
300 Nutrition: For school age Promote proper disposal of human, animal and environmental High
children (5-10 years) waste
301 Nutrition: For school age Provide school based de-worming service High
302 Nutrition: For school age Promote healthy eating and exercise to prevent childhood Low
children (5-10 years) obesity
303 Nutrition: For school age Detect and treat anaemia High
304 Nutrition: For school age Detect and treat acute malnutrition High
305 Nutrition: Adolescent (10 - Intermittent weekly iron-folic acid supplementation in HFs and Medium
19 years) schools
306 Nutrition: Adolescent (10 - Nutritional assessment, school screening for eating disorder Medium
19 years)
307 Nutrition: Adolescent (10 - De-worming for school and out of school children High
19 years)
308 Nutrition: Adolescent (10 - School feeding program for vulnerable adolescents High
19 years)
309 Nutrition: Adolescent (10 - Promotion of iodized salt use High
19 years)
310 Nutrition: Adolescent (10 - Promote physical exercise and healthy eating in Medium
19 years)
311 Nutrition: Adolescent (10 - Socio-behavioural change communication to prevent HTP (food High
19 years) taboos, diversified food intake,)
312 Nutrition: Adolescent (10 - Promote delay in early marriage until 18 years and delay first High
19 years) pregnancy until age 19
313 Nutrition: Adolescent (10 - Nutrition for adolescent girls in special situation (HIV, High
19 years) emergency, obesity, eating disorder)
314 Nutrition: Adolescent (10 - Management of acute malnutrition in adolescents Medium
19 years)
315 Nutrition: Adolescent (10 - Promote adolescent RH services High
19 years)
316 Nutrition: Adolescent (10 - Promote establishment of nutrition clubs in schools High
19 years)
317 Nutrition: Adolescent (10 - Promote establishment of school gardening program High
19 years)
318 Nutrition: Adolescent (10 - Promote school nutrition demonstration program High
19 years)
319 Nutrition: Productive work Nutrition assessment, counselling and support for HIV+, TB and medium
force (19-65 yrs.): other infectious diseases
Communicable and NCD
320 Nutrition: Productive work Promote healthy dietary behaviours and exercise to prevent High
force (19-65 yrs.): obesity/reduce risk of NCDs
321 Nutrition: Productive work Promote salt, alcohol, cigarettes, chat and sugar restrictions High
force (19-65 yrs.):
37
322 Nutrition: Productive work Enforce taxation of alcohol, cigarette, chat and sugary High
force (19-65 yrs.): beverages
323 Nutrition: Productive work Utilize tax recovery to support nutrition High
force (19-65 yrs.):
324 Nutrition: Productive work Link HIV+ and TB clients with IGAs and other nutrition sensitive High
force (19-65 yrs.): interventions
325 Nutrition: Productive work Promote local food processing factories to produce RUTF and High
force (19-65 yrs.): RUSF for HIV+ and TB
326 Nutrition: Productive work Promote nutrition education for improve nutrition behaviour Low
force (19-65 yrs.): and practices
327 Nutrition: Productive work promote nutrition education, healthy eating and Exercises at Medium
force (19-65 yrs.): industry parks, system level cost
328 Nutrition: Productive work promote and ensure food safety and quality to the general High
force (19-65 yrs.): population
329 Nutrition: Productive work Promote production and consumption of organic foods High
force (19-65 yrs.):
330 Nutrition: Elderly (>65 yrs.) Nutrition assessment, counselling and support to elderly Medium
people
331 Nutrition: Elderly (>65 yrs.) Promote healthy eating and exercise to prevent obesity/reduce Medium
risk of NCDs
332 Nutrition: Elderly (>65 yrs.) Community care and support for the elderly, oral nutritional Low
supplements in older malnourished care home residents
333 Nutrition: Elderly (>65 yrs.) Extended nutritional intervention in older hospitalized patients Low
4.2 Major communicable diseases

In this major programme area, HIV/AIDS, TB and malaria interventions are included. In addition, the
interventions targeting sexually transmitted infections and leprosy are listed. Therefore, in total, 62
interventions are included in this section.
Table 9: Essential HIV/AIDS, TB and malaria interventions
IC Sub-programme Essential HIV/AIDS, TB and malaria interventions Priority

398 HIV/AIDS: prevention Targeted behavioural change communication (BCC) for the High
most at-risk population and vulnerable groups
399 HIV/AIDS: prevention HIV/AIDS BCC for the general population High
400 HIV/AIDS: prevention Condom distribution for the most at-risk population and High
vulnerable groups
401 HIV/AIDS: prevention Prevention and treatment of STI in the context of HIV High
prevention
38
402 HIV/AIDS: prevention Targeted quality assured HIV testing and counselling services: High
self-testing
VCT
PITC
405 HIV/AIDS: prevention PMTCT High
406 HIV/AIDS: prevention Voluntary medical male circumcisions High
407 HIV/AIDS: prevention Post-exposure prophylaxis (PEP) for occupational exposure and Low
sexual assault victims
408 HIV/AIDS: prevention Pre-exposure prophylaxis (PrEP) for FSWs and zero-discordant Low
HIV negative partner
409 HIV/AIDS: prevention Ensuring quality assured testing of all donated load for high
transfusion transmissible infections (TTIs)_HIV,HBV,HCV and
syphilis
410 HIV/AIDS: care and ART (first-line treatment) for adults High
treatment
411 HIV/AIDS: care and ART (second-line treatment) for adults High
treatment
412 HIV/AIDS: care and ART (third-line treatment) for adults Medium
treatment
413 HIV/AIDS: care and Cotrimoxazole for children and adolescents Medium
treatment
414 HIV/AIDS: care and Paediatric ART High
treatment
415 HIV/AIDS: care and Additional ART for TB patients and adolescents High
treatment
416 HIV/AIDS: care and Management of opportunistic infections associated with High
treatment HIV/AIDS and adolescents
417 HIV/AIDS: care and Nutrition supplements in first six months for HIV/AIDS cases High
treatment
418 HIV/AIDS: care and Collaborative HIV/AIDS and TB interventions screening, High
treatment community screening every six month and administer IPT and
initiation of ART
419 HIV/AIDS: care and Screen HIV+ cases for TB infection High
treatment
420 HIV/AIDS: care and ART for TB HIV+ patients high
treatment
421 HIV/AIDS: care and HIV prevention for TB patients high
treatment
422 STI: prevention BCC on safer sexual behaviour Medium
423 STI: prevention Partner notification and treatment medium
424 STI: prevention Provision of condoms to key and priority populations High
425 STI: prevention HIV testing in STI patients VS inpatient testing High
426 STI: prevention Provide human papilloma virus (HPV) vaccination Low
427 STI: prevention Hepatitis B virus vaccination High
428 STI: treatment Syndromic case management Low
429 STI: treatment Treatment of STI to prevent HIV High
430 STI: treatment Provide STI clinical services and outreach to female sex workers High
and their male clients
431 STI: treatment Screening and treatment for syphilis during pregnancy High
39
432 STI: treatment Adolescent-friendly STI services (provision of condom, STI Low
screening and treatment) within schools or health facilities
433 TB: diagnosis Treatment + Detection (smear + Xpert) + Drug sensitivity High
analysis
analysis and ART prioritisation for TB cases
analysis, ART prioritisation for TB cases, preventive therapy for
children
analysis and preventive therapy
analysis and preventive therapy for children
438 TB: diagnosis Treatment + Detection (smear generally and culture for MDR) + High
Drug sensitivity analysis
Drug sensitivity analysis and ART prioritisation for TB cases
Drug sensitivity analysis and ART prioritisation for TB cases and
preventive therapy for children
Drug sensitivity analysis and preventive therapy
Drug sensitivity analysis and Preventive therapy for children
443 Leprosy: elimination Reconstructive surgery for leprosy High
444 Leprosy: elimination Footwear and self-care education for leprosy High
445 Leprosy: elimination Chemoprophylaxis for contacts of leprosy cases and for ulcer High
446 Leprosy: elimination Detection and management of disability owing to leprosy High
447 Malaria: prevention Long-lasting insecticide-treated nets (LLIN) High
448 Malaria: prevention Indoor residual spraying with propoxure High
449 Malaria: prevention Other vector control: mosquito repellent Low
450 Malaria: prevention Other vector control: window screening Low
451 Malaria: prevention Other vector control: larviciding Low
452 Malaria: prevention Other vector control: drainage of breeding swampy and Low
marshy sites/irrigation canals
453 Malaria: prevention Intermittent preventive treatments (pregnant women) Low
454 Malaria: prevention Active surveillance of cases, school-based intermittent screen High
and treat
455 Malaria: case management Detection [RDT] and treatment of uncomplicated malaria High
456 Malaria: case management Detection [Microscopy] and treatment of uncomplicated High
malaria with artemether-lumefantrine
457 Malaria: case management Detection [RDT] and treatment of severe malaria High
458 Malaria: case management Detection [Microscopy] and treatment of severe malaria High
459 Malaria: case management G6PD testing and radical cure treatment for vivax Medium
4.3. Non-communicable diseases (NCDs)
40
In this section, 218 essential NCD interventions included in the package are listed. About 70 of the
interventions target neoplastic conditions. About 50 interventions target mental, neurological and
substance-use disorders, and there are 28 cardiovascular interventions. About 14 interventions are for
respiratory diseases, 8 are for renal diseases and 8 are for non-communicable eye health problems. In
addition, 23 policies, BCC and interventions targeting all NCDs and risk factors are included in this sub-
section of the EHSP.
Table 10: Essential NCD interventions for Ethiopia
IC Sub-programme Essential NCD interventions for Ethiopia Priority

495 All NCDs: BCC and policy BCC to increase physical activity + obesity reduction educations Low
interventions
496 All NCDs: BCC and policy Tobacco: protect people from tobacco smoke High
interventions
497 All NCDs: BCC and policy Tobacco: warn about danger: warning labels Medium
interventions
498 All NCDs: BCC and policy Tobacco: warn about danger: mass media campaign Medium
interventions
499 All NCDs: BCC and policy Tobacco: enforce bans on tobacco advertising High
interventions
500 All NCDs: BCC and policy Tobacco: enforce youth access restriction Medium
interventions
501 All NCDs: BCC and policy Raise taxes on all tobacco products High
interventions
502 All NCDs: BCC and policy Hazardous alcohol use: enforce restrictions on the availability of Low
interventions retailed alcohol
503 All NCDs: BCC and policy Hazardous alcohol use: enforce restrictions on alcohol medium
interventions advertising
504 All NCDs: BCC and policy Physical inactivity: awareness campaigns to encourage Low
interventions increased physical activity
505 All NCDs: BCC and policy Raise taxes on alcoholic beverages Medium
interventions
506 All NCDs: BCC and policy Sodium: harness industry for reformulation High
interventions
507 All NCDs: BCC and policy Sodium: Adopt standards: Front of pack labelling High
interventions
508 All NCDs: BCC and policy Sodium: knowledge: education and communication High
interventions
509 All NCDs: BCC and policy Sodium: environment: salt reduction strategies in community- High
interventions based eating spaces
510 All NCDs: BCC and policy Offer to help quit tobacco use: brief intervention Medium
interventions
511 All NCDs: BCC and policy Screening and brief intervention for hazardous and harmful Medium
interventions alcohol use
512 All NCDs: BCC and policy Physical inactivity: brief advice as part of routine care High
interventions
513 All NCDs: BCC and policy Restrictions on retail and use of Khat and other substances Medium
interventions
41
514 All NCDs: BCC and policy Implement large graphic health warnings on all tobacco Medium
interventions packages
515 All NCDs: BCC and policy Nutritional labelling (reduce salt, sugar and fat intake through Medium
interventions the implementation of front-of pack labelling)
516 All NCDs: BCC and policy Health and age warnings on alcohol products Medium
interventions
517 All NCDs: BCC and policy Implement community-wide mass sporting, education and Medium
interventions awareness campaign for physical activity
518 All NCDs: BCC and policy Enact policies on the design of buildings and roads which Medium
interventions encourage physical activity (play grounds parks, sidewalks,
bicycle tracks and workplace exercise corners)
519 All NCDs: BCC and policy Enact and enforce restrictions on the physical availability of Medium
interventions retailed alcohol (via reduced hours and age of sale)
520 All NCDs: BCC and policy Provide brief psychosocial intervention for persons with Low
interventions hazardous and harmful alcohol use
521 All NCDs: BCC and policy Setting of target levels for the amount of salt in foods and Medium
interventions meals
522 All NCDs: BCC and policy Encourage production and/or importation of healthy (mono Medium
interventions and poly unsaturated) fats
523 All NCDs: BCC and policy Eliminate industrial trans-fats through the development of Medium
interventions legislation to ban their use in the food chain
524 All NCDs: BCC and policy Increase access to electricity and low-emission energy-efficient Medium
interventions cooking stoves
525 All NCDs: BCC and policy Raise tax on Khat Medium
interventions
526 All NCDs: BCC and policy Screening for Khat use and brief intervention Medium
interventions
527 All NCDs: BCC and policy Management of Khat intoxication and withdrawal Medium
interventions
528 All cancers Basic palliative care for cancer at home, community and health Medium
facility
529 All cancers Raise awareness on the risk factors of cancers, media Medium
awareness
530 All cancers Early detection/screening of most common cancers, biennial Medium
clinical breast examination (CBE) screening (40–69) +
treatment of stage I to IV
531 Breast cancer Basic breast cancer awareness education and education on self- Medium
examination
532 Breast cancer Screening: clinical breast exam Medium
533 Breast cancer Screening: mammography Low
534 Breast cancer Breast cancer treatment: stage 1 Medium
538 Breast cancer Basic palliative care for breast cancer Medium
539 Breast cancer Extended palliative care for breast cancer Low
540 Cervical cancer Vaccination against HPV of girls aged 9–14 years High
541 Cervical cancer Cervical conisation/loop electro-surgical excision procedure Medium
(LEEP)
542 Cervical cancer HPV DNA and cryotherapy High
543 Cervical cancer Visual inspection with acetic acid (VIA) and cryotherapy High
42
544 Cervical cancer PAP smear and cryotherapy High
545 Cervical cancer HPV DNA test High
546 Cervical cancer VIA High
547 Cervical cancer Papanicolaou test (Pap smear) High
548 Cervical cancer HPV DNA + VIA High
549 Cervical cancer HPV DNA + Pap smear High
550 Cervical cancer Cryotherapy Medium
551 Cervical cancer LEEP Medium
552 Cervical cancer Cervical cancer treatment: stage I High
553 Cervical cancer Cervical cancer treatment: stage II Medium
554 Cervical cancer Cervical cancer treatment: stage III Medium
555 Cervical cancer Cervical cancer treatment: stage IV Medium
556 Cervical cancer Basic palliative care for cervical cancer Low
557 Cervical cancer Extended palliative care for cervical cancer Low
558 Ovarian cancer Diagnosis and management of ovarian cancer (surgery), primary Low
debulking surgery
559 Thyroid cancer Diagnosis and management of thyroid cancer, surgery vs. low- Medium
dose radioactive iodine
560 Colorectal cancer Screening: faecal occult blood testing Low
561 Colorectal cancer Screening: sigmoidoscopy Low
562 Colorectal cancer Screening: colonoscopy Low
563 Colorectal cancer Colorectal cancer treatment: stage I (+ colonoscopy) Low
564 Colorectal cancer Colorectal cancer treatment: stage II (+ colonoscopy) Low
565 Colorectal cancer Colorectal cancer treatment: stage III (+ colonoscopy) Low
566 Colorectal cancer Colorectal cancer treatment: stage IV (+ colonoscopy) Low
567 Colorectal cancer Basic palliative care for colorectal cancer Low
568 Colorectal cancer Extended palliative care for colorectal cancer Low
569 Oesophageal cancer Diagnosis with endoscopy, biopsy/pathology High
570 Oesophageal cancer Treatment of oesophageal cancer Low
(chemotherapy/surgery/radiotherapy)
571 Lip and oral cancer Diagnosis of lip and oral cancer High
572 Lip and oral cancer Lip and oral cancer treatment radiotherapy + chemotherapy Low
573 Lip and oral cancer Treatment with chemo/hormonal therapy medium
574 Nasopharynx cancer Nasopharynx cancer: diagnosis using MRI and positron emission medium
tomography
575 Nasopharynx cancer Nasopharynx cancer treatment: radiotherapy + chemotherapy, Medium
576 Liver cancer (hepatoma) Diagnosis: blood tests, ultrasound/fine needle aspiration, Medium
pathology, annual surveillance for hepatocellular carcinoma in
cirrhotic patients
577 Liver cancer (hepatoma) Treatment of hepatitis C, all eligible patients receiving Low
conventional combination therapy after stabilising on
methadone maintenance therapy in 1000 IDUs
578 Liver cancer (hepatoma) Biopsy, surgery, chemotherapy, transarterial radioembolisation Low
vs. sorafenib
579 Liver cancer (hepatoma) Treat late stage liver cancer, liver transplant with one year Low
follow-up
580 Liver cancer (hepatoma) Viral hepatitis surveillance High
581 Liver cancer (hepatoma) Screening blood transfusion for hepatitis B and C, HIV combo + Medium
HCV combo + HBsAg
582 Liver cancer (hepatoma) Hepatitis B vaccination High
43
583 Liver cancer (hepatoma) Vaccination of health care workers High
584 Liver cancer (hepatoma) Diagnosis and treatment of HBV High
585 Liver cancer (hepatoma) Diagnosis and treatment of HCV Medium
586 Liver cancer (hepatoma) Treatment of intrahepatic cholangiocarcinoma, hepatic Medium
resection for ICC greater than 6 cm vs. initial systemic
chemotherapy
587 Prostate cancer Diagnosis of prostate cancer: PSA, blood tests, rectal Low
examination, PSA screening at age 55–59 years at 2-year
intervals
588 Prostate cancer Treatment of prostate cancer: surgery, chemotherapy, Low
radiotherapy, stereotactic body radiation therapy vs. intensity-
modulated radiation therapy
589 Hodgkin lymphoma Treatment of Hodgkin lymphoma cancer Low
590 Childhood cancers Diagnosis and treatment of childhood leukaemia, childhood Medium
cancer treatment
591 Childhood cancers Treatment of non-Hodgkin’s lymphomas, treatment with Low
cyclophosphamide, doxorubicin, vincristine and prednisone
(CHOP)
592 Childhood cancers Diagnosis of Wilm's tumour in children with Beckwith‐ Low
Wiedemann syndromes
593 Childhood cancers Diagnosis and treatment of retinoblastoma Low
594 Childhood cancers Diagnosis and treatment of childhood Hodgkin’s lymphomas Medium
595 Childhood cancers Diagnosis and management childhood bone and cartilage Low
cancers
596 Hypertension Targeted screening for hypertension, 140/90 mm Hg compared High
with 160/95 mm Hg for initiation of drug
597 Hypertension Management of hypertension (pharmacologic and life style High
modifications), management through community health
workers
598 Hypertension Healthy life style counselling for the management of High
hypertension, combined home health education (HHE) and
trained general practitioner (GP)
599 Hypertension Management of hypertensive crisis High
600 Ischemic heart disease, Screening for risk of CVD, screening with coronary artery Medium
stroke and peripheral artery calcification on CT vs. current practice
diseases
601 Ischemic heart disease, Follow-up care for those at low to moderate risk of CVD, aspirin Medium
stroke and peripheral artery
diseases
602 Ischemic heart disease, Treatment for those with high absolute risk of CVD (>35%) with High
stroke and peripheral artery a combination of drugs
diseases
603 Ischemic heart disease, Treatment for those with high blood pressure but low absolute High
stroke and peripheral artery risk of CVD, CVD > 15% compared with CVD > 20%
diseases
604 Ischemic heart disease, Treatment for those with absolute risk of CVD 20%–30%, CVD > High
stroke and peripheral artery 20% compared with CVD > 30%
diseases
605 Ischemic heart disease, Treatment for those with high absolute risk of CVD (>30%), High
stroke and peripheral artery compared with CVD > 40%
diseases
44
606 Ischemic heart disease, Treatment adherence counselling, state-wide campaign to Medium
stroke and peripheral artery promote aspirin use for primary prevention of cardiovascular
diseases diseases
607 Ischemic heart disease, Palliative care to ischemic heart disease, stroke, PAD with Medium
stroke and peripheral artery amputation, cholesterol lowering treatment for total chol. > 6.2
diseases mmol/l
608 Acute myocardial infarction Treatment of new cases of acute myocardial infarction (AMI) Low
(AMI) with aspirin
609 AMI Conventional cardiac troponin (cTnT) assay for the diagnosis of Low
AMI
610 AMI Management of acute coronary syndrome Medium
611 AMI Treatment of cases with established ischemic heart disease Low
(IHD)
612 AMI Prehospital and emergency care for suspected AMI, fractional Low
flow reserve (FFR) vs. angiography
613 AMI Treatment of new cases of MI with primary percutaneous Low
coronary intervention
614 AMI Treatment of cases with MI with coronary artery bypass graft Low
615 AMI Treatment of cases with MI with percutaneous coronary low
intervention
616 AMI Care for suspected stroke (CVA), ASA Low
617 AMI Treatment of acute ischemic stroke with intravenous Low
thrombolytic therapy, streptokinase
618 AMI Treatment for those with established cerebrovascular disease Low
and post stroke, ACE-inhibitor
619 Peripheral artery diseases Management for acute critical limb ischemia PAD, clopidogrel Medium
vs. aspirin
620 Rheumatic heart disease Treatment of acute suspected bacterial tonsilopharyngitis to High
prevent rheumatic fever, management of acute rheumatic fever
(ARF) and rheumatic heart disease (RHD) compared to do
nothing options
621 Rheumatic heart disease Screening of cases with rheumatic heart disease High
622 Rheumatic heart disease Management of rheumatic heart disease complications, High
management of ARF and RHD compared to do nothing options
623 Heart failure Medical management of heart failure with diuretics, beta- Low
blockers, ACE inhibitors and mineralocorticoid antagonists
624 Asthma Asthma: inhaled short acting beta agonist for intermittent Low
asthma
625 Asthma Asthma: low dose inhaled beclometasone + SABA Low
626 Asthma Asthma: high dose inhaled beclometasone + SABA Low
627 Asthma Asthma: theophylline + High dose inhaled beclometasone + Low
SABA
628 Asthma Asthma: oral prednisolone + theophylline + high dose inhaled Low
beclometasone + SABA
629 Chronic respiratory disorders COPD: smoking cessation High
630 Chronic respiratory disorders COPD: inhaled salbutamol Medium
631 Chronic respiratory disorders COPD: low-dose oral theophylline Medium
632 Chronic respiratory disorders COPD: ipratropium inhaler Low
633 Chronic respiratory disorders COPD: exacerbation treatment with antibiotics Low
634 Chronic respiratory disorders COPD: exacerbation treatment with oral prednisolone High
45
635 Chronic respiratory disorders COPD: exacerbation treatment with oxygen, pulmonary Low
rehabilitation
636 Bronchiectasis Diagnosis, management including rehabilitation for Low
bronchiectasis (with antibiotics, rehabilitative and preventive)
637 Occupational lung diseases Diagnosis, management and prevention of occupational lung Medium
diseases
638 Diabetes mellitus treatment Targeted screening for type 2 diabetes, screening beginning Medium
from age 40 years
639 Diabetes mellitus treatment Healthy life style counselling for management of diabetes, Medium
screening and exercise intervention starting from age 25 years
640 Diabetes mellitus treatment Comprehensive management of type 2 DM, BTT vs. TTT Low
641 Diabetes mellitus treatment Diagnosis and comprehensive management of type 1 DM High
642 Diabetes mellitus treatment Screening and laser treatment for diabetic retinopathy and Medium
macular oedema
643 Diabetes mellitus treatment Screening and treatment of people with diabetes type 2 DM Low
644 Acute renal failure Dialysis for acute, reversible kidney injury Medium
645 Chronic kidney diseases Haemodialysis for chronic kidney failure compared to do Low
nothing
646 Chronic kidney diseases Peritoneal dialysis for chronic kidney failure Low
647 Chronic kidney diseases Screening for chronic kidney disease in high-risk groups, 2-year Low
interval microalbuminuria screening beginning at age 50 years
for 1 million individuals
648 Chronic kidney diseases Diagnosis and treatment of CKD, sevelamer for the treatment of Low
hyperphosphatemia in chronic kidney disease
649 Chronic kidney diseases Treatment of hypertension in kidney disease, renal denervation Medium
therapy
650 Chronic kidney diseases Management of complications of CKD, moderate protein diet High
651 Chronic kidney diseases Kidney transplantation Low
652 Cataract Awareness creation and screening for cataract, combined Medium
maternity ward and well-baby clinic eye screening compared
with well-baby clinic screening alone
653 Cataract Cataract surgery High
654 Refractive error Awareness creation of RE and importance of eye glasses Medium
655 Refractive error School screening Medium
656 Refractive error Opportunistic screening for refractive errors in adults High
657 Refractive error Correction of refractive error with eye glass, screening in health High
facilities spectacles for 5–15-year-old children
658 Glaucoma Screening for glaucoma for selected population groups High
659 Glaucoma Medical and surgical treatment of glaucoma, laser Medium
trabeculoplasty
660 MNSD: BCC and policy BCC and awareness creation programme on all MNSD High
interventions
661 MNSD: BCC and policy Enact mental health legislation High
interventions
662 MNSD: BCC and policy Workplace stress reduction programmes, health promotion Medium
interventions targeting physical activity and healthy eating in mental health
care
663 MNSD: BCC and policy In school: mental health awareness among school children and High
interventions structured physical activity, programmes that advance positive
thinking, stress reduction programmes and psychological and
educational counselling
46
664 Depressive disorders Basic psychosocial treatment for mild depression High
665 Depressive disorders Basic psychosocial treatment and anti-depressant medication of High
the first episode moderate-severe cases
666 Depressive disorders Intensive psychosocial treatment and anti-depressant High
medication of the first episode moderate-severe cases
medication of recurrent moderate-severe cases on an episodic
basis
medication of recurrent moderate-severe cases on a
maintenance basis
669 Depressive disorders Psychosocial care for peril-natal depression High
670 Psychotic disorders Diagnosis and management of psychosis with first generation Low
and second generation antipsychotics and CBT
671 Psychotic disorders Basic psychosocial support and anti-psychotic medication Medium
672 Psychotic disorders CBT as adjunctive treatment for positive symptoms. Cognitive Low
remediation therapies in the early stages of the disorder.
Psychoeducation reduces relapse, readmission
and length of hospital stay while encouraging
medication compliance
673 Psychotic disorders Basic psychosocial support and anti-psychotic medication Medium
674 Psychotic disorders Psychosocial interventions to reducing the need for High
antipsychotic medications
675 Psychotic disorders Intensive psychosocial support and anti-psychotic medication Low
676 Psychotic disorders Continuing care of schizophrenia High
677 Psychotic disorders Management of refractory psychosis with clozapine Low
678 Bipolar disorder Basic psychosocial treatment, advice and follow-up for bipolar Low
disorder plus mood-stabilising medication
679 Bipolar disorder Intensive psychosocial intervention for bipolar disorder plus Low
mood-stabilising medication
680 Anxiety disorders Basic psychosocial treatment for anxiety disorders (mild cases) High
681 Anxiety disorders Basic psychosocial treatment and anti-depressant medication High
for anxiety disorders (moderate-severe cases)
682 Anxiety disorders Intensive psychosocial treatment and anti-depressant High
medication for anxiety disorders (moderate-severe cases)
683 Stress-related disorders Non-trauma-focused CBT and eye movement High
(PTSD) desensitisation and reprocessing, CBT (particularly trauma-
focused CBT)
684 Epilepsy Diagnosis and management of epilepsy, partial seizure Low
685 Epilepsy Epilepsy: basic psychosocial support, advice and follow-up plus High
anti-epileptic medication
686 Dementia Diagnosis and treatment of dementia, specialist unit to care for Low
older people with delirium and dementia
687 Dementia Opportunistic screening for the detection of dementia Low
688 Childhood and adolescent Parenting programmes in infancy to promote early child High
mental, behavioural and development
developmental disorders
689 Childhood and adolescent Improve the quality of antenatal and perinatal care to reduce High
mental, behavioural and risk factors associated with intellectual disability
47
690 Childhood and adolescent Low
mental, behavioural and Screening for congenital hypothyroidism among infants
691 Developmental disorders Family psychoeducation High
692 Behavioural disorders Psychosocial interventions for treatment of behavioural Low
disorders
693 ADHD Diagnosis and treatment of ADHD including methylphenidate Low
694 ADHD Family psychoeducation (ADHD) Medium
695 Common childhood mental Identification of children with MNS disorders in schools Medium
disorders
696 Emotional disorders Psychosocial interventions, treatment of emotional disorders, Low
CBT
697 Depression in older children Antidepressants among adolescents with moderate-severe Medium
and adolescents depressive disorder for whom psychosocial interventions have
proven ineffective
698 Childhood and adolescent Anxiety, post-traumatic stress disorder-Cognitive and Medium
mental, behavioural and behavioural therapy
699 Alcohol use disorders Screening and brief interventions for alcohol use disorders medium
700 Alcohol use disorders Management of alcohol withdrawal medium
701 Alcohol use disorders Relapse prevention medication for alcohol use/dependence medium
702 Opioid use disorder Opioid substitution therapy (methadone and buprenorphine) Low
for opioid dependence, methadone
703 Others drug use disorders Identification and assessment of new cases of drug Low
(illicit, cannabis, Khat, use/dependence
tobacco and others)
704 Others drug use disorders Brief interventions and follow-up for drug use/dependence, Low
(illicit, cannabis, Khat, multidimensional family therapy compared to cognitive
tobacco and others) behavioural therapy
705 Others drug use disorders Management of drug withdrawal, 7% to full coverage of Low
(illicit, cannabis, Khat, medically managed smoking cessation
tobacco and others)
706 Others drug use disorders Management of tobacco (nicotine) dependence, varenicline Medium
(illicit, cannabis, Khat,
tobacco and others)
707 Suicide and self-harm Assess and care for person with self-harm, suicide prevention Low
programme
708 Suicide and self-harm Basic psychosocial treatment, advice and follow-up for self- High
harm/suicide
709 Suicide and self-harm Safer storage of pesticides in the community and farming Medium
households, provision of low cost/free equipment
710 Suicide and self-harm Emergency management of poisoning, penicillamine chelation High
with crossover to EDTA provocation test if toxicity occurs.
711 Suicide and self-harm Planned follow-up and monitoring of suicide attempters Low
712 Suicide and self-harm Treatment of comorbid mood and substance use disorder, Medium
internet-based therapeutic education system plus usual care
4.4. Surgery and injury care
48
Essential surgical care is defined as a condition that is primarily or extensively treated by surgical
procedures. Accordingly, 44 procedures have been identified as essential surgical procedures meeting the
above criteria. Majority of the procedures can be performed at the primary care level, and the list includes
emergency lifesaving procedures as well as selected non-emergency essential surgical interventions for
obstetric, ophthalmic, dental and congenital conditions. In this section, 206 interventions are included
(Table 11).
Table 11: Essential surgical intervention for Ethiopia
IC Sub-programme Essential surgical intervention Priority

713 Gynaecology and obstetrics Caesarean section High
conditions
714 Gynaecology and obstetrics Abdominal hysterectomy medium
conditions
715 Gynaecology and obstetrics Repair of uterine perforation and rupture High
conditions
716 Gynaecology and obstetrics Surgical management of pelvic organ prolapse Medium
conditions
717 Gynaecology and obstetrics Conservative management of pelvic organ prolapse Medium
conditions
718 Gynaecology and obstetrics Repair of obstetric fistula High
conditions
719 Gynaecology and obstetrics Cervical biopsy Low
conditions
720 Gynaecology and obstetrics Endometrial biopsy High
conditions
721 Gynaecology and obstetrics Surgical management of major benign gynaecological Medium
conditions conditions
722 Gynaecology and obstetrics Surgical management of major malignant gynaecological High
conditions conditions
723 Gynaecology and obstetrics Female genital anomalies surgeries Low
conditions
724 Gynaecology and obstetrics Salpingo-ophorectomy Medium
conditions
725 Gynaecology and obstetrics Colposcopy Low
conditions
726 Gynaecology and obstetrics Hystero-salpingography Medium
conditions
727 Gynaecology and obstetrics Ectopic pregnancy laparotomy Medium
conditions
728 Gynaecology and obstetrics Destructive delivery High
conditions
729 Gynaecology and obstetrics Laparotomy for gynaecologic emergency High
conditions
730 Gynaecology and obstetrics Diagnostic and therapeutic laparoscopy Low
conditions
731 Trauma and injury Laceration repair and wound care Low
49
732 Trauma and injury Air way procedures including Tracheostomy and crico- Low
thyroideotomy
733 Trauma and injury Tube thoracostomy for air or fluid collection in the pleura Low
734 Trauma and injury Focused assessment of sonography for trauma (FAST) Medium
735 Trauma and injury Explorative laparotomy for trauma Medium
736 Trauma and injury Emergency thoracotomy for severe chest injury Medium
737 Trauma and injury Vascular exploration and repair/anastomosis for trauma Medium
738 Trauma and injury Neck exploration for severe neck injuries Low
739 Trauma and injury Cut-down for vascular access Low
740 Trauma and injury Non-operative management of fracture and dislocation (pain Medium
management, immobilisation, POP application, traction,
dislocation reduction
741 Trauma and injury Operative management of fractures (internal and external High
fixations)
742 Trauma and injury Non-operative burn management (resuscitation, oxygen Medium
delivering, pain management and wound care), enclosed silver
dressing
743 Trauma and injury Burn management: escharotomy and fasciotomy Medium
744 Trauma and injury Skin graft and flap Medium
745 Trauma and injury Management of acute hand trauma (tendon and Medium
neurovascular)
746 Trauma and injury Trauma-related amputation High
747 Trauma and injury Basic wound management including wound toilet, Low
debridement repair of lacerations and splinting of fractures
748 Trauma and injury Burr-hole and elevation of depressed skull fracture for head Medium
injuries
749 Trauma and injury Comprehensive intracranial pressure management/monitoring Medium
750 Trauma and injury Cervical and back protection Medium
751 Trauma and injury Post trauma extremity rehabilitation Medium
752 Non-trauma surgical Draining superficial abscesses Medium
conditions
753 Non-trauma surgical Excision of small soft tissue tumours: cysts, lipoma and Low
conditions ganglion
754 Non-trauma surgical Male circumcision High
conditions
755 Non-trauma surgical Hydrocelectomy High
conditions
756 Non-trauma surgical Relieving acute urinary retention by catheterisation, closed Low
conditions supra-pubic cystectomy
757 Non-trauma surgical Orchidopexy Low
conditions
758 Non-trauma surgical Trans vesical prostatectomy (TVP) Low
conditions
759 Non-trauma surgical TURBT Medium
conditions
760 Non-trauma surgical Cysto-lithotomy Low
conditions
761 Non-trauma surgical Rectal tube deflation for sigmoid volvulus High
conditions
762 Non-trauma surgical Management of intussusception High
conditions
50
763 Non-trauma surgical Colostomy for ano-rectal malformation Medium
conditions
764 Non-trauma surgical Management of foreign body swallowing/aspiration High
conditions
765 Non-trauma surgical Explorative laparotomy for acute abdomen (acute appendicitis, High
conditions ectopic pregnancy, ovarian torsion, perforation and trauma)
766 Non-trauma surgical Laparoscopy, cholecystectomy and appendectomy High
conditions
767 Non-trauma surgical Biliary bypass procedures and T-tube insertion for hepato- High
conditions biliary pathologies
768 Non-trauma surgical Repair of hernias: tissue repair and mesh repair High
conditions
769 Non-trauma surgical Colostomy construction and reversal Medium
conditions
770 Non-trauma surgical Hemicolectomies Medium
conditions
771 Non-trauma surgical Surgical management of peri-anal conditions: haemorrhoids, Medium
conditions fistula in anus, anal fissures and peri-anal abscess)
772 Non-trauma surgical Repair of cleft lip and palate High
conditions
773 Non-trauma surgical Shunt for hydrocephalus Low
conditions
774 Non-trauma surgical Cardiac surgery for congenital heart disease High
conditions
775 Non-trauma surgical Repair of neural tube defects Medium
conditions
776 Non-trauma surgical Modified radical mastectomy Medium
conditions
777 Non-trauma surgical Thyroidectomy (all forms): STT, NTT and TT Medium
conditions
778 Non-trauma surgical Gastrectomy Medium
conditions
779 Non-trauma surgical Esophactemies Low
conditions
780 Non-trauma surgical Pulmonary resections and mediastinal procedures for chest Low
conditions pathologies
781 Non-trauma surgical Tenotomy for club foot and Ponsetti cast for club foot Medium
conditions
782 Non-trauma surgical Surgical management of septic arthritis Low
conditions
783 Non-trauma surgical Surgical management of osteomyelitis Medium
conditions
784 Non-trauma surgical Surgical management of pyomyositis Medium
conditions
785 Non-trauma surgical Surgical management of hand infection Medium
conditions
786 Non-trauma surgical Complex orthopaedic trauma care including hemi arthroplasty, Medium
conditions intra-articular fractures and spine and pelvic fracture
management
787 Non-trauma surgical Cardiac surgery for valvular heart disease Low
conditions
51
788 Non-trauma surgical Skin grafting Medium
conditions
789 Non-trauma surgical Splenectomy Medium
conditions
790 Non-trauma surgical Pancreatic pseudo cyst operation Medium
conditions
791 Non-trauma surgical Cystocele repair Medium
conditions
792 Non-trauma surgical Diaphragmatic hernia repair Medium
conditions
793 Non-trauma surgical Antrectomy with vagotomy Medium
conditions
795 Non-trauma surgical Abdominal dehiscence repair Medium
conditions
796 Non-trauma surgical Small intestinal resection/E-Anastomosis Low
conditions
797 Non-trauma surgical Intestinal derotation Medium
conditions
798 Non-trauma surgical Anterior resection Medium
conditions
799 Non-trauma surgical Abdominal perineal resection (APR) Medium
conditions
800 Non-trauma surgical Colectomy right or left Low
conditions
801 Non-trauma surgical Total colectomy Low
conditions
802 Non-trauma surgical Anal sphinicterotomy Low
conditions
803 Non-trauma surgical Fistulectomy High
conditions
804 Non-trauma surgical Cystic hygroma excision Low
conditions
805 Non-trauma surgical Mesenteric mass excision Medium
conditions
806 Non-trauma surgical Excision of retroperitoneal tumour Medium
conditions
807 Non-trauma surgical Meatotomy Medium
conditions
808 Non-trauma surgical Breast lump removal Medium
conditions
809 Non-trauma surgical Gastroscopy with biopsy: UGIE Low
conditions
810 Non-trauma surgical Pyelolithotomy Low
conditions
811 Non-trauma surgical Ureterolithotomy Medium
conditions
812 Non-trauma surgical Nephrectomy Low
conditions
813 Non-trauma surgical Urethroplasty Low
conditions
52
814 Non-trauma surgical Thoracotomy Low
conditions
815 Non-trauma surgical Pneumonectomy Low
conditions
816 Non-trauma surgical Lobar pneumonectomy Low
conditions
817 Non-trauma surgical Parotidectomy Low
conditions
818 Non-trauma surgical Neck dissection for head and neck cancers High
conditions
819 Non-trauma surgical Uretroscopy Low
conditions
820 Non-trauma surgical Trans urethral resection Medium
conditions
821 Non-trauma surgical Urinary diversion Medium
conditions
822 Non-trauma surgical Whipple's procedure Low
conditions
823 Non-trauma surgical Radical cystectomy Low
conditions
824 Non-trauma surgical Decortication Low
conditions
825 Non-trauma surgical Pyeloplasty Medium
conditions
826 Non-trauma surgical Hellers myotomy Medium
conditions
827 Non-trauma surgical Nissen's fundoplication Low
conditions
828 Non-trauma surgical Inguinal orchiedectomy Low
conditions
829 Non-trauma surgical Bronchoscopy with GA Medium
conditions
830 Non-trauma surgical UGIE and biopsy Low
conditions
831 Non-trauma surgical Pericardial window Low
conditions
832 Non-trauma surgical Pericadiectomy Low
conditions
833 Non-trauma surgical Kidney transplant surgery Low
conditions
834 Non-trauma surgical Pull throug, pyloromyotomy and paediatrics procedures Low
conditions
835 Dermatology procedures Dermatological curetting and electro surgery Low
836 Dermatology procedures Cryotherapy Medium
837 Dermatology procedures Skin biopsy examination (punch, incisional or shave) Low
838 Dermatology procedures Patch test Low
839 Dermatology procedures Laser therapy Medium
840 Dermatology procedures Narrow band UVB photo therapy Low
841 Dermatology procedures Slit skin smear for leishmaniasis Medium
842 Dermatology procedures Complex skin biopsy excision and repair Low
843 Dermatology procedures Electo cauterisation Low
53
844 Dermatology procedures Punch biopsy Low
845 Dermatology procedures Skin snip for microfilaria Medium
846 Dermatology procedures Interalesional steroid injection Low
847 Oral and dental procedures Extraction of primary and permanent tooth High
848 Oral and dental procedures Periodontal and dental abscess incision and drainage High
849 Oral and dental procedures Dental caries treatments and scaling High
850 Oral and dental procedures Management facial bone fractures and/or dislocation and High
injury to dentition (inter-dental wiring, arch bar, IMF and open
reduction)
851 Oral and dental procedures Management of oro-facial infection High
852 Oral and dental procedures Management of common benign tumours and cysts of oral and Low
maxillofacial regions
853 Oral and dental procedures Management of common malignant tumours and cysts of oral Medium
and maxillofacial regions
854 Oral and dental procedures Dental trauma care High
855 Ophthalmic procedures Cataract extraction and insertion of intraocular lens High
856 Ophthalmic procedures Eyelid surgery for trachoma (Tarsotomy) High
857 Ophthalmic procedures Glaucoma surgery (Canaloplasty) Medium
858 Ophthalmic procedures Corneal surgery High
859 Ophthalmic procedures Corneal transplant Low
860 Ophthalmic procedures Oculoplastic surgery Low
861 Ophthalmic procedures Strabismus surgery Medium
862 Ophthalmic procedures Retinal detachment repair Medium
863 Ophthalmic procedures Vitrectomy Low
864 Ophthalmic procedures Eye enucleation Low
865 Ophthalmic procedures Eye irrigation High
866 Ophthalmic procedures Laser therapy Low
867 ENT procedure Ear irrigation Medium
868 ENT procedure Hearing aid placement (including audiometry) Medium
869 ENT procedure Myringotomy for otitis media High
870 ENT procedure Management of nasal obstruction, septoplasty vs. non- High
operative management
871 ENT procedure Polypectomy (Nose) Medium
872 ENT procedure Tonsillectomy High
873 ENT procedure Sleep disorder surgery Low
874 ENT procedure Corrective breathing surgery Low
875 ENT procedure Sinus surgery Low
876 ENT procedure Mastoidectomy and drainage Medium
877 ENT procedure Laryngeal polyp excision, endoscopic polypectomy for chronic Medium
rhino sinusitis
878 ENT procedure Thympanoplasty High
879 Anaesthesia and critical care Local anaesthesia High
880 Anaesthesia and critical care General anaesthesia with tracheal intubation High
881 Anaesthesia and critical care General anaesthesia without tracheal intubation High
882 Anaesthesia and critical care Lumbar puncture Medium
883 Anaesthesia and critical care Spinal anaesthesia High
884 Anaesthesia and critical care Caudal anaesthesia/analgesia, post-surgery syndrome Low
885 Anaesthesia and critical care Epidural anaesthesia/analgesia, central spinal stenosis Low
886 Anaesthesia and critical care Peripheral nerve blocks, standard care Low
887 Anaesthesia and critical care Procedural sedation: continuous quantitative scenography Low
54
888 Anaesthesia and critical care Central venous catheter insertion High
889 Anaesthesia and critical care Arterial catheter insertion High
890 Anaesthesia and critical care Blood transfusion (including exchange) High
891 Anaesthesia and critical care Intubation/Estuation (single and double lumen) High
892 Anaesthesia and critical care Fibrotic bronchoscopy Low
893 Anaesthesia and critical care Mechanical ventilation, non-invasive: CPAP Low
894 Anaesthesia and critical care Mechanical ventilation, invasive High
4.5. Emergency and critical care

Table 12: Essential emergency and critical care interventions for Ethiopia
IC Sub-programme Essential emergency and critical care interventions Priority
895 Pre-hospital emergency care Initial syndrome-based management at scene and during High
transport for difficulties in breathing, shock and altered mental
status
896 Pre-hospital emergency care Initial syndrome-based management at scene and during High
transport for polytrauma
897 Pre-hospital emergency care Basic initial assessment and management at scene and during High
transport of labour, precipitous childbirth and complications of
pregnancy and childbirth
898 Pre-hospital emergency care Ambulance transport with direct provider monitoring and High
management during transport (in procedures – structured
handover to hospital personnel)
899 Pre-hospital emergency care User-activated dispatch of basic ambulance services High
900 Pre-hospital emergency care Basic initial assessment and management of acute pain (use High
existing interventions)
901 Pre-hospital emergency care Advanced pre-hospital care Medium
902 Pre-hospital emergency care Community-based first aid delivery High
903 Basic emergency care Initial assessment and management of acute difficulties in High
services breathing, shock and altered mental status
904 Basic emergency care Basic initial assessment and management of acute injury (BTLS, High
services ATLS)
905 Advanced emergency care Initial advanced assessment and management of acute High
services difficulty in breathing, shock and altered mental status
906 Advanced emergency care Initial assessment and management of wounds (including High
services burns)
907 Advanced emergency care Initial assessment and management of acute head injury High
services
908 Advanced emergency care Initial assessment and management of acute thoracic injury High
services
909 Advanced emergency care Initial assessment and management of acute intra-abdominal High
services injury (non-bony)
910 Advanced emergency care Initial assessment and management of acute musculoskeletal High
services injury (including fracture/dislocations)
911 Advanced emergency care Initial assessment and management of acute neurologic injury High
services
912 Advanced emergency care Initial management of cardiovascular emergencies (ischemia, High
services failure, arrhythmia, critical limb ischemia and stroke) including
defibrillation, pacing and synchronised cardioversion
55
IC Sub-programme Essential emergency and critical care interventions Priority
913 Advanced emergency care Initial management of gastrointestinal emergencies (including High
services obstruction, bleeding and peritonitis)
914 Advanced emergency care Initial management of metabolic emergencies (glucose, High
services thyroid, potassium, calcium and sodium)
915 Advanced emergency care Advanced management of sepsis High
services
916 Advanced emergency care Advanced management of acute pain High
services
917 Advanced emergency care Management of acute toxic ingestions/exposures High
services
918 Advanced emergency care Management of ocular emergencies High
services
919 Advanced emergency care Management of urgent soft tissue conditions High
services
920 Advanced emergency care Management of ENT emergencies High
services
921 Advanced emergency care Management of acute urinary obstruction High
services
922 Advanced emergency care Management of acute infectious exposures (including sexual High
services exposures, needle stick, rabies and tetanus)
923 Advanced emergency care Management of snake bite (in-procedures include wound care, High
services pressure dressing and anti-venin
924 Advanced emergency care Management of acute psychosis High
services
925 Advanced emergency care Acute management of dental emergencies High
services
926 Advanced emergency care Advanced management of post-partum haemorrhage High
services
927 Advanced emergency care Management of ectopic pregnancy High
services
928 Advanced emergency care Management of precipitous delivery High
services
929 Emergency and critical care: Establish acuity based triage clinical checklist implementation High
all
930 Emergency and critical care: Establish rapid surge of service delivery capacity High
all
931 Emergency and critical care: Establish case based syndrome surveillance and reporting of High
all emerging and infectious diseases
932 Emergency and critical care: Establish protocol for management of mass casualty and High
all emerging infectious disease surveillance
933 Emergency and critical care: Mass casualty management (protocol-based) for rapid surge of High
all service delivery capacity
4.6. Neglected tropical diseases
Seven interventions targeting lymphatic filariasis elimination, three interventions on onchocerciasis
elimination, four interventions on trachoma elimination, four interventions on schistosomiasis control,
four interventions on soil transmitted helminths control, two interventions on scabies control, two
interventions targeting leishmaniosis control, three interventions on Guinea worm disease case control
56
and six interventions on podoconiosis elimination are incorporated. Therefore, in this package, 35 high-
priority NTD interventions are included (Table 13).
Table 13: Essential NTD intervention for Ethiopia.
IC Sub-programme Essential NTD interventions Priority

460 NTD: lymphatic filariasis BCC for targeted areas High
elimination
461 NTD: lymphatic filariasis Mass drug administration for lymphatic filariasis High
elimination
462 NTD: lymphatic filariasis Vector control using IRS, house screening, LLIN, larvicides and High
elimination environmental management
463 NTD: lymphatic filariasis Screening and management of scrotal swelling High
elimination (hydrocelectomy)
464 NTD: lymphatic filariasis Lymphedema morbidity management High
elimination
465 NTD: lymphatic filariasis Management of acute attack dermato-lymphangioadenitis with High
elimination appropriate antibiotics
466 NTD: lymphatic filariasis Avail custom-made shoes for those with lymphedema High
elimination
467 NTD: onchocerciasis Mass drug administration High
elimination
468 NTD: onchocerciasis Vector control using ground larviciding with environmentally High
elimination safe insecticides
469 NTD: onchocerciasis Treatment with Ivermectin High
elimination
470 NTD: orachoma elimination BCC (face washing, open deification free environment, etc.) High
471 NTD: orachoma elimination Early diagnosis and treatment of active trachoma High
472 NTD: orachoma elimination Screening and diagnosis of TT cases (TT surgery) High
473 NTD: orachoma elimination Post-operative azithromycin High
474 NTD: schistosomiasis control BCC for targeted areas (avoid swimming in fresh water, High
promotion of use of toilets, hygiene and sanitation)
475 NTD: schistosomiasis control Snail control for schistosomiasis molluscicides (Niclosamide) High
476 NTD: schistosomiasis control Urine filtration for S. haematobium eggs High
477 NTD: schistosomiasis control Case management using praziquantel, mass drug High
administration
478 NTD: soil transmitted BCC for targeted areas (Promotion of use of toilets, hygiene High
helminths control and sanitation, footwear use)
479 NTD: soil transmitted Mass drug administration for PreSAC, SAC and women in the High
helminths control reproductive age group
480 NTD: soil transmitted Treatment of pregnant mothers High
helminths control
481 NTD: soil transmitted Case management of soil transmitted helminths using High
helminths control Mebendazole and Albendazole
482 NTD: scabies control Preventive chemotherapy via mass drug administration High
483 NTD: scabies control Case management of scabies using scabicides (perimethrin, High
BBL, ivermectin sulphur)
57
IC Sub-programme Essential NTD interventions Priority
484 NTD: leishmaniasis control Early diagnosis and management of VL (rapid test, DAT test, High
splenic aspirate, lymph node aspirate)
485 NTD: leishmaniasis control Early diagnosis and management of CL (clinical examination High
and skin snip)
486 NTD: Guinea worm disease Management of Guinea worm disease High
cases control
487 NTD: Guinea worm disease Treat unsafe water sources with ABATE High
cases control
488 NTD: Guinea worm disease Controlled immersion and bandaging for Guinea worm disease High
cases control cases.
489 NTD: podoconiosis BCC for targeted areas (promotion of footwear use, hygiene) High
elimination
490 NTD: podoconiosis Preventing episodes of dermato lymphangioadenitis among High
elimination lymphedema or elephantiasis cases
491 NTD: podoconiosis Screening of patients with lower leg swelling High
elimination
492 NTD: podoconiosis Lymphedema morbidity management High
elimination
493 NTD: podoconiosis Management of dermato-lymphangioadenitis with appropriate High
elimination antibiotics
494 NTD: podoconiosis Surgical nodulectomy for people with nodules High
elimination
4.7. Multi-sectoral interventions: hygiene and environmental health

In this section, 29 essential multi-sectoral high-priority hygiene and environmental health interventions
are included (Table 14).
Table 14: Essential multi-sectoral hygiene and environmental health interventions for Ethiopia
IC Sub-programme Hygiene and environmental health interventions Priority
934 HEH: sanitation Promote proper/improved latrine construction in all High
households
935 HEH: sanitation Promote construction of hand washing facilities near/in the High
latrine
936 HEH: sanitation Construct communal latrines High
937 HEH: sanitation Avail proper liquid waste collection and disposal mechanism High
938 HEH: sanitation Avail proper domestic solid waste collection and disposal High
services
939 HEH: personal hygiene Promote appropriate personal hygiene practices High
940 HEH: personal hygiene Create awareness on menstrual hygiene management High
941 HEH: personal hygiene Avail communal clothes washing facilities High
942 HEH: personal hygiene Create awareness on proper face washing with soap High
943 HEH: personal hygiene Create awareness on proper oral hygiene practices High
944 HEH: water supply Promote proper water management at the household level as High
per the water safety plan
945 HEH: water supply Avail improved adequate and potable water within the High
standard distance (30 min to 1 h)
946 HEH: water supply Conduct water quality sanitary surveillance High
947 HEH: water supply Household disinfection and storage for HIV people High
58
IC Sub-programme Hygiene and environmental health interventions Priority
948 HEH: water supply Point use of water filter for HIV infected adults High
949 HEH: water supply Point use of water filter High
950 HEH: water supply Centralised water treatment system High
951 HEH: water supply Source-based protection of water supply High
952 HEH: water supply Household chlorination High
953 HEH: water supply Household filtration High
954 HEH: water supply Household Solar disinfection High
955 HEH: water supply Household flocculation High
956 HEH: water supply Household connection with water supply High
957 HEH: sanitation Sanitation promotion only High
958 HEH: sanitation Safe sanitation facilities High
959 HEH: sanitation Wet pit latrine High
960 HEH: sanitation Social marketing and education on hygiene alone High
961 HEH: sanitation Social marketing and education on top of existing hardware High
962 HEH: sanitation Social marketing and education as well as hardware together High
4.8 Health education and behavioural change communication

In this section, 61 essential health education and behavioural change communication interventions are
included. Fifty-one interventions are in the high-priority, five interventions are in the low-priority and
three interventions are in the medium priority group (Table 15).
Table 15: Essential health education and behavioural communication interventions for Ethiopia
IC Sub-programme Health education and behavioural change communication Priority

963 HEP: RMNCH/FP Conduct counselling about family planning at the household High
level
964 HEP: RMNCH/FP Develop tailored SBCC materials on FP High
965 HEP: RMNCH/FP Demonstrate FP methods High
966 HEP: RMNCH/FP Conduct mass awareness on FP High
967 HEP: RMNCH/FP Conduct community mobilisation on FP High
968 HEP: Fertility Provision of counselling on fertility High
969 HEP: Fertility Conduct community awareness creation against fertility- High
related stigma and discrimination
970 HEP: sexual and reproductive Promote adolescent life skill interventions (in-schools, out of High
health schools, community)
971 HEP: sexual and reproductive Create awareness on the impacts of unsafe abortion High
health
972 HEP: sexual and reproductive Strengthen AYSRH promotional services (in-schools, out of High
health schools, community)
973 HEP: sexual and reproductive Promote provision of user-friendly services High
health
974 HEP: sexual and reproductive Facilitate post-abortion counselling services High
health
59
975 HEP: cervical and breast Promote cervical cancer screening High
cancer
976 HEP: cervical and breast Promote cervical cancer vaccination High
cancer
977 HEP: cervical and breast Promote self-examination and routine medical check-up for High
cancer breast cancer
978 HEP: gender-based violence Promote the impact of positive gender norms on health High
979 HEP: gender-based violence Promote life skills which can help to prevent gender-based Low
violence
980 HEP: gender-based violence Create awareness on the impact of gender-based violence on High
health
981 HEP: gender-based violence Promote/strengthen psychosocial support for victims of GBV High
(one window service and hotlines)
982 HEP: harmful traditional Create awareness on the impacts of HTP High
practices
983 HEP: harmful traditional Conduct community dialogue and mobilisation on HTP High
practices
984 HEP: harmful traditional Provide psychosocial support to victims of HTPs High
practices
985 HEP: harmful traditional Promote testimonials of HT practitioners on the health impacts High
practices of HTP
986 HEP: prenatal care (pre- Promote early ANC High
pregnancy)
987 HEP: prenatal care (pre- Promote pregnancy readiness services High
pregnancy)
988 HEP: antenatal care Promote the use of optimal ANC High
989 HEP: skilled delivery Promote the use of delivery at health facilities High
990 HEP: postnatal care Provide postnatal counselling to create awareness on postnatal High
danger signs
991 HEP: postnatal care Conduct home visit to promote health services to new-borns High
992 HEP: community-based new- Create awareness on proper new-born care (washing, KMC, High
born care exclusive breast feeding)
993 HEP: community-based new- Conduct home visits to promote the impact of HTPs High
born care
994 HEP: community-based new- Create awareness on the danger signs of new-borns and High
born care measures to be taken
995 HEP: community-based new- Demonstrate new-born care (washing, KMC, Exclusive breast High
born care feeding)
996 HEP: immunisation Promote the importance of immunisation High
997 HEP: IMNCI Create awareness on signs and symptoms of childhood High
illnesses
998 HEP: IMNCI Promote early visit of health facilities High
999 HEP: IMNCI Promote adherence to medical recommendations (treatment High
and advices)
1000 HEP: IMNCI Promote supplementary feeding practices high
1001 HEP: IMNCI Promote visit of under-five 5 children to facilities for GMP, Low
deworming, VAS and screening programmes
1002 HEP: IMNCI Promote good feeding practice (balanced diet, hygienic High
practice)
1003 HEP: IMNCI Conduct food demonstration for children with severe acute High
malnutrition (SAM)
60
1004 HEP: IMNCI Create awareness on the type of services provide at health High
facilities for inder-five children
1005 HEP: IMNCI Promote child care including personal hygiene (proper baby High
wash)
1006 HEP: IMNCI Create awareness on the prevention of childhood accidents Medium
and injuries
1007 HEP: IMNCI Create awareness on the reduction of HTPs High
1008 HEP: adolescent health and Create awareness on balanced diet high
pre-conception nutrition
1009 HEP: adolescent health and Promote healthy and hygienic feeding practices Medium
pre-conception nutrition
1010 HEP: pregnant and Promote balanced diet and intake of micronutrients High
Breastfeeding women
nutrition
1011 HEP: micronutrient Promote use of fortified products high
supplementation and
fortification
1012 HEP: all CVD, CRD, DM and Promote adherence to medications High
RD
1013 HEP: all CVD, CRD, DM and Promote healthy life style including physical exercise and High
RD feeding habits
1014 HEP: all CVD, CRD, DM and Promote reduction in the use of alcohol, tobacco, sweetened High
RD beverages, etc.
1015 HEP: all CVD, CRD, DM and Create awareness on the impacts of saturated fat products High
RD
1016 HEP: all CVD, CRD, DM and Promote the use of unsaturated fat products Low
RD
1017 HEP: all CVD, CRD, DM and Promote regular medical check-ups High
RD
1018 HEP: all CVD, CRD, DM and Promote the establishment of support groups for substance High
RD abusers and chronic patients
1019 HEP: all CVD, CRD, DM and Advocate for proper standards and protocols of products High
RD during advertisement
4.9. Multi-sectoral interventions: nutrition interventions

In this section, 64 essential multi-sectoral nutrition interventions are included. Mainly because most of
these interventions are cost-effective and have high equity impact, all multi-sectoral nutritional
interventions are high-priority interventions (Table 16). These interventions should be aligned with other
sectors, such as agriculture, education, industry, social protection, trade and disaster risk management.
Table 16: Essential multi-sectoral nutritional interventions for Ethiopia.
61
IC Sub-programme Essential multi-sectoral nutritional interventions Priority
334 Nutrition multi-sector: with Promote production and consumption of fruits and vegetables High
agriculture and livestock
sector
335 Nutrition multi-sector: with Promote production and consumption of nutrient dese cereals High
agriculture and livestock and pulses
sector
336 Nutrition multi-sector: with Promote production and consumption of animal source foods High
agriculture and livestock (meat, milk, fish and eggs)
sector
337 Nutrition multi-sector: with Promote homestead and school gardening High
sector
338 Nutrition multi-sector: with Promote and support urban agriculture High
sector
339 Nutrition multi-sector: with Promote production and consumption of bio-fortified foods High
sector
340 Nutrition multi-sector: with Promote post-harvest management High
sector
341 Nutrition multi-sector: with Promote technologies for post-harvest food processing, High
agriculture and livestock handling, preservation and preparation
sector
342 Nutrition multi-sector: with Promote assets building interventions High
sector
343 Nutrition multi-sector: with Target vulnerable households (malnourished children and High
agriculture and livestock PLW)
sector
344 Nutrition multi-sector: with Improve nutritional value of PSNP food basket High
sector
345 Nutrition multi-sector: with Implement soft conditionality’s for HHs with vulnerable High
agriculture and livestock households (malnourished children and PLW)
sector
346 Nutrition multi-sector: with Promote women labour and time saving technologies High
sector
347 Nutrition multi-sector: with Promote small-scale, high-tech irrigation for priority areas for High
agriculture and livestock better nutrition outcomes
sector
348 Nutrition multi-sector: with Promote nutrition sensitive agriculture and livestock High
agriculture and livestock knowledge and practice among farmers and AEWs
sector
349 Nutrition multi-sector: with Promote climate-smart and nutrition-sensitive agriculture High
sector
350 Nutrition multi-sector: with Promote wild and endogenous food High
sector
62
351 Nutrition multi-sector: with Promote school feeding programme High
education sector
352 Nutrition multi-sector: with Promote school gardening High
education sector
353 Nutrition multi-sector: with Promote school wash High
education sector
354 Nutrition multi-sector: with Promote nutrition clubs in schools High
education sector
355 Nutrition multi-sector: with Celebrate nutrition days in schools High
education sector
356 Nutrition multi-sector: with Establish school mini-medias High
education sector
357 Nutrition multi-sector: with School deworming High
education sector
358 Nutrition multi-sector: with Weekly intermittent IFA supplementation High
education sector
359 Nutrition multi-sector: with Strengthen community-based nutrition service provision by High
education sector higher education institutes
360 Nutrition multi-sector: with Mainstream nutrition in school curriculum High
education sector
361 Nutrition multi-sector: with Train nutrition professionals in higher education High
education sector
362 Nutrition multi-sector: with Promote access to safe and clean water High
water supply sector
363 Nutrition multi-sector: with Promote access to high-tech small- and large-scale irrigation High
water supply sector for better nutrition outcomes
364 Nutrition multi-sector: with Strengthen fluorosis mitigation interventions through High
water supply sector nutritional interventions
365 Nutrition multi-sector: with Produce and distribute fortified food High
industry sector
366 Nutrition multi-sector: with Create awareness on nutrition-related requirements and High
industry sector standards for locally manufactured food items
367 Nutrition multi-sector: with Strengthen the capacity of food producers and millers to High
industry sector produce fortified foods
368 Nutrition multi-sector: with Support in availing industrial inputs (pre-mix, equipments, raw High
industry sector materials) for food fortification
369 Nutrition multi-sector: with Ensure quality and safety of locally produced foods High
industry sector
370 Nutrition multi-sector: with Ensure the quality and safety of imported food items as per High
trade sector national standard
371 Nutrition multi-sector: with Regulate the quality and safety of locally produced foods High
trade sector
372 Nutrition multi-sector: with Promote the use of safe, fortified foods High
trade sector
373 Nutrition multi-sector: with Ensure safety and quality of street foods High
trade sector
374 Nutrition multi-sector: with Create awareness in public and private sectors on nutrition- High
trade sector related requirements and standards for improved food items
375 Nutrition multi-sector: with Support importation of fortified foods High
trade sector
63
376 Nutrition multi-sector: with Ensure access to and supply chain for food and food items High
trade sector
377 Nutrition multi-sector: with Ensure targeting of vulnerable HHs by PSNP High
social protection sector
378 Nutrition multi-sector: with Implement conditional support for malnourished PLW and High
social protection sector children under two through PSNP
379 Nutrition multi-sector: with Integrate nutrition practices and services in PSNP High
social protection sector
380 Nutrition multi-sector: with Promote income generating activities for improved access to High
social protection sector nutritious food
381 Nutrition multi-sector: with Employ fee waiver scheme for the management of acute High
social protection sector malnutrition
382 Nutrition multi-sector: with Promote nutrition services for elderly and person with High
social protection sector disability
383 Nutrition multi-sector: with Strengthen and scale-up an early warning system for food and High
disaster risk management nutrition information
sector
384 Nutrition multi-sector: with Support nutrition emergency response and recovery through High
disaster risk management participatory risk assessment and preparedness planning
sector
385 Nutrition multi-sector: with Promote SBCC strategies to impart information about High
disaster risk management resilience to nutrition-related shocks
sector
386 Nutrition multi-sector: with Certify competent food and nutrition product manufacturers, High
food and drug authority importers, exporters, distributors and quality control
sector laboratories
387 Nutrition multi-sector: with Control the quality and safety of food products by developing High
food and drug authority directives, standards, legislations and manuals
sector
388 Nutrition multi-sector: with Enforce and regulate food manufacturers, importers and High
food and drug authority distributors
sector
389 Nutrition multi-sector: with Ensure the quality and safety of infant formulas, High
food and drug authority complementary foods, fortified foods, food fortificants and
sector pre-mix, therapeutic and supplementary foods
390 Nutrition multi-sector: with Register and issue market authorisation for nutritious food High
food and drug authority products
sector
391 Nutrition multi-sector: with Ensure safety and quality of public and bottled water and food High
food and drug authority products used up to standard
sector
392 Nutrition multi-sector: with Ensure gender responsive nutrition implementation and High
gender sector reporting
393 Nutrition multi-sector: with Ensure gender integration in sector nutrition implementation High
gender sector strategies, guidelines and programmes
394 Nutrition multi-sector: with Mobilise women’s groups in nutrition advocacy and skill High
gender sector transfer
395 Nutrition multi-sector: with Ensure women economic empowerment High
gender sector
396 Nutrition multi-sector: with Promote women empowerment and child protection High
gender sector interventions
64
397 Nutrition multi-sector: with Create awareness on HTPs that affect the nutritional status of High
gender sector women and children
65
Chapter 5: Implementation strategies of the
package
The ESHP for Ethiopia serves as a management tool that will help the health system to focus
and act on priory health interventions. The implementation of the EHSP starts with laying out
the key strategic priorities for the implementation within the health system of Ethiopia. Thus,
to effectively implement the EHSP, a detailed implementation guide that will describe the
situational analysis, planning, implementation, monitoring and evaluation will be presented in
a separate document. This chapter only presents a brief account of the key strategic areas and
a set of intertwined strategic priorities that need to exist for the effective implementation of the
EHSP. This chapter also proposes an institutional arrangement and the roles and
responsibilities of various stakeholders for the sound implementation of the package in a
sustainable and efficient manner.
5.1. Key and strategic priority areas

The implementation of Ethiopia’s EHSP requires a sound implementation strategy that enables
proper planning, accurate measurement of performance and tracking the progress as well as
impact of the EHSP. Accordingly, the following 10 key strategic priority areas are proposed.
(i) Enhance community participation in the planning, implementation, monitoring and
evaluation of the EHSP
(ii) Enhance stakeholder engagement
(iii) Improve health service delivery
(iv) Improve the availability, competency and capacity of human resources for health
(HRH)
(v) Ensure sustainable health financing and a clear and viable payment mechanism
(vi) Strengthen the logistics and supply chain management system to ensure access to
essential medicines and equipment
(vii) Improve data utilisation for decision-making at all levels of the health system
(viii) Continue improvement of leadership and management
(ix) Enhance partnership and coordination with other sectors
(x) Create interface and integration with other national strategies, initiatives and
strategic priorities (such as the Woreda Transformation Agenda, HSTP and Public–
Private Partnership (PPP))
66
(i) Enhance community participation in the planning, implementation,
monitoring and evaluation of the EHSP
Community participation includes individual or community members taking greater
responsibility and showing higher involvement at different stages of decision-making in issues
such as identifying priorities, monitoring and evaluation. The effective implementation of the
EHSP requires active community participation and awareness about the interventions and
engagement of the community in the planning and implementation process of the EHSP. In
addition, the community needs to be aware of the interventions included in the EHSP, be
knowledgeable about the entitlement to the approved interventions and services, request for its
provision, and take responsibility for the sound implementation of the package. The awareness
of the community/customers about the ESHP should be communicated through existing and
other newly developed channels of communication.
Strategic actions
 Engage the existing community-level structures in the planning, implementation and
monitoring of EHSP implementation.
 Develop systematic community engagement strategies (including approaches by the
Health Development Army structure or other alternative community mobilisation
strategies).
 Create community ownership and partnership by implementing the already in-use
community score card mechanism and other similar community engagement
strategies.
 Strengthen the engagement of the community representatives in the decision-making
process regarding the planning and implementation of the EHSP.
(ii) Enhance stakeholder engagement

Enhancing stakeholder engagement in the planning and implementation of the package is very
important. All relevant stakeholders with a key stake in the implementation of the package
(such as RHBs, zonal health offices, Woreda health offices and health service providers) should
be trained on the package content and its implementation process. In addition, professional
associations, patient associations, development partners, NGOs and other civil society
organisation needs to be actively involved in the planning, implementation, monitoring and
67
evaluation of the EHSP by harmonising with their strategic priority and organisational core
businesses. Situational analysis and capacity gaps assessments will need to be continually
conducted or integrated with other initiatives to learn about the situation and gaps of the current
health system in implementing the package. This should be conducted in tandem with the
implementation process and other health sector activities.
Strategic actions
 Map and identify stakeholders (their interests, roles and responsibilities) in relation
to the implementation of the re-defined EHSP.
 Create stakeholder engagement mechanisms and platforms for the effective
engagement of all relevant stakeholders.
 Harmonise the plans and budget and monitor and evaluate the systems of the health
sector stakeholders.
 Understand and analyse the expectations of stakeholders and create and/or use
existing forums to discuss and develop joint planning.
 Use EHSP as the main health sector performance measure and ensure that all
health sector stakeholders clearly understand the EHSP.
 Encourage all health sector stakeholders to use the EHSP document as a planning
and management tool.
(iii) Improve health service delivery

Improving the health service delivery by focusing on the appropriate mix of health
interventions at all service delivery points will improve the efficient delivery of the service
provision. When planning and implementing the EHSP of Ethiopia, attention is needed on the
following.
Strategic actions
 Develop (update and review) interventions and clinical guidelines for the high-priority
services included in this EHSP.
 Develop referral guidelines and implement the functional referral system and gate-
keeping mechanism for high-priority services.
 Review staffing requirements, qualifications and ‘standards’ to ensure the proper
implementation of the EHSP of Ethiopia.
68
 Conduct training needs assessment and ensure that the staff is trained in such a way that
the on-the-job training topics are linked to the EHSP.
 Train all health worker and mainly the medical staff (physicians, nurses and laboratory
professionals) on the delivery and standards of the ESHP.
 Train back-office public health managers and officers (FMOH, RHBs, Woreda health
management staff, HC CEO/managers and hospital managers) on the standards of the
EHSP.
 Re-orient the facility-level ‘quality improvement team’ on the standards of the EHSP
for continued quality improvement of the EHSP service delivery.
 Monitor whether the services provided in the facilities meet the specified quality
requirements/standards. This may include developing explicit organisational standards
and accreditation mechanisms and the standardisation and measurement of
performance against set standards for EHSP.
(iv) Enhance the competency and capacity of HRH

To provide the EHSP services, health service providers at different levels need to be resourced
with the required health professionals and supervisory staff, facilities, equipment and supplies.
The delivery of the EHSP of Ethiopia requires trained, equipped and responsive health
workforce to achieve the best health outcomes, given the available resources and
circumstances. The health workforce planning requires a sufficient, fairly distributed,
competent, responsive and productive health workforce.
Strategic actions
 Improve the quality of the health workforce by focusing on the quality of the
pre-service training.
 Increase specialty and sub-specialty programmes to expand the access and
coverage of the interventions included in the package.
 Ensure the implementation of continued professional development (CPD) to
improve the continued technical capacity of the health professionals and health
service quality.
 Institutionalisation of CPD training and HRH development plan.
 Improve HRIS to ensure the efficient and effective management of HRH
through the use of information and communication technology.
69
(v) Sustainable health financing and a clear and viable payment
mechanism
The implementation of Ethiopia’s EHSP requires a sustainable health financing system with
adequate financing in ways that also ensure adequate FRP. Health financing systems that
achieve universal coverage also encourage the provision and use of an effective and efficient
mix of payment modality at the point of service.
The payment arrangement, from the patient/client’s perspective, for the EHSP is illustrated in
Figure 3. The three layers represent the total number of health services that should be provided
by a health facility or at a population level. Some of the essential health services should be
provided free of charge (i.e. exempted services) (e.g. immunisation, TB, family planning, and
delivery at primary health care facilities). Some of the essential health services can be provided
on a cost-recovery basis (commonly referred to as high-cost services). The middle layer
represents the part of the EHSP that is offered on a cost-sharing basis. A proposed payment
mechanism for each of the health services is presented in Annex 1.
However, from providers’ perspective, a clear and viable financing arrangement shall be
established for all services to enable health facilities to provide quality health services without
financial constraints. Therefore, a cost-of-service database should be established and regularly
updated and an appropriate combination of reimbursement methods (i.e. capitation, fee-for-
service and diagnosis related groupings) should be applied.
70
Cost-recovery
Cost-sharing
Exemted-
serivces
Figure 3: Financial arrangement for Ethiopia’s EHSP
Strategic actions
 Ensure the full implementation of the health insurance system to reduce OOP
payments as a means of FRP.
 Ensure effective and efficient utilisation of the health insurance fund.
 Improve the quality of the health facilities to mobilise finance and motivate clients
to enrol into the health insurance system.
 Clearly define the linkage between the health insurance benefit package and the
services and interventions included in the EHSP.
 Identify and implement second and third generation health financing reform
strategies.
 Develop and implement domestic and innovative health financing mechanisms.
 Introduce and implement performance-based financing by directing incentives to
service providers and purely financial awards based on the achievement of certain
pre-established verified performance indicators. Payments could be conditional on
performance, often defined in terms of process or output indicators, adjusted by
some measures of quality.
71
 Reduce reliance on OOP payments by strengthening pre-payment mechanisms and
the Ethiopian Health Insurance Agency and moving toward pre-payment systems.
 Implement ‘waiver mechanism’ by ensuring that the poor have access to the needed
essential health services and that paying for services does not result into
catastrophic health expenditures.
 Improving generation of data on the health financing mechanism.
(vi) Improve logistics and supply chain management systems

The effective delivery of EHSP and the health interventions included in the package requires a
functioning health system that ensures equitable access to diagnostic facilities and supportive
services, essential medicines, vaccines and technologies. The essential medicines/drugs list by
type of facility will need to be identified and updated based on the finally approved package.
To facilitate the delivery of EHSP, adequate diagnostic facilities and supportive services that
ensure the delivery of the package at service delivery points are required.
Laboratory services, radiology and other image services and medical equipment are critical for
the provision of the ESHP for Ethiopia. The laboratory services include haematology, serology,
clinical chemistry, bacteriology, parasitology and cytology. Radiology and other imaging
services include X-ray (chest, abdomen and skeletal), ultrasound and ECG. Radiology and
other imaging services by type of facility are annexed to this document. Medical equipment
includes imaging, laboratory, dental unit and EPI (immunisation) as well as labour and delivery
unit, consultation room and minor OR (minor surgery). The medical equipment by type of
facility is annexed to this document.
Strategic actions
 Revise the essential medicine list and develop essential equipment list.
 Procurement and development of distribution systems to ensure equitable access to
essential medical products, vaccines and technologies should be strengthened.
 Ensure rational use of essential medicines, commodities and equipment by developing
appropriate guidelines and strategies in such a way that the EHSP is taken into account.
 Promote equitable access to quality products, vaccines and technologies by
strengthening the supply chain management system.
72
 Strengthen local production of essential drugs and medical equipment by initiating and
supporting PPP initiatives to improve the supply of medicines and improve the logistics
system.
 Monitor the quality and safety of medical products, vaccines and technologies by
analysing their use to ensure the effective delivery of the package using data.
(vii) Improve HMIS and data utilisation for decision-making

The generation and strategic use of data and information is an integral part of the leadership
and governance function of the health system. Hence, HMIS is a key component for the sound
implementation of the EHSP.
Strategic actions
 Generate population and facility-based data: from censuses, household surveys, civil
registration data, public health surveillance, medical records, data on health services
and health system resources (e.g. human resources, health infrastructure and financing).
 Develop capacity to detect, investigate, communicate and contain events that threaten
public health security at the place they occur and as soon as they occur.
 Develop capacity to synthesise information and promote the availability and application
of this knowledge.
 Support improved population- and facility-based information systems.
 Establish a set of core and additional health system metrics to track the progress and
performance in relation to the implementation of the EHSP.
(viii) Strengthen institutional capacity and the role of leadership and

management
Leadership and governance involve ensuring the development and existence of strategic policy
frameworks combined with effective oversight, capacity building, regulation and enacting
accountability. Leadership should strengthen the supportive supervision system, enhance the
use of data for decision-making and quality improvement and enact accountability for the
implementation of the package. In addition, leadership should strengthen the institutional
capacity.
Strategic actions
73
 Build the capacity of the health sector leaders and managers by establishing
leadership incubation centres.
 Work with academic institutions to coordinate trainings and capacity building
initiatives.
 Create a reward system for high performing leaders.
 Develop a health sector leadership development strategy.
 Cultivate the culture of accountability by developing management and setting standards

and expected deliverables at all levels.
(ix) Partnership and coordination with other sectors
The implementation of the inter-sectoral interventions in the package requires the involvement
of other sectors. The major sectors include agriculture, education, water and mass media. The
working modalities will be clearly defined in the implementation plan for the EHSP that will
be developed separately.
Strategic actions
 Create an EHSP steering committee involving all relevant stakeholders.
 Develop memorandums of understanding regarding the joint implementation of the
EHSP.
 Integrate the planning, budgeting and monitoring and evaluation system.
 Work with media to ensure that the media plays a supportive role by providing valid
information and awareness about the EHSP of Ethiopia.
 Develop clear inter-sectoral collaboration mechanisms and structures with other sectors
in the planning and implementation of the EHSP.
(x) Integrate with other national existing initiatives and strategic priorities
Integrate with other national existing initiatives and strategic priorities such as the Woreda
Transformation Agenda, HSTP and PPP.
Strategic actions
 Engage appropriate individuals, directorates and agencies to ensure the alignment of
their respective plans, budget and monitoring system with the EHSP implementation.
 Integrate, plan and evaluate.
74
 Harmonise all strategies with the implementation of the ESHP.
 Use EHSP as a minimum and an entry point when developing other health sector
strategies and plans.
 Assign a relevant directorate (with dedicated staff for EHSP) that is responsible for the
planning, implementation, monitoring and evaluation of the EHSP.
5.2. Institutional arrangement

The key actors involved in the implementation of EHSP will be the FMOH, RHBs, zonal health
department, Woreda health office, Kebele administration and community-level groups
(community groups). The key actors also include the EHPI and EHIA5.
The implementation of EHSP requires institutional arrangements with defined roles and
responsibilities of the institutions involved in the planning, implementation, monitoring and
evaluation. In this section, issues including administrative arrangements, human resources,
infrastructure and diagnostic requirements as well as the role of each level of the management
and financing arrangements will be discussed.
Roles and responsibilities

Federal Ministry of Health:
 Provides guidance regarding what is expected of the regions, Woredas and health
facilities to plan and implement the EHSP of Ethiopia.
 The FMOH issues policy and guidelines for the implementation of the EHSP.
 Monitors the effect, relevance and appropriateness of the EHSP in addressing the basic
needs of the society from time to time nationally and gives guidance on areas for
improvement.
 Secures the funds and support needed to deliver EHSP.
 Performs various assessments to measure the performance and coverage of the EHSP
on a regular basis and monitor coverage figures.
 Revises the EHSP on a regular basis and/or evaluates new services to be included
through systematic health technology assessment.
5
The roles of EPHI and EHIA will be defined in the due process/towards the final phase of developing the
package.
75
Regional health bureaus:
The RHBs will adapt the national EHSP to their regional context by supplementing their own
priorities. They also give guidance on the appropriate resource allocation for the
implementation of the EHSP. The responsibilities of the RHBs are as follows:
 Provide training and orientation to the appropriate regional and Woreda authorities on
the content, planning, implementation and quality improvement of the EHSP.
 Perform the planning process based on the EHSP as well as the assessment and
performance of the system at various levels.
 Monitor and evaluate the application of EHSP.
 Produce and monitor coverage figures regularly for the region, facilities and Woreda
and communicate these figures to the regional and district authorities and the FMOH.
 Ensure supportive supervision to sample facilities at each stage of the referral level and
provide feedback accordingly.
 Keep records of available staffing (HRIS) and resource/logistics pattern as well as the
availability and functionality of various inputs at all levels in the region with respect to
the needs of the EHSP and ensure equitable distribution of human and other resources
among districts.
Woreda health offices:

The Woreda health offices ensure the following:
• Every health facility is delivering the EHSP for its level; there is strong linkage and
support between the various levels.
• Guidance and support in planning; in their annual plans, each health facility sets
appropriate targets in relation to each of the components of the EHSP; the faculty sets
make appropriate efforts to achieve their targets.
• Each facility gets appropriate resources to achieve their agreed-upon targets.
Kebele administration:
At the community level, the HP will serve as the centre of service as well as coordination for
delivering the EHSP. The Kebele administration will perform the following:
• Plan for the regular supplies and resources required to deliver the EHSP.
76
• Review and monitor the effectiveness of the planned interventions as well as the
satisfaction of the community with the EHSP.
• Provide feedback at the Woreda level.
• Make sure that all the records and copies of reports are kept properly.
• Enhance inter-sectoral collaboration and action by bringing together the various
stakeholders at the Kebele level.
Diagnostic and supportive services
To facilitate the delivery of EHSP, selected diagnostic facilities and supportive services will
be required. The HP level will address the major problems based on clinical diagnoses.
However, the other level of the service delivery points needs diagnostic facilities.
77
Chapter 6: Monitoring and evaluation
framework
To track the implementation, effectiveness and efficiency of the EHSP, the presence of a sound
monitoring and evaluation framework will be critical. This framework is based on the
objectives and expected results of the EHSP (Figure 4) and is generally expected to be
harmonised and aligned with HMIS- and population-based surveys that exist in the health
system. The existing monitoring and evaluation system components will be reviewed and
adjusted to accommodate the changes made in the priority promotive, preventive, curative and
rehabilitative health interventions at various levels of the health system and to serve the purpose
of monitoring and evaluation of the delivery of EHSP.
Effective,
Priority setting Improve efficient,
resource use Universal
in health and equitable,
evidence-based and focus on health
sutstainable
decision- high-impact and resilent coverage
making interventions health (UHC)
system
Figure 4: Theory of change for the monitoring and evaluation of the EHSP.
6.1. Monitoring
The monitoring of ESHP encompasses key mechanisms such as recording and reporting
through the established system, review meetings, supervisions and regular assessments. The
system will track aggregate data of both health services and disease/morbidities, where the
latter is captured using the ‘event capture’ feature or application of second version of District
Health Information System (DHIS2). All mechanisms of monitoring to track the
implementation status, challenges and lessons regarding the planning and implementation of
the EHSP will be harmonised and integrated with the existing monitoring mechanisms. The
priority promotive, preventive, curative and rehabilitative health interventions will be recorded
using the existing HMIS tools at various levels of the health system with possible modification
78
as deemed necessary. The health facilities and health administrative units are expected to report
the priority clinical and public health interventions based on the predefined monthly, quarterly
and annual schedule. Disease report based on NCOD is monthly reportable. Following the
adoption and deployment of the DHIS2 to the Ethiopian HMIS, which is a flexible, open-source
web-based system with an off-line feature, both service and disease reports are expected using
this system.
Tracking of the implementation status, challenges and successes regarding the planning and
implementation status of the EHSP will be integrated with the sector-wide and programme-
specific review meetings and supervisions such integrated supportive supervision (ISS).
Standardised assessments such as service availability and readiness assessments (SARA),
service provision assessment (SPA) and EmONC should be revisited while taking the changes
made in the revised EHSP into account.
6.2. Evaluation
To evaluate the progress in achieving the ESHP objectives and its impact, existing population-
based surveys will be utilised. These periodic evaluations will also help assess the relevance,
efficiency and sustainability of the EHSP implementation. The existing population-based
surveys such as Demographic and Surveys (DHS), Civil Registration and Vital Statistics
(CRVS), Malaria Indicator Surveys (MIS) and other disease and behavioural surveillance and
special surveys will be utilised to determine the extent of the achievement of the EHSP
objectives and measure the status of the indicators.
6.3. Indicators to measure the progress of ESHP
The progress in the availability of EHSP can be monitored and evaluated using selected key
indicators that can be tracked using the routine health information system and surveys. The
core indicators are grouped into three: service coverage indicators, FRP indicators (Table 16a)
and mortality and morbidity (Table 17b) impact indicators (Table 17a).
79
Table 17a. Improvement/change in BoD will be tracked by Age-standardised death rate and DALYs
Rank Causes of death or injury (GBD level - 2) 2019 2021 2023 2025 Data
Death DALY Death DALY Death DALY Death DALY Sources
1 Maternal and neonatal disorders HMIS/GBD
2 Respiratory infections and tuberculosis HMIS/GBD
3 Enteric infections HMIS/GBD
4 Other infectious diseases HMIS/GBD
5 Other NCDs HMIS/GBD
6 Nutritional deficiencies HMIS/GBD
7 HIV/AIDS and sexually transmitted infections HMIS/GBD
8 Cardiovascular diseases HMIS/GBD
9 Neoplasms HMIS/GBD
10 Mental disorders HMIS/GBD
11 Unintentional injuries HMIS/GBD
12 Digestive diseases HMIS/GBD
13 Neurological disorders HMIS/GBD
14 Self-harm and interpersonal violence HMIS/GBD
15 Musculoskeletal disorders HMIS/GBD
16 Diabetes and kidney diseases HMIS/GBD
17 NTDs and malaria HMIS/GBD
18 Skin and subcutaneous diseases HMIS/GBD
19 Sense organ diseases HMIS/GBD
20 Transport injuries HMIS/GBD
21 Chronic respiratory diseases HMIS/GBD
22 Substance-use disorders HMIS/GBD
80
Table 17b: Change in quality UHC service for monitoring and evaluation of EHSP
S.NO Major group Tracer indicator Description Data source

1 RMNCH Family planning Demand satisfied with modern method among women aged 15–49 years who EDHS
are married or in a union
2 RMNCH Pregnancy care   Average coverage of four or more antenatal visits and skilled birth attendance EDHS
3 RMNCH Full child immunisation   One-year-old children who have received three doses of vaccine containing EDHS
diphtheria, tetanus and pertussis
4 RMNCH Child treatment   Care-seeking behaviour for children with suspected pneumonia EDHS
5 Infectious diseases TB treatment   TB cases detected and cured WHO

6 Infectious diseases HIV treatment   People living with HIV receiving ART HMIS
7 Infectious diseases Malaria prevention   Population at risk sleeping under insecticide-treated bed nets MIS
8 Infectious diseases Improved water and Average coverage of households with access to improved water and sanitation EDHS
sanitation  
9 NCDs Treatment of CVD Prevalence of raised blood pressure STEPs
10 NCDs Management of DM  Prevalence of raised blood glucose STEPs
11 NCDs Cervical cancer screening Cervical cancer screening among women aged 30–49 years STEPs
12 NCDs Tobacco control Adults aged ≥ 15 years not smoking tobacco in the last 30 days STEPSs
13 Service capacity and Hospital access   In-patient admissions per capita HMIS
access
14 Service capacity and Health worker density Health professionals per capita physicians, psychiatrists and surgeons HMIS
access
15 Service capacity and Access to essential Average proportion of WHO-recommended core list of essential medicines SPA
access medicines present in health facilities
16 Service capacity and Health security   International Health Regulations core capacity index FMOH
access
81
Table 17c. Change in FRP core indicators for monitoring and evaluation of EHSP.
S.NO Tracer indicator Description Data source

1 Proportion catastrophic OOP expenditure Proportion of households with catastrophic OOP health expenditure NHA
exceeding 40% of non-food total expenditure
2 Incidence of medical impoverishment NHA
3 Proportion of households enrolled in Number of households in the district enrolled in the CBHI scheme in EHIA
community-based health insurance the year divided by the total number of households in the district
82
Annexes
Annex I: Costs and fiscal space for EHSP implementation
Costs of EHSP implementation
The total estimated costs of EHSP implementation depend on several factors, including the
scope and number of services included, the assumption for the costs related to each service,
and the target coverage. In order to assess variation in projected resource needs, three cost
scenarios were developed, labelled ‘low’, ‘medium’ and ‘high’. Here, the only difference
between the scenarios is the difference set in coverage rate, while the service package and the
cost assumptions remain the same across the three.
To calculate the projected cost for the low scenario, 30% target coverage for most of NCD
interventions and 80% target coverage for most of RMNCH and infectious disease
interventions was taken (target coverage refers to year 2030, with coverage scaled up over time
from current baseline). The medium scenario is more ambitious, with costs calculated based
on 50% target coverage for NCD interventions and 95% target coverage for RMNCH and
infectious disease interventions. Finally, cost for the high scenario was calculated based on
target coverage of 80% for NCD interventions and 100% for most RMNCH and infectious
disease interventions) for all included services by 2030 (figure 5).
In order to implement EHSP within the next 10 year (2020 – 2030), for instance based on
medium coverage variant, a total of about USD 95.1 Billion is needed. In 2020, about US$
3.56, US$ 4.24, or USD 4.88 Billion is needed based on low, medium or high coverage variant
assumptions respectively. Majority of costs will be for total medicines, commodities.
83
Figure 5. Required resources for the implementation the EHSP over (2020-2030)
Figure 6 shows the same cost projections in per capita terms (adjusting for population growth
in the period 2020-2030, UNDP medium projections). Observe that these are the full cost,
without taking into account the funding source, needed for implementing the EHSP. The
findings align well with global projections for the estimated minimum health expenditure for
essential services for a low-income country by the year 2030: around USD100-120 per capita
[35].
140
120
100
80
US$
60
40
20
0
2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030
Low need Medium need High need
Figure 6. Required resource needs (USD per capita) for implementation of the EHSP (over
2020-2030) (low, medium and high coverage variant)
Budgetary room for EHSP implementation
Recognizing the low national overall health sector spending, Ethiopia’s FMOH is committed
to increase government expenditure on health and on other social services to achieve universal
health coverage (UHC) with provision of financial risk protection [18, 36]. The government of
Ethiopia also recognizes the obligation to devote the maximum available domestic resources
to health, and to not merely rely on international assistance and donor aid, in order to achieve
the progressive realization of UHC [37].
Fiscal space can be simply understood as the “budgetary room” that would allow the Ethiopian
government to devote resources to specific services or activities without jeopardizing the
84
sustainability of the government’s finances [38]. The budgetary room is largely determined by
three factors: economic growth, the level of total government expenditure and the percentage
of total government expenditure devoted to health (or percent of gross domestic product (GDP)
spent on health). In addition, total health expenditure is also a function of household direct
expenditures (i.e. out-of-pocket (OOP) expenditures), other private expenditures (from
employers, NGOs and others), and of external resources for health (i.e. development aid). By
defining reasonable assumptions and defining realistic targets, projections for the available
fiscal space into the future can be made.
This report provides three possible scenarios for budget expansion for the EHSP; they are
labeled: ‘low available’, ‘medium available’, and ‘high available’ (i.e. an aspirational
scenario). These three variants for possible budget expansion paths for total health expenditures
towards UHC are illustrated in Figure 7.
140
120
100
80
US$
60
40
20
0
2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030
Low available Medium avaiable High available
Figure 7. Per capita total health expenditure projections, 2020-2030 (low, medium, and high
available scenario).
Data for Ethiopia from WHO’s Global Health Observatory on health expenditures as baseline
was used for the projections, and scenarios were simulated up to the year 2030 [39]. The
underlying assumptions for these projections are as follows:
 Economic growth (GDP) per year: 7.6 – 8.6 – 9.7%. Although Ethiopia in the last
decade has had higher economic growth (around 10% annual) [40], only a few countries
were found to have been able to sustain such growth over time.
85
 Increase in actual government health expenditure to 3-4-5 % of GDP. This is in line
with international recommendations .[41, 42] In their analysis of the relationship
between government spending on health and a range of indicators related to UHC goals,
McIntyre et al. recommend a target of domestic government spending on health of at
least 5% of GDP. Assumption was taken that this target to be met by 2030 in the high
variant, while 3% is used in the low variant, and 4% is used in the medium variant.
 External funding for health. Relatively stable external funding for health was assumed,
i.e. no change in absolute figures, but with a relative decrease. Development partners
recognize the need to sustain the substantial health improvement seen in Ethiopia since
the early 1990s. Although this support is likely to continue in the years ahead,
Ethiopia’s transition towards a middle-income country implies a decreased relative
proportion of external funding for health.
 Out-of-pocket expenditure. We assumed unchanged OOP. An assumption of 20% OOP

is in line with WHO recommendations [43]. According to Ethiopia’s National Health
Accounts (NHA VII, 2019), household OOP expenditures comprised 33% of total
health expenditures [44]. OOP does not directly affect government spending, but would
likely go down in relative terms when government spending for health goes up.
No change in other private health expenditures (CBHI and SHI) was assumed.
Neither did any change in efficiency gains was assumed. This is a conservative
assumption. Table 18 summarizes main assumptions.
Table 18. Assumptions for simplified budget expansion scenarios
Assumptions (targets, by 2030) Low Medium High

GDP growth per year 7.6 % 8.6 % 9.7 %
Government total health expenditure target, as % of GDP 3.0 % 4.0 % 5.0 %
External funding for health Fixed* Fixed* Fixed*
Out-of-pocket expenditure Fixed* Fixed* Fixed*
Other private health expenditures Fixed* Fixed* Fixed*
86
Efficiency Fixed* Fixed* Fixed*
* Fixed at 2018 level.
Note: GDP growth assumptions from Ministry of Finance
Disaggregated health expenditure projections for the low, medium and high variants are shown
in Figure 8. Two major and uncertain drivers are economic growth and government spending
on health as percent of GDP. A target of domestic government spending of 5% is in line with
current national health care financing strategic document [37], although current government
spending is much lower [44].
Low variant Medium variant

80 100
90
70
80
60
70
50 60
US$
US$
40 50
40
30
30
20
20
10
10
0 0
High variant
160
140
Out of Pocket Expenditure
120 (OOP) per Capita in US$
100
Other private expenditure as
US$
80 per Capita in US$

60
External Resources for
40
health per Capita in US$
20
0 Actual Government Health

Expenditure per Capita in
US$
Figure 8. Total Health Expenditure (USD per capita) projected with low, medium, and high
variant scenarios
87
Comparison of resource needs and projected available resources
Needed resources mapped to projected available resources are shown in Figure 9. We see from
the figure that the required resources would map well projected available resources by the year
2030. However, sustained economic growth and substantial political commitment will be
required to achieve the medium and high coverage scenarios.
Total Health Budget Scenario and Need per Capita $ Total Health Budget Scenario and Need per Capita $
(low, medium and high variant) (low variant)
140 140
120 120
100 100
80
80
60
60
40
40
20
20
0
2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 0
Low need Medium need High need 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030
Low available Medium avaiable High available Low need Low available
Total Health Budget Scenario and Need per Capita $ Total Health Budget Scenario and Need per Capita $
(medium variant) (high variant)
140 140
120 120
100 100
80 80
60 60
40 40
20 20
0 0
2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030
Medium need Medium avaiable High need High available
Figure 9: Required resources compared with expected available resources for EHSP
implementation, per capita USD (2020-2030)
Further analytic work is needed to align resource needs with a realistic and feasible budget
expansion path for each year. If the assumed budget expansion path are unfeasible, another
option for scaling up the EHSP is to only scale up a limited number of the highest priority
services.
Resource generation and mobilization
Whether economic growth slows down or not, other ways to increase fiscal space will be
critical. These include increased mobilization of domestic resources, intersectoral reallocations
88
and reprioritizations, and efficiency gains. As for increased mobilization of domestic resources,
one particularly important option for low- and middle-income countries to consider is increased
taxation of tobacco and alcohol products. Such an increase is likely not only to increase
revenue, but also to improve population health. Improved systems for tax collection are also
crucial.
With respect to intersectoral reallocations, a related strategy is to reduce or eliminate energy

subsidies and other unwarranted subsidies. This can, among other things, increase the fiscal
space for public spending on high-priority health services.
As for efficiency gains, there are many promising strategies to be pursued. The 2010 Word
Health Report lists ten leading causes of inefficiencies that could be addressed: underuse of
generic drugs (instead of brand-name drugs) and higher than necessary prices for medicines;
use of substandard and counterfeit medicines; inappropriate and ineffective use of medicines;
overuse or supply of equipment, investigations, and procedures; inappropriate or costly staff
mix and unmotivated workers; inappropriate hospital admissions and length of stay;
inappropriate hospital size (low use of infrastructure); medical errors and suboptimal quality
of care; waste, corruption, and fraud; and inefficient mix or inappropriate level of strategies
[43].
89
Annex II: Interventions by level of delivery and payment mechanisms
Table 19: Components of the ESHP for Ethiopia by program area, level of delivery, and payment mechanisms
(IC= Intervention Codes, HP = Health Posts, HC=Health Centres, PH=Primary Hospitals, GH=General Hospitals, TH= Tertiary Hospitals).
IC Sub- programs Interventions Level of delivery Payment
HP HC PH GH TH Co mechanism
RMNCH
1 Family Planning Outreach Family planning services X Free
2 Family Planning Counselling on family planning X X X X X X Free
3 Family Planning Provision of male condoms X X X X X X Free
4 Family Planning Provision of female condoms X X X X X Free
5 Family Planning Provision of oral contraceptive X X X X X X Free
6 Family Planning Provision of injectable contraceptives X X X X X X Free
7 Family Planning Provision of emergency contraception X X X X X X Free
8 Family Planning Provision of implants X X X X X Free
9 Family Planning Provision of intrauterine devices (IUD) X X X X X Free
10 Family Planning Female sterilization service X X X X Free
11 Family Planning Male sterilization service X X X X Free
12 Family Planning Provision of monthly vaginal ring or patch X X X X Free
13 Family Planning Diaphragm X X X X X Free
14 Family Planning Lactational amenorrhea X X X X X X Free
15 Family Planning Provision of postpartum family planning X X X X X X Free
16 Infertility management Identification and management of infertility X X X X Recovery
17 Infertility management Psycho social counselling for individuals and a couple X X X X X free
18 Comprehensive abortion care Safe abortion services (included medication abortion, MVA, D&C) X X X X Free
20 Comprehensive abortion care Post abortion case management (management of unsafe abortion X X X X Free
complications including E&C, sepsis management, etc)
21 Comprehensive abortion care Post abortion follow up X X X X X X Free
22 Comprehensive abortion care Ectopic pregnancy case management X X X X Free
90
23 Prevention and treatment of gynaecological Education on menstrual hygiene and cycle X X X X Free
problem
24 Prevention and treatment of gynaecological Treatment of menstrual problems and irregularities X X X X X Free
problem
25 Prevention and treatment of gynaecological Cervical cancer screening X X X Free
problem
26 Prevention and treatment of gynaecological Clinical breast examination X X X X X X Free
problem
27 Prevention and treatment of gynaecological Diagnosis and treatment of syphilis X X X X Sharing
problem
28 Prevention and treatment of gynaecological Diagnosis and treatment of gonorrhoea X X X X Sharing
problem
29 Prevention and treatment of gynaecological Diagnosis and treatment of chlamydia X X X X Sharing
problem
30 Prevention and treatment of gynaecological Diagnosis and treatment of trichomoniasis X X X X Sharing
problem
31 Prevention and treatment of gynaecological Diagnosis and treatment of Pelvic inflammatory disease (PID) X X X X Sharing
problem
32 Prevention and treatment of gynaecological Diagnosis and treatment of Urinary tract infection (UTI) X X X X recovery
problem
33 Prevention and treatment of gynaecological Provision of HPV vaccine X X X X X X Free
problem
34 Sexual health issues Comprehensive sexual health education X X X X X X Free
35 Sexual health issues Adolescent sexual and reproductive health X X X X Free
36 Sexual health issues Age appropriate comprehensive sex education X X X X Free
37 Sexual health issues Provide adolescent friendly contraceptive services X X X X Free
38 Sexual health issues Expand access to and promotion of the use of condoms and other X X X Free
contraceptives
91
49 Gender based violence Comprehensive health education about GBV X X X X free

40 Gender based violence Conduct community dialogue about GBV X X X X free
41 Gender based violence Investigation, diagnosis, and reporting of GBV X X X X Sharing
42 Gender based violence Pregnancy test (HCG) for GBV X X X X Sharing
43 Gender based violence HTC at least 3 times (initial 6 weeks and 6 months) X X X X X free
44 Gender based violence Emergency treatment of life threatening condition due to GBV X X X X X X Sharing
45 Gender based violence Surgical treatment for physical trauma X X X X Sharing
46 Gender based violence Treatment for burn due to GBV X X X X Sharing
47 Gender based violence Medical treatment for infection due to GBV X X X X Sharing
48 Gender based violence Medical treatment for pain due to GBV X X X X X Sharing
59 Gender based violence Tetanus anti-toxoids X X X X Sharing
50 Gender based violence Hepatitis B vaccination for GBV victims X X X X Sharing
51 Gender based violence Comprehensive abortion care X X X X Free
52 Gender based violence Provision of psychiatric treatment for GBV victims X X X X Free
53 Gender based violence Provision of psychosocial support for GBV victims X X X X X X Free
54 Gender based violence Post exposure prophylaxis for HIV with repeat testing X X X X Free
55 Harmful traditional practice (HTP) Health education and community advocacy against HTP X X X Free
56 Harmful traditional practice (HTP) Family planning for child marriage X X X X X X Free
57 Harmful traditional practice (HTP) Special care for teen pregnancy X X X X X X Free
58 Harmful traditional practice (HTP) Psychiatric treatment for abduction X X X X Free
59 Harmful traditional practice (HTP) Counselling and management of female genital mutilation victims X X X X Free
60 Harmful traditional practice (HTP) Diinfbulation and surgical correction for female genital mutilation X X Free
victims
61 Prenatal care Folic acid supplementation/fortification X X X X X X Free
62 Antenatal care Comprehensive health education about early ANC, skilled delivery, X X X X Free
postpartum care, family planning, nutrition, maternal waiting services
63 Antenatal care Focused ANC follow up X X X X Free
92
64 Antenatal care Antenatal corticosteroids for for preterm labour X X X X Free

65 Antenatal care Detection and management of fetal growth restriction X X X X Free
66 Antenatal care Gestational diabetes case management X X X X Free
67 Antenatal care Antibiotics for pre-mature rupture of membrane (PRoM) X X X X Free
68 Antenatal care Management of pre-eclampsia (antihypertensives, induction of labour, X X X X Free
ultrasound to asses fetal growth)
69 Antenatal care Management of eclampsia (MgSO4) X X X X Free
70 Antenatal care Hypertensive disorder case management X X X X Free
71 Skilled delivery care Labour and Delivery Management X X X X Free
72 Skilled delivery care Induction of labour for pregnancies lasting 41+ weeks X X X X Free
73 Skilled delivery care Active management of the third stage of labour X X X X Free
74 Skilled delivery care Basic emergency obstetric and newborn care (BEmONC) X X X X Free
75 Skilled delivery care Comprehensive emergency obstetric and newborn Care (CEmONC) X X X X Free
76 Skilled delivery care Pre-referal management of labour complications X X X X Free
77 Postnatal care Maternal sepsis case management X X X X Free
78 Postnatal care Clean postnatal practices X X X X X Free
79 Postnatal care Mastitis management X X X X Free
80 Postnatal care Treatment of postpartum haemorrhage X X X X Free
81 Postnatal care Chlorhexidine application to the cord X X X X Free
82 Neonatal care Comprehensive new born care X X X X X Free
83 Neonatal care Detection and management of congenital anomalies (cleft lip, palate, X X X X X Free
imperforate anus, club foot, meningocele, spina bifida, dysmorphism,
microcephaly)
84 Neonatal care Screening for congenital hypothyroidism and management X X X X Free
85 Neonatal care Screening for congenital heart diseases and management X X X Free
86 Neonatal care Parental chromosomal screening: amniocentesis (antenatal) for X X X Free
chromosomal screening
93
87 Neonatal care Screening for retinoblastoma X X X Free

88 Neonatal care Kangaroo mother care X X X X X Free
89 Neonatal care Voluntary Neonatal male surgical circumcision X X X Sharing
90 Neonatal care Early infant diagnosis for HIV (DBS) X X X X Free
91 Intensive neonatal care (specialized neonatal Essential new born care X X X Free
care)
92 Intensive neonatal care (specialized neonatal Identification and treatment of Neonatal sepsis X X X Free
care)
93 Intensive neonatal care (specialized neonatal Prevention of neonatal infections X X X Free
care)
94 Intensive neonatal care (specialized neonatal Premature sick Neonatal care: incubator and nutritional X X X Free
care)
95 Intensive neonatal care (specialized neonatal Phototherapy and exchange transfusion X X X Free
care)
96 Intensive neonatal care (specialized neonatal Prolonged intravenous antibiotics for sever neonatal infection X X X Free
care)
97 Intensive neonatal care (specialized neonatal Treatment of birth trauma X X X Free
care)
98 Intensive neonatal care (specialized neonatal Management of perinatal asphyxia X X X Free
care)
99 Intensive neonatal care (specialized neonatal Management of thermoregulation: radiant warmer therapy X X X Free
care)
100 Intensive neonatal care (specialized neonatal Nutrition: breastfeeding and feeding other than breast milk X X X Free
care)
101 Intensive neonatal care (specialized neonatal Management of neonatal tetanus X X X Free
care)
102 Intensive neonatal care (specialized neonatal Management of NEC X X X Free
care)
94
103 Intensive neonatal care (specialized neonatal Management of neonatal jaundice X X X Free
care)
104 Intensive neonatal care (specialized neonatal Management of metabolic disorder X X X Free
care)
105 Intensive neonatal care (specialized neonatal Management of meconium aspiration syndrome X X X Free
care)
106 Intensive neonatal care (specialized neonatal Management of neonatal seizure X X X Free
care)
107 Intensive neonatal care (specialized neonatal Management of neonatal hematologic problems X X X Free
care)
108 Intensive neonatal care (specialized neonatal Management of birth trauma X X X Free
care)
109 Intensive neonatal care (specialized neonatal Management of fluid and electronic imbalance X X X Free
care)
110 Intensive neonatal care (specialized neonatal Management of shock in neonates X X X Free
care)
111 Intensive neonatal care (specialized neonatal Internal feeding for premature babies X X X Free
care)
112 Intensive neonatal care (specialized neonatal Management of neonatal acute emergency surgical conditions X X X Free
care)
113 Intensive neonatal care (specialized neonatal Prevention of respiratory distress syndrome in neonates using X X X Free
care) surfactants
114 Intensive neonatal care (specialized neonatal Management of neonatal respiratory distress with continuous positive X X X Free
care) airway pressure (CPAP)
115 Intensive neonatal care (specialized neonatal Early developmental stimulation X X X Free
care)
116 Immunization and vaccinations Promotion and counselling on immunization X X X X Free
117 Immunization and vaccinations Provision of HBV: at birth X X X X X Free
95
118 Immunization and vaccinations Provision of BCG: at birth X X X X X Free

119 Immunization and vaccinations Provision of OPV: at birth, 6, 10, 14 weeks X X X X X Free
120 Immunization and vaccinations Provision of PCV: at 6, 10, 14 weeks X X X X X Free
121 Immunization and vaccinations Provision of Rota Virus Vaccine: at 6 and 10 week X X X X X Free
122 Immunization and vaccinations Provision of HepB: at Birth X X X X X Free
123 Immunization and vaccinations Provision of DPT-HepB-Hib (Pentavalent): at 6, 10, 14 weeks X X X X X Free
124 Immunization and vaccinations Provision of 1st dose of measles vaccine at 9 month X X X X X Free
125 Immunization and vaccinations Provision of 2nd dose of measles vaccine: at 15-18 months or first X X X X X Free
contact after 15 months
126 Immunization and vaccinations Provision of Tetanus Toxoid (TT) Vaccine X X X X X Free
127 Immunization and vaccinations Provision of 1st doses of IPV X X X X X Free
128 Child health: iCCM Integrated community case management of Neonatal & childhood X X X Free
illness (iCCM)
129 Child health: IMNCI Vitamin A for treatment of measles X X X X Free
130 Child health: IMNCI Treatment of severe measles X X X X Free
131 Child health: IMNCI Vitamin A Supplementation for treatment of xerophthalmia X X X X Free
132 Child health: IMNCI ORS - oral rehydration solution X X X X X Free
133 Child health: IMNCI Treatment of severe diarrhoea (children) X X X X Free
134 Child health: IMNCI Antibiotics for treatment of dysentery X X X X Free
135 Child health: IMNCI Zinc for treatment of diarrhoea X X X X Free
136 Child health: IMNCI Oral antibiotics for pneumonia X X X X Free
137 Child health: IMNCI Treatment of severe pneumonia X X X X Free
138 Child health: IMNCI ACTs - Artemisinin compounds for treatment of malaria X X X X Free
139 Child health: IMNCI Treatment of severe malaria X X X X Free
140 Child health: IMNCI SAM - treatment for severe acute malnutrition X X X X Free
141 Child health: IMNCI MAM - treatment for moderate acute malnutrition X X X X Free
142 Child health: Deworming Deworming every 6 months X X X Free
96
143 Vitamin A supplementation Provision of Vitamin A every 6 months X X X Free

144 Child health: curative care Paediatric HIV care and treatment Services X X X X Free
145 Child health: curative care Paediatric Palliative care X X X X X X Free
146 Child health: curative care Paediatric end of life care & support X X X X X X Free
147 Child health: curative care Management of Pharyngitis/Tonsillitis/Sinusitis X X X X recovery
148 Child health: curative care Management of eye infections: trachoma, X X X X recovery
149 Child health: curative care Management of ear infections: Otitis media X X X X recovery
150 Child health: curative care Management of Croup Syndrome (laryngitis, tracheatis, epiglottitis) X X X X recovery
151 Child health: curative care Management of Paediatric asthma X X X X recovery
152 Child health: curative care Management of Paediatrics bronchiolitis X X X X recovery
153 Child health: curative care Management of aspiration syndrome: foreign body, near drowning X X X X recovery
154 Child health: curative care Management of Congenital Heart Diseases in Paediatrics X X X recovery
155 Child health: curative care Management of infective endocarditis X X X recovery
156 Child health: curative care Management of rheumatic fever/ Rheumatic heart diseases X X X recovery
157 Child health: curative care Management of congestive heart failure X X X recovery
158 Child health: curative care Management of shock in Paediatrics X X X X recovery
159 Child health: curative care Management of Hypertension in Paediatrics X X X recovery
160 Child health: curative care Management of Hepatitis/Jaundice in Paediatrics X X X recovery
161 Child health: curative care Management of Liver failure in Paediatrics X X X recovery
162 Child health: curative care Management of ascites X X X recovery
163 Child health: curative care Management of malabsorption X X recovery
164 Child health: curative care Management of gastro intestinal bleeding X X recovery
165 Child health: curative care Management of acute abdomen X X X recovery
166 Child health: curative care Management of Haemolytic-Uraemia Syndrome X X recovery
167 Child health: curative care Management of Nephritis X X X X recovery
168 Child health: curative care Management of Nephrotic syndrome X X X X recovery
169 Child health: curative care Management of Renal Failure X X recovery
97
170 Child health: curative care Management of Urinary Tract Infections (Lower) X X X X recovery
171 Child health: curative care Management of Pyelonephritis X X X X recovery
172 Child health: curative care Management of Wilms’ Tumour (Nephroblastoma) X X recovery
173 Child health: curative care Management of Ambiguous Genitalia X X recovery
174 Child health: curative care Management of Pyomyositis X X X recovery
175 Child health: curative care Management of Septic arthritis X X X X recovery
176 Child health: curative care Management of Osteomyelitis X X X X recovery
177 Child health: curative care Management of juvenile rheumatoid arthritis X X X X recovery
178 Child health: curative care Management of Impetigo X X X recovery
179 Child health: curative care Management of Dermatitis/Eczema X X X X recovery
180 Child health: curative care Management of Scabies X X X X recovery
181 Child health: curative care Management of Fungal skin infections (ringworms) X X X X recovery
182 Child health: curative care Management of Meningitis X X X X recovery
183 Child health: curative care Management of Encephalitis X X recovery
184 Child health: curative care Management of Seizure disorders X X X X recovery
185 Child health: curative care Management of Cerebral palsy X X recovery
186 Child health: curative care Management of raised intracranial pressure X X recovery
187 Child health: curative care Coma Management X X X X recovery
188 Child health: curative care Management of Poisoning X X X X recovery
189 Child health: curative care Management of Diabetes Mellitus X X X X recovery
190 Child health: curative care Management of Hypothyroidism X X X recovery
191 Child health: curative care Management of Hyperthyroidism X X X recovery
192 Child health: curative care Management of Anaemia X X X X sharing
193 Child health: curative care Management of Septicaemia X X X X sharing
194 Child health: curative care Management of Haemophilia X X recovery
195 Child health: curative care Management of Idiopathic Thrombocytopenic Purpura (ITP) X X X recovery
196 Child health: curative care Management of Leukaemia X X recovery
98
197 Child health: curative care Management of Lymphoma X X recovery

198 Child health: curative care Prevention and management of Child Abuse X X X X X recovery
199 Child health: curative care Paediatric social services X X X X X recovery
200 Child health: curative care Management of Chromosomal anomalies in Paediatrics X X recovery
201 Child health: curative care Management of Down’s Syndrome in Paediatrics X X recovery
202 Child health: curative care Management of Edward’s Syndrome in Paediatrics X X recovery
203 Child health: curative care Management of autism X X X X X X recovery
204 Nutrition: Pregnant women Promote one extra meal and rest during pregnancy X X X X Free
205 Nutrition: Pregnant women Promote on healthy eating, diversified meal X X X X Free
206 Nutrition: Pregnant women Promote ITN use for malaria endemic areas X X X X Free
207 Nutrition: Pregnant women Promote early initiation ( colostrum feeding) and exclusive breast X X X X Free
feeding
208 Nutrition: Pregnant women Nutritional screening and weight gain monitoring during pregnancy X X X X Free
209 Nutrition: Pregnant women Link pregnancy mothers to supplementary feeding program X X X X Free
(Productive Safety Net Program (PSNP) and other programs)
210 Nutrition: Pregnant women Treat malnourished pregnant mothers with therapeutic foods X X X X Free
211 Nutrition: Pregnant women Iron-folic acid supplementation X X X X Free
212 Nutrition: Pregnant women De-worming during pregnancy (2nd trimester) X X X X Free
213 Nutrition: Pregnant women Promote family members (husband, grandparents and other HH X X X X Free
members) involvement to provide nutritional care for pregnancy
women
214 Nutrition: Pregnant women Behaviour change communication on maternal nutrition ( X X X X Free
215 Nutrition: Pregnant women Promote use of iodized salt X X X X Free
216 Nutrition: Pregnant women Promote use of fortified foods X X X X Free
217 Nutrition: Pregnant women Promote personal hygiene, environmental sanitation and infection X X X X Free
prevention measures
218 Nutrition: Pregnant women Provide outreach nutrition services X X X X Free
99
219 Nutrition: Pregnant women Promote use of time and labour saving technologies X X X X Free
220 Nutrition: Pregnant women Promote use of reproductive health services after delivery X X X X Free
221 Nutrition: Pregnant women Promote gender equity and economic empowerment X X X X Free
222 Nutrition: Pregnant women Calcium supplementation for prevention and treatment of pre- X X X X Free
eclampsia and eclampsia
223 Nutrition: Pregnant women Nutritional care and support for HIV+ pregnant women X X X X Free
224 Nutrition: Pregnant women Anaemia diagnosis and treatment X X X X Free
225 Nutrition: Breastfeeding mothers Counsel on two extra meals and rest during lactation X X X X Free
226 Nutrition: Breastfeeding mothers Counsel on optimal breast feeding practices on, proper positioning and X X X X Free
attachment, exclusive breast feeding and feeding on demand)
227 Nutrition: Breastfeeding mothers Promote healthy eating, diversified diet during lactation X X X X Free
228 Nutrition: Breastfeeding mothers Nutritional screening and counselling during lactation X X X X Free
229 Nutrition: Breastfeeding mothers Counsel on exposing infants to sun light X X X X Free
230 Nutrition: Breastfeeding mothers Promote continued use of iron folate (to complete 90 tabs) X X X X Free
231 Nutrition: Breastfeeding mothers Measure birth weight, length and head circumference in the first 1 X X X X Free
hour
232 Nutrition: Breastfeeding mothers Link Breastfeeding mothers to supplementary feeding program (PSNP X X X X Free
and other programs)
233 Nutrition: Breastfeeding mothers Treat malnourished Breastfeeding mothers with therapeutic foods X X X X Free
234 Nutrition: Breastfeeding mothers Promote family members (husband, grandparents and other HH X X X X Free
members) involvement to provide nutritional care for Breastfeeding
women
235 Nutrition: Breastfeeding mothers Promote shift in food taboos using religious leaders and influential X X X X Free
community members
236 Nutrition: Breastfeeding mothers Promote access to reproductive health services X X X X Free
237 Nutrition: Breastfeeding mothers Strengthen women economic control and equitable decision making X X X X Free
role to improve nutrition
100
238 Nutrition: Breastfeeding mothers Nutritional care and support (HIV+ pregnant and Breastfeeding X X X X Free
women)
239 Nutrition: Non-pregnant and non- Promote adequate intake of diversified food X X X X Free
Breastfeeding women
240 Nutrition: Non-pregnant and non- Nutritional care and support for HIV+ women X X X X Free
Breastfeeding women
241 Nutrition: Neonatal and infants (0-5 months) Early initiation of breast feeding within one hour X X X X Free
242 Nutrition: Neonatal and infants (0-5 months) Feeding of colostrum X X X X Free
243 Nutrition: Neonatal and infants (0-5 months) Avoidance of pre-lacteal feeding X X X X Free
244 Nutrition: Neonatal and infants (0-5 months) Promote exclusive breast feeding up to 6 months (Breast feeding on X X X X Free
demand and day and night and empty one breast at a time)
245 Nutrition: Neonatal and infants (0-5 months) Demonstrate proper positioning and attachment X X X X Free
246 Nutrition: Neonatal and infants (0-5 months) Promote appropriate feeding options for infants born to HIV infected X X X X Free
mothers
247 Nutrition: Neonatal and infants (0-5 months) Promote Kangaroo mother care for pre-term and LBW infants X X X X Free
248 Nutrition: Neonatal and infants (0-5 months) Monthly growth monitoring and promotion (measure weight and age, X X X X Free
record, interpret and counsel accordingly)
249 Nutrition: Neonatal and infants (0-5 months) Continued breast feeding during illness and recovery X X X X Free
250 Nutrition: Neonatal and infants (0-5 months) Zinc and ORS for diarrheal treatment X X X X Free
251 Nutrition: Neonatal and infants (0-5 months) Early detection and management of acute malnutrition X X X X Free
252 Nutrition: Neonatal and infants (0-5 months) Establish BFHF Initiative in all public and private health facilities X X X X Free
253 Nutrition: Neonatal and infants (0-5 months) Enforce international code of marketing for breast milk substitutes X X X X Free
254 Nutrition: Neonatal and infants (0-5 months) Promote enactment of maternity leave according to international X X X X Free
labour organization convention No. 183
255 Nutrition: Neonatal and infants (0-5 months) Promote designated breast feeding rooms in all service providing X X X X Free
institutions
256 Nutrition: Neonatal and infants (0-5 months) Support breast feeding working mothers to breast feed until 6 months X X X X Free
101
257 Nutrition: Neonatal and infants (0-5 months) Provide age appropriate immunization services X X X X Free
258 Nutrition: Infant and young child nutrition (6- Nutrition screening and counselling in health facility and community X X X X Free
23)
259 Nutrition: Infant and young child nutrition (6- Counsel on optimal complementary feeding practices (age appropriate X X X X Free
23) amount, frequency and diversity of feeding, responsive feeding)
260 Nutrition: Infant and young child nutrition (6- Timely initiation of complementary feeding at 6 months X X X X Free
23)
261 Nutrition: Infant and young child nutrition (6- Continued breast feeding until 24 months and beyond X X X X Free
23)
262 Nutrition: Infant and young child nutrition (6- Promote feeding of sick child during illness and recovery X X X X Free
23)
263 Nutrition: Infant and young child nutrition (6- Zinc and ORS for diarrhoeal treatment X X X X Free
23)
264 Nutrition: Infant and young child nutrition (6- Vitamin A supplementation biannually X X X X Free
23)
265 Nutrition: Infant and young child nutrition (6- Zinc supplementation X X X X Free
23)
266 Nutrition: Infant and young child nutrition (6- Detect and manage Acute Malnutrition X X X X Free
23)
267 Nutrition: Infant and young child nutrition (6- Link malnourished children to supplementary food support (B/TSFP, X X X X Free
23) PSNP,
268 Nutrition: Infant and young child nutrition (6- Promote micronutrient powder in areas where iron deficiency is > 20% X X X X Free
23)
269 Nutrition: Infant and young child nutrition (6- Promote enforcement of minimum standard nutritional services for X X X X Free
23) young children in special situations (refugee camps, orphanage, day
care centres, PSNP public work sites etc)
270 Nutrition: Infant and young child nutrition (6- Promote local production of enriched complementary foods X X X X Free
23)
102
271 Nutrition: Infant and young child nutrition (6- Demonstrate preparation and utilization of diversified complementary X X X X Free
23) foods
272 Nutrition: Infant and young child nutrition (6- Promote key actions for diversification and utilization of X X X X Free
23) complementary foods at household levels
273 Nutrition: Infant and young child nutrition (6- Promote production and utilization of bio fortified foods X X X X Free
23)
274 Nutrition: Infant and young child nutrition (6- Promote food technologies (powder meat, etc) X X X X Free
23)
275 Nutrition: Infant and young child nutrition (6- Identify and treat anaemia X X X Free
23)
276 Nutrition: Infant and young child nutrition (6- Support local food processing factories to participate in production of X X X Free
23) ready to use therapeutic food and supplementary food
277 Nutrition: Infant and young child nutrition (6- Provide free medical treatment to malnourished children X X X Free
23)
278 Nutrition: Infant and young child nutrition (6- Support food for care takers whose children admitted to Stabilization X X X Free
23) Centre
279 Nutrition: Infant and young child nutrition (6- Promote hygiene and sanitation and access to safe and clean water X X X Free
23)
280 Nutrition: Infant and young child nutrition (6- Promote hand washing at critical times with soap X X X Free
23)
281 Nutrition: Infant and young child nutrition (6- Promote use of household water treatment practices X X Free
23)
282 Nutrition: Infant and young child nutrition (6- Promote safe and hygienic preparation, storage and handling of food X X Free
23)
283 Nutrition: Infant and young child nutrition (6- Promote safe and clean household environment (in relation to poultry, X X Free
23) small reminants, household waste management, etc)
284 Nutrition: Infant and young child nutrition (6- Promote construction and use of household latrine X X X Free
23)
103
285 Nutrition: Infant and young child nutrition (6- Link food insecure households with children under two to social X X X Free
23) protection services and nutrition sensitive livelihood and economic
opportunities
286 Nutrition: Infant and young child nutrition (6- Integrate early childhood care and development stimulation with X X X X Free
23) existing community and facility based nutrition programs
287 Nutrition: Infant and young child nutrition (6- Promote use of ITN X X X X Free
23)
288 Nutrition: Infant and young child nutrition (6- Promote prevention of food taboos and mal-feeding practices X X X Free
23)
289 Nutrition: Infant and young child nutrition (6- Promote family members involvement during child feeding practices X X X Free
23)
290 Nutrition: Child nutrition (24 - 59 months) De-worming on biannual basis X X X Free
291 Nutrition: Child nutrition (24 - 59 months) Promote enforcement of minimum standard nutritional services for X X X Free
young children in special situations (refugee camps, orphanage, day
care centres, chronic infections, PSNP public work sites etc)
292 Nutrition: Child nutrition (24 - 59 months) Demonstrate preparation and utilization of diversified foods X X X Free
293 Nutrition: Child nutrition (24 - 59 months) Promote key actions for diversification and utilization of diversified X X X Free
foods at household levels
294 Nutrition: Child nutrition (24 - 59 months) Promote home or kitchen gardening and small scale food production X X X Free
that support a diverse range of nutrient dense foods (small animals,
cows,
295 Nutrition: For school age children (5-10 years) Promote nutrition education for young children X X X Free
296 Nutrition: For school age children (5-10 years) Promote nutrition in schools using teachers and parents association X X X Free
and schools nutrition clubs
297 Nutrition: For school age children (5-10 years) Demonstrate and promote food diversification through school X X X Free
gardening nutrition clubs
298 Nutrition: For school age children (5-10 years) Initiate home grown school feeding program for school age children X X X Free
104
299 Nutrition: For school age children (5-10 years) Promote access to safe potable water and sanitation in schools and at X X X Free
home
300 Nutrition: For school age children (5-10 years) Promote proper disposal of human, animal and environmental waste X X X Free
301 Nutrition: For school age children (5-10 years) Provide school based de-worming service X X X Free
302 Nutrition: For school age children (5-10 years) Promote healthy eating and exercise to prevent childhood obesity X X X Free
303 Nutrition: For school age children (5-10 years) Detect and treat anaemia X X X X X Free
304 Nutrition: For school age children (5-10 years) Detect and treat acute malnutrition X X X X X Free
305 Nutrition: Adolescent (10 - 19 years) Intermittent weekly iron-folic acid supplementation in HFs and schools X X X X Free
306 Nutrition: Adolescent (10 - 19 years) Nutritional assessment, education and counselling X X X Free
307 Nutrition: Adolescent (10 - 19 years) De-worming for school and out of school children X X X Free
308 Nutrition: Adolescent (10 - 19 years) School feeding program for vulnerable adolescents X X X Free
309 Nutrition: Adolescent (10 - 19 years) Promotion of iodized salt use X X X Free
310 Nutrition: Adolescent (10 - 19 years) Promote physical exercise and healthy eating in youth centres X X X Free
311 Nutrition: Adolescent (10 - 19 years) Socio-behavioural change communication to prevent HTP (food X X X Free
taboos, diversified food intake,)
312 Nutrition: Adolescent (10 - 19 years) Promote delay in early marriage x x Free
313 Nutrition: Adolescent (10 - 19 years) Nutrition for adolescent girls in special situation (HIV, emergency, X X X Free
obesity, eating disorder)
314 Nutrition: Adolescent (10 - 19 years) Management of acute malnutrition in adolescents X X X Free
315 Nutrition: Adolescent (10 - 19 years) Promote adolescent RH services X X X X Free
316 Nutrition: Adolescent (10 - 19 years) Promote establishment of nutrition clubs in schools x NA
317 Nutrition: Adolescent (10 - 19 years) Promote establishment of school gardening program x NA
318 Nutrition: Adolescent (10 - 19 years) Promote school nutrition demonstration program x NA
319 Nutrition: Productive work force (19-65 yrs): Nutrition assessment, counselling and support for HIV+, TB and other X X X X Free
Communicable and NCD infectious diseases
320 Nutrition: Productive work force (19-65 yrs): Promote healthy dietary behaviours and exercise to prevent X X X Free
Communicable and NCD obesity/reduce risk of NCDs
105
321 Nutrition: Productive work force (19-65 yrs): Promote salt, alcohol, cigarettes, chat and sugar restrictions X X X Free
322 Nutrition: Productive work force (19-65 yrs): Enforce taxation of alcohol, cigarette, chat and sugary beverages X X X Free
323 Nutrition: Productive work force (19-65 yrs): Utilize tax recovery to support nutrition X X X Free
324 Nutrition: Productive work force (19-65 yrs): Link HIV+ and TB clients with IGAs and other nutrition sensitive X X X X Free
Communicable and NCD interventions
325 Nutrition: Productive work force (19-65 yrs): Promote local food processing factories to produce RUTF and RUSF for X X X Free
Communicable and NCD HIV+ and TB
326 Nutrition: Productive work force (19-65 yrs): Promote nutrition education for improve nutrition behaviour and X X X Free
Communicable and NCD practices
327 Nutrition: Productive work force (19-65 yrs): promote nutrition education, healthy eating and Exercises at industry X X X Free
Communicable and NCD parks
328 Nutrition: Productive work force (19-65 yrs): promote and ensure food safety and quality to the general population X X X Free
329 Nutrition: Productive work force (19-65 yrs): Promote production and consumption of organic foods X X X Free
330 Nutrition: Elderly (>65 yrs) Nutrition assessment, counselling and support to elderly people X X X Free
331 Nutrition: Elderly (>65 yrs) Promote healthy eating and exercise to prevent obesity/reduce risk of X X X Free
NCDs
332 Nutrition: Elderly (>65 yrs) Strengthen community care and support for the elderly X X X Free
333 Nutrition: Elderly (>65 yrs) Extended nutrition intervention in older hospitalized patients X X X Free
Multi-sectoral nutrition interventions
334 Nutrition multisector: With agriculture and Promote production and consumption of fruits and vegetables X Free
Livestock sector
335 Nutrition multisector: With agriculture and Promote production and consumption of nutrient dese cereals and X Free
Livestock sector pulses
106
336 Nutrition multisector: With agriculture and Promote production and consumption of animal source foods (meat, X Free
Livestock sector milk, fish and egg)
337 Nutrition multisector: With agriculture and Promote homestead and school gardening X Free
Livestock sector
338 Nutrition multisector: With agriculture and Promote and support urban agriculture X Free
Livestock sector
339 Nutrition multisector: With agriculture and Promote production and consumption of bio fortified foods X Free
Livestock sector
340 Nutrition multisector: With agriculture and Promote post-harvest management X Free
Livestock sector
341 Nutrition multisector: With agriculture and Promote technologies for post-harvest food processing, handling, X Free
Livestock sector preservation and preparation
342 Nutrition multisector: With agriculture and Promote assets building interventions X Free
Livestock sector
343 Nutrition multisector: With agriculture and Target vulnerable households (malnourished children and PLW) X Free
Livestock sector
344 Nutrition multisector: With agriculture and Improve nutritional value of PSNP food basket X Free
Livestock sector
345 Nutrition multisector: With agriculture and Implement soft conditionality for HHs with vulnerable households X Free
Livestock sector (malnourished children and PLW)
346 Nutrition multisector: With agriculture and Promote women labour and time saving technologies X Free
Livestock sector
347 Nutrition multisector: With agriculture and Promote small scale high tech irrigation for priority areas for better X Free
Livestock sector nutrition outcomes
348 Nutrition multisector: With agriculture and Promote nutrition sensitive agriculture and livestock knowledge and X Free
Livestock sector practice among farmers and AEWs
349 Nutrition multisector: With agriculture and Promote climate smart and nutrition sensitive agriculture X Free
Livestock sector
107
350 Nutrition multisector: With agriculture and Promote wild and indigenous foods X Free
Livestock sector
351 Nutrition multisector: With Education sector Promote school feeding program X Free
352 Nutrition multisector: With Education sector Promote school gardening X Free
353 Nutrition multisector: With Education sector Promote school WASH X Free
354 Nutrition multisector: With Education sector Promote nutrition clubs in schools X Free
355 Nutrition multisector: With Education sector Celebrate nutrition days in schools X Free
356 Nutrition multisector: With Education sector Establish school mini-medias X Free
357 Nutrition multisector: With Education sector School deworming X Free
358 Nutrition multisector: With Education sector Weekly Intermittent IFA supplementation X Free
359 Nutrition multisector: With Education sector Strengthen community based nutrition service provision by higher X Free
education institutes
360 Nutrition multisector: With Education sector Mainstream nutrition in school curriculum X Free
361 Nutrition multisector: With Education sector Train nutrition professionals in higher education X Free
362 Nutrition multisector: With Water supply Promote access to safe and clean water X Free
sector
363 Nutrition multisector: With Water supply Promote access to high tech small and large scale irrigation for better X Free
sector nutrition outcomes
364 Nutrition multisector: With Water supply Strengthen florosis mitigation interventions through nutritional X Free
sector interventions
365 Nutrition multisector: With Industry sector Produce and distribute fortified food X Free
366 Nutrition multisector: With Industry sector Conduct awareness creation on nutrition related requirements and X Free
standards for locally manufactured food items
367 Nutrition multisector: With Industry sector Strengthen food producers and millers capacity to produce foritified X Free
foods
368 Nutrition multisector: With Industry sector Support in availing industrial inputs (pre-mix, equipment, raw X Free
materials) for food fortification
108
369 Nutrition multisector: With Industry sector Ensure quality and safety of locally produced foods X Free
370 Nutrition multisector: With Trade sector Ensure the quality and safety of imported food items as per national X Free
standard
371 Nutrition multisector: With Trade sector Regulate the quality and safety of locally produced foods X Free
372 Nutrition multisector: With Trade sector Promote the use of safe fortified foods X Free
373 Nutrition multisector: With Trade sector Ensure safety and quality of street foods X Free
374 Nutrition multisector: With Trade sector Create awareness to public and private sectors on nutrition related X Free
requirements and standards for improved food items
375 Nutrition multisector: With Trade sector Support importation of fortified foods X Free
376 Nutrition multisector: With Trade sector Ensure access to and supply chain for food and food items X Free
377 Nutrition multisector: With Social Protection Ensure targeting of vulnerable HHs by PSNP X Free
sector
378 Nutrition multisector: With Social Protection Implement conditional support for malnourished PLW and children X Free
sector under two through PSNP
379 Nutrition multisector: With Social Protection Integrate nutrition practices and services in PSNP X Free
sector
380 Nutrition multisector: With Social Protection Promote income generating activities for improved access to nutritious X Free
sector food
381 Nutrition multisector: With Social Protection Employ fee waiver scheme for management of acute malnutrition X Free
sector
382 Nutrition multisector: With Social Protection Promote nutrition services for elderly and person with disability, X Free
sector
383 Nutrition multisector: With Disaster Risk Strengthen and scale up early warning system for food and nutrition X Free
Management sector information
384 Nutrition multisector: With Disaster Risk Support nutrition emergency response and recovery through X Free
Management sector participatory risk assessment and preparedness planning
385 Nutrition multisector: With Disaster Risk Promote SBCC strategies to impart information about resilience to X Free
Management sector nutrition related shocks
109
386 Nutrition multisector: With Food and Drug Certify competent food and nutrition product manufacturers, X Free
Authority sector importers, exporters, distributors, quality control labouratories,
387 Nutrition multisector: With Food and Drug Control the quality and safety of food products by developing X Free
Authority sector directives, standards, legislations and manuals
388 Nutrition multisector: With Food and Drug Enforce and regulate food manufacturers, importers and distributors X Free
Authority sector
389 Nutrition multisector: With Food and Drug Ensure the quality and safety of infant formulas, complementary X Free
Authority sector foods, fortified foods, food fortificants, pre-mix, therapeutic and
supplementary foods
390 Nutrition multisector: With Food and Drug Register and issue market authorization for nutritious food products X Free
Authority sector
391 Nutrition multisector: With Food and Drug Ensure safety and quality of public and bottled water and food X Free
Authority sector products used up to standard
392 Nutrition multisector: with Gender sector Ensure gender responsive nutrition implementation and reporting X Free
393 Nutrition multisector: with Gender sector Ensure gender integration in sector nutrition implementation strategy, X Free
guidelines and programs
394 Nutrition multisector: with Gender sector Mobilize women groups in nutrition advocacy and skill transfer X Free
395 Nutrition multisector: with Gender sector Ensure women economic empowerment X Free
396 Nutrition multisector: with Gender sector Promote women empowerment and child protection interventions X Free
397 Nutrition multisector: with Gender sector Create awareness on HTPs that affect the nutritional status of women X Free
and children
HIV/AIDS, TB, and Malaria
398 HIV/AIDS: prevention Targeted BCC for the most at risk population and vulnerable groups X X X Free
399 HIV/AIDS: prevention HIV/AIDS BCC for the general populations X X X X Free
400 HIV/AIDS: prevention Condom distribution for the most at risk population and vulnerable X X X X X X Free
groups
401 HIV/AIDS: prevention Prevention and treatment of STI in the context of HIV prevention X X X X Free
110
402 HIV/AIDS: prevention Targeted quality assured HIV testing and counselling services: self- X X X Free
testing
403 HIV/AIDS: prevention Targeted quality assured HIV testing and counselling services: VCT X X X X X X Free
404 HIV/AIDS: prevention Targeted quality assured HIV testing and counselling services: PITC X X X X X Free
405 HIV/AIDS: prevention PMTCT X X X Free
406 HIV/AIDS: prevention Voluntary medical male circumcisions X X Free
407 HIV/AIDS: prevention Post exposure prophylaxis (PEP) for occupational exposure and sexual X X X X Free
assault victims
408 HIV/AIDS: prevention Pre-Exposure prophylaxis (PrEP) for FSWs and sero-discordant HIV X X X X Free
negative partner
409 HIV/AIDS: prevention Ensuring quality assured testing of all donated load for transfusion X X X Free
transmissible infections (TTIs)_HIV,HBV,HCV & Syphilis
410 HIV/AIDS: care and treatment ART (First-Line Treatment) for adults X X X X Free
411 HIV/AIDS: care and treatment ART (Second-Line Treatment) for adults X X X X
412 HIV/AIDS: care and treatment ART (Third-line treatment) for adults X X Free
413 HIV/AIDS: care and treatment Cotrimoxazole for children X X X X Free
414 HIV/AIDS: care and treatment Paediatric ART X X X X Free
415 HIV/AIDS: care and treatment Additional ART for TB patients X X X X Free
416 HIV/AIDS: care and treatment Management of opportunistic infections associated with HIV/AIDS X X X X Free
417 HIV/AIDS: care and treatment Nutrition supplements in first 6 months for HIV/AIDS cases X X X X Free
418 HIV/AIDS: care and treatment Collabourative HIV/AIDS and TB interventions X X X X Free
419 HIV/AIDS: care and treatment Screen HIV+ cases for TB X X X X Free
420 HIV/AIDS: care and treatment ART (+CPT) for TB HIV+ patients X X X X Free
421 HIV/AIDS: care and treatment HIV prevention for TB patients X X X X X X Free
422 STI: prevention BCC on safer sexual behaviour X X X Free
423 STI: prevention Partner notification and treatment X X X X Free
424 STI: prevention Provision of condoms to key and priority populations X X X X X X Free
111
425 STI: prevention HIV testing in STI patients X X X X X X sharing

426 STI: prevention Provide Human Papilloma Virus (HPV) vaccination X X X X X X sharing
427 STI: prevention Hepatitis B Virus Vaccination X X X X sharing
428 STI: treatment Syndromic case management X X X X X sharing
429 STI: treatment Aeitologic case management X X X sharing
430 STI: treatment Provide STI clinical services and outreach to female sex workers and X X Free
their male clients
431 STI: treatment Screening and Treatment for Syphilis in Pregnancy X X X X Free
432 STI: treatment Adolescent friendly STI services (provision of condom, STI screening X X X Free
and treatment) with in schools or health facilities
433 Tuberculosis: diagnosis Treatment+Detection (smear + Xpert) +Drug Sensitivity analysis X X X X Free
434 Tuberculosis: diagnosis Treatment+Detection (smear + Xpert) +Drug Sensitivity analysis & ART X X X X Free
Prioritization for TB cases
435 Tuberculosis: diagnosis Treatment+Detection (smear + Xpert) +Drug Sensitivity analysis & ART X X X X Free
Prioritization for TB cases & Preventive therapy&Preventive therapy
for children
436 Tuberculosis: diagnosis Treatment+Detection (smear + Xpert) +Drug Sensitivity analysis & X X X X Free
Preventive therapy
437 Tuberculosis: diagnosis Treatment+Detection (smear + Xpert) +Drug Sensitivity analysis & X X X X Free
Preventive therapy for children
438 Tuberculosis: diagnosis Treatment+Detection (smear generally and culture for MDR) +Drug X X X Free
Sensitivity analysis
Sensitivity analysis & ART Prioritization for TB cases
Sensitivity analysis & ART Prioritization for TB cases & Preventive
therapy&Preventive therapy for children
112
Sensitivity analysis & Preventive therapy
Sensitivity analysis & Preventive therapy for children
443 Leprosy: Elimination [Detection] and treatment of leprosy X X X X Free
444 Leprosy: Elimination Treatment of drug resistant leprosy X X Free
445 Leprosy: Elimination Chemoprophylaxis for contacts of leprosy cases X X X X Free
446 Leprosy: Elimination Detection and management of disability due to leprosy X X X X Free
457 Malaria: Prevention Long Lasting Insecticide-Treated Nets (LLIN) X X X Free
458 Malaria: Prevention Indoor residual spraying with propoxure X X free
459 Malaria: Prevention Other vector control: Mosquito repellent X X free
450 Malaria: Prevention Other vector control: window screening X X free
451 Malaria: Prevention Other vector control: Larviciding X X free
452 Malaria: Prevention Other vector control: drainage of breeding swampy and marshy X free
sites/irrigation canals
453 Malaria: Prevention Intermittent preventive treatments (pregnant women) X X X X free
454 Malaria: Prevention Active surveillance of cases X X X NA
455 Malaria: case management Detection [RDT] and treatment of uncomplicated malaria X X X Sharing
456 Malaria: case management Detection [Microscopy] and treatment of uncomplicated X X Sharing
457 Malaria: case management Detection [RDT] and treatment of severe malaria X X X X Sharing
458 Malaria: case management Detection [Microscopy] and treatment of severe malaria X X X X Sharing
459 Malaria: case management G6PD testing and radical cure treatment for vivax X X X Free
NTD
460 NTD: Lymphatic filariasis elimination BCC for targeted areas X X X X X X Free
461 NTD: Lymphatic filariasis elimination Mass drug administration for lymphatic filariasis X Free
462 NTD: Lymphatic filariasis elimination Vector control using IRS, house screening, LLITN, larvicides, and X Free
environmental management
113
463 NTD: Lymphatic filariasis elimination Screening and management of scrotal swelling (hydrocelectomy) X X X X Sharing
464 NTD: Lymphatic filariasis elimination Lymphedema morbidity management X X X X Sharing
465 NTD: Lymphatic filariasis elimination Management of acute attack dermato-lymphangioadenitis with X X X Sharing
appropriate antibiotics
466 NTD: Lymphatic filariasis elimination Avail custom-made shoes for those with lymphedema X Free
467 NTD: Onchocerciasis elimination Mass drug administration X Free
468 NTD: Onchocerciasis elimination Vector control using ground larviciding using environmentally safe X Free
insecticides
469 NTD: Onchocerciasis elimination Treatment with Ivermectin X X X X Free
470 NTD: Trachoma elimination BCC (face washing, Open deification free environment, etc) X X Free
471 NTD: Trachoma elimination Early diagnosis and treatment active trachoma X X X X Sharing
472 NTD: Trachoma elimination Screening and diagnosis of TT cases (TT surgery) X X X X Sharing
473 NTD: Trachoma elimination Post-operative Azithromycin X X X X Sharing
474 NTD: Schistosomiasis control BCC for targeted areas (avoid swimming in fresh water, promotion of X X Free
use of toiles, hygiene and sanitation)
475 NTD: Schistosomiasis control Snail control for schistosomiasis Molluscicides (Niclosamide) X Free
476 NTD: Schistosomiasis control Urine filtration for S. haematobium eggs x X X X Sharing
477 NTD: Schistosomiasis control Case management using praziquantel X X X X Sharing
478 NTD: Soil Transmitted Helminths control BCC for targeted areas (Promotion of use of toiles, hygiene and X x x X Free
sanitation, Footwear use)
479 NTD: Soil Transmitted Helminths control Mass drug administration for PreSAC, SAC and women in reproductive X Free
age group
480 NTD: Soil Transmitted Helminths control Treatment of pregnant mothers X X X X Free
481 NTD: Soil Transmitted Helminths control Case management Soil Transmitted Helminths using Mebendazole and X X X X Sharing
Albendazole
482 NTD: Scabies control Preventive chemotherapy via mass drug administration X Free
114
483 NTD: Scabies control Case management of scabies using scabicides (Perimethrin, BBL, X X X X Sharing
Ivermectin Sulphur)
484 NTD: Leishmaniasis control Early diagnosis and management of VL (Rapid test, DAT test, Splenic X X Free
Aspirate, Lymph node aspirate)
485 NTD: Leishmaniasis control Early diagnosis and management of CL (clinical examination and skin X X Free
snip)
486 NTD: Guinea Worm Disease cases control Management of Guinea Worm disease X X X x Free
487 NTD: Guinea Worm Disease cases control Treat unsafe water sources with ABATE X Free
488 NTD: Guinea Worm Disease cases control Controlled immersion and bandaging for Guinea Worm Disease cases. X X X Free
489 NTD: Podoconiosis elimination BCC for targeted areas (promotion of footwear use, hygiene) X x X Free
490 NTD: Podoconiosis elimination Preventing episodes of dermato lymphangioadenitis among X X X x Sharing
lymphedema or elephantiasis cases
491 NTD: Podoconiosis elimination Screening of patients with lower leg swelling X X X Sharing
492 NTD: Podoconiosis elimination Lymphedema morbidity managemen X X X X Sharing
493 NTD: Podoconiosis elimination Management of dermato-lymphangioadenitis with appropriate X X X x Sharing
antibiotics
494 NTD: Podoconiosis elimination Surgical nodulectomy for people with nodules X X X X Sharing
NCD
495 All NCDs: BCC and policy interventions Physical activity + obesity reduction X Free
496 All NCDs: BCC and policy interventions Tobacco: Protect people from tobacco smoke X NA
497 All NCDs: BCC and policy interventions Tobacco: Warn about danger: Warning labels X NA
498 All NCDs: BCC and policy interventions Tobacco: Warn about danger: Mass media campaign X NA
499 All NCDs: BCC and policy interventions Tobacco: Enforce bans on tobacco advertising X NA
500 All NCDs: BCC and policy interventions Tobacco: Enforce youth access restriction X NA
501 All NCDs: BCC and policy interventions Raise taxes on all tobacco products X NA
502 All NCDs: BCC and policy interventions Hazardous alcohol use: Enforce restrictions on availability of retailed X NA
alcohol
115
503 All NCDs: BCC and policy interventions Hazardous alcohol use: Enforce restrictions on alcohol advertising X NA
504 All NCDs: BCC and policy interventions Physical inactivity: Awareness campaigns to encourage increased X Free
physical activity
505 All NCDs: BCC and policy interventions Raise taxes on alcoholic beverages X NA
506 All NCDs: BCC and policy interventions Sodium: Harness industry for reformulation X NA
507 All NCDs: BCC and policy interventions Sodium: Adopt standards: Front of pack labelling X NA
508 All NCDs: BCC and policy interventions Sodium: Knowledge: Education and communication X Free
509 All NCDs: BCC and policy interventions Sodium: Environment: Salt reduction strategies in community-based X Free
eating spaces
510 All NCDs: BCC and policy interventions Offer to help quit tobacco use: Brief intervention X Sharing
511 All NCDs: BCC and policy interventions Screening and brief intervention for hazardous and harmful alcohol X X Sharing
use
512 All NCDs: BCC and policy interventions Physical inactivity: Brief advice as part of routine care X X X X X X Free
513 All NCDs: BCC and policy interventions Restrictions on retail and use of khat and other substances X NA
514 All NCDs: BCC and policy interventions Implement large graphic health warnings on all tobacco packages X NA
515 All NCDs: BCC and policy interventions Nutritional labelling (reduce salt, sugar and fat intake through the X NA
implementation of front-of pack labelling)
516 All NCDs: BCC and policy interventions Health and age warnings on alcohol products X Free
527 All NCDs: BCC and policy interventions Implement community-wide mass sporting, education and awareness X Free
campaign for physical activity
518 All NCDs: BCC and policy interventions Enact policies on design of buildings and roads which encourage X Free
physical activity (play grounds parks, sidewalks, bicycle tracks, work
place exercise corners)
519 All NCDs: BCC and policy interventions Enact and enforce restrictions on the physical availability of retailed X NA
alcohol (via reduced hours and age of sale)
520 All NCDs: BCC and policy interventions Provide brief psychosocial intervention for persons with hazardous and X X Sharing
harmful alcohol use
116
521 All NCDs: BCC and policy interventions Setting of target levels for the amount of salt in foods and meals X NA
522 All NCDs: BCC and policy interventions Encourage production and/or importation of healthy (mon and poly X NA
unsaturated) fats
523 All NCDs: BCC and policy interventions Eliminate industrial trans-fats through the development of legislation X NA
to ban their use in food chain
524 All NCDs: BCC and policy interventions Increase access to electricity and low emission energy efficient cooking X recovery
stoves
525 All NCDs: BCC and policy interventions Raise tax on Khat X NA
526 All NCDs: BCC and policy interventions Screening for Khat use and brief intervention X X Sharing
527 All NCDs: BCC and policy interventions Management of khat intoxication and withdrawal X X Sharing
528 All cancers Basic palliative care for cancer at home, community and health facility X X X X X X Sharing
based
529 All cancers Awareness raising on risk factors of cancers X X X X X X Free
530 All cancers Early detection/screening of most common cancers X X X X X Sharing
531 Breast cancer Basic breast cancer awareness education and education on self- X X X X X X Free
examination
532 Breast cancer Screening: Clinical breast exam X X X X X Free
533 Breast cancer Screening: Mammography X Sharing
534 Breast cancer Breast cancer treatment: Stage 1 X X X Sharing
535 Breast cancer Breast cancer treatment: Stage 2 X X X Sharing
536 Breast cancer Breast cancer treatment: Stage 3 X X Sharing
537 Breast cancer Breast cancer treatment: Stage 4 X Sharing
538 Breast cancer Basic palliative care for breast cancer X X X X X X Free
539 Breast cancer Extended palliative care for breast cancer X X X X X Free
540 Cervical cancer Vaccination against HPV of ages 9-14 old girls X Free
541 Cervical cancer Cervical conization /Loop Electro-surgical Excision Procedure (LEEP) X X X Sharing
542 Cervical cancer HPV DNA and Cryotherapy X X X Sharing
117
543 Cervical cancer VIA and cryotherapy X X X Sharing

544 Cervical cancer PAP smear and Cryotherapy X X Sharing
545 Cervical cancer HPV DNA test X recovery
546 Cervical cancer Visual inspection with acetic acid (VIA) X X X Free
547 Cervical cancer Papanicolaou test (Pap smear) X X Sharing
548 Cervical cancer HPV DNA + VIA X recovery
549 Cervical cancer HPV DNA + Pap smear X recovery
550 Cervical cancer Cryotherapy X X X Sharing
551 Cervical cancer Loop Electrosurgical Excision Procedure (LEEP) X X X Sharing
552 Cervical cancer Cervical cancer treatment: Stage I X X X Sharing
553 Cervical cancer Cervical cancer treatment: Stage II X X X Sharing
554 Cervical cancer Cervical cancer treatment: Stage III X X Sharing
555 Cervical cancer Cervical cancer treatment: Stage IV X Sharing
556 Cervical cancer Basic palliative care for cervical cancer X X X X X X Free
557 Cervical cancer Extended palliative care for cervical cancer X X X X X Free
558 Ovarian Cancer Diagnosis and Management of Ovarian Cancer (Surgery) X X X Sharing
559 Thyroid Cancer Diagnosis and Management of Thyroid Cancer X X X Sharing
560 Colorectal cancer Screening: Fecal occult blood testing X X X Sharing
561 Colorectal cancer Screening: Sigmoidoscopy X X Sharing
562 Colorectal cancer Screening: Colonoscopy X X Sharing
563 Colorectal cancer Colorectal cancer treatment: Stage I X X X Sharing
564 Colorectal cancer Colorectal cancer treatment: Stage II X X X Sharing
565 Colorectal cancer Colorectal cancer treatment: Stage III X X Sharing
566 Colorectal cancer Colorectal cancer treatment: Stage IV X Sharing
567 Colorectal cancer Basic palliative care for colorectal cancer X X X X X X Free
568 Colorectal cancer Extended palliative care for colorectal cancer X X X X X Free
569 Esophageal cancer Diagnosis with endoscopy, biopsy/pathology, X Sharing
118
570 Esophageal cancer Treatment with chemotherapy, surgery, radiotherapy X Sharing

571 Lip and oral cancer Lip and oral cancer treatment: Surgery+chemotherapy X Sharing
572 Lip and oral cancer Lip and oral cancer treatment radiotherapy+chemothrapy X Sharing
573 Lip and oral cancer Treatment with Chemo/hormonal therapy X Sharing
574 Nasopharynx cancer Nasopharynx cancer treatment: Surgery+chemotherapy X Sharing
575 Nasopharynx cancer Nasopharynx cancer treatment: radiotherapy+chemothrapy X Sharing
576 Liver cancer (hepatoma) Diagnosis: Blood tests, ultrasound/fine needle aspiration, pathology X X Sharing
577 Liver cancer (hepatoma) Treatment of hepatitis C X X Sharing
578 Liver cancer (hepatoma) Biopsy, surgery, chemotherapy X X Sharing
579 Liver cancer (hepatoma) Treat late stage liver cancer X Sharing
580 Liver cancer (hepatoma) Viral Hepatitis Surveillance X X X X X NA
581 Liver cancer (hepatoma) Screening blood transfusion for hepatitis B and C X X X Free
582 Liver cancer (hepatoma) Hepatitis B vaccination (including birth dose) X X X X Free
583 Liver cancer (hepatoma) Vaccination of health care workers X X X X X Free
584 Liver cancer (hepatoma) Diagnosis and Treatment of HBV X X X Sharing
585 Liver cancer (hepatoma) Diagnosis and Treatment of HCV X X X Sharing
586 Liver cancer (hepatoma) Treatment of decompensated cirrhosis X X X Sharing
587 Prostate cancer Diagnosis of prostate cancer: PSA, blood tests, rectal examination X X X Sharing
588 Prostate cancer Treatment of prostate cancer: surgery, chemotherapy, radiotherapy X X Sharing
589 Hodgkin lymphoma Diagnosis of Hodgkin lymphoma cancer X X Sharing
590 Childhood cancers Diagnosis and treatment of childhood leukemias X X Sharing
591 Childhood cancers Diagnosis and treatment of childhood Non Hodgkin's Lymphomas X X Sharing
592 Childhood cancers Diagnosis and treatment of Wilm's Tumor X Sharing
593 Childhood cancers Diagnosis and treatment of Retinoblastoma X Sharing
594 Childhood cancers Diagnosis and treatment of childhood Hodgkin's Lymphomas X X Sharing
595 Childhood cancers Diagnosis and management childhood Bone and Cartilage cancers X Sharing
596 Hypertension Targeted screening for hypertension X X X X X X Free
119
597 Hypertension Management of Hypertension (pharmacologic and life style X X X X Sharing

modifications)
598 Hypertension Healthy Life Style Counselling for management of X X X X X X Free
hypertension(tobacco cessation, brief interventions for problematic
alcohol use, unhealthy diet and physical inactivity)
599 Hypertension Management of hypertensive crisis X X X X Sharing
600 Ischemic heart disease, stroke, and peripheral Screening for risk of CVD X X X X X Free
artery diseases
601 Ischemic heart disease, stroke, and peripheral Follow-up care for those at low to moderate risk of CVD (absolute risk: X X X X Sharing
artery diseases 10-30%)
602 Ischemic heart disease, stroke, and peripheral Treatment for those with high absolute risk of CVD (>30%) with X X X X Sharing
artery diseases combination of drugs
603 Ischemic heart disease, stroke, and peripheral Treatment for those with high blood pressure but low absolute risk of X X X X Sharing
artery diseases CVD (< 20%)
604 Ischemic heart disease, stroke, and peripheral Treatment for those with absolute risk of CVD 20-30% X X X X Sharing
artery diseases
605 Ischemic heart disease, stroke, and peripheral Treatment for those with high absolute risk of CVD (>30%) X X X X Sharing
artery diseases
606 Ischemic heart disease, stroke, and peripheral Treatment adherence counselling X X X X Sharing
artery diseases
607 Ischemic heart disease, stroke, and peripheral Palliative care to ischemic heart disease, stroke, PAD with amputation X X X X X Sharing
artery diseases
608 Acute myocardial infarction (AMI) Treatment of new cases of acute myocardial infarction (AMI) with X X X Sharing
aspirin
609 Acute myocardial infarction (AMI) Follow up of AMI cases X X X Sharing
610 Acute myocardial infarction (AMI) Management of acute coronary syndrome X X X Sharing
611 Acute myocardial infarction (AMI) Treatment of cases with established ischemic heart disease (IHD) X X X Sharing
120
612 Acute myocardial infarction (AMI) Prehospital and emergency care for suspected Acute Myocardial X X X X X X Sharing
Infarction
613 Acute myocardial infarction (AMI) Treatment of new cases of MI with primary Percutaneous Coronary X Sharing
Intervention
614 Acute myocardial infarction (AMI) Treatment of cases with MI with Coronary artery bypass graft X Sharing
615 Acute myocardial infarction (AMI) Treatment of cases with MI with Percutaneous Coronary Intervention X Sharing
616 Acute myocardial infarction (AMI) Prehospital and emergency care for suspected stroke (CVA) X X X X X X Sharing
617 Acute myocardial infarction (AMI) Treatment of acute ischemic stroke with intravenous thrombolytic X Sharing
therapy
618 Acute myocardial infarction (AMI) Treatment for those with established cerebrovascular disease and post X X X Sharing
stroke
619 Peripheral artery diseases Management for acute critical limb ischemia with unfractionated X Sharing
heparin and revascularization if available, with amputation as a last
resort
620 Rheumatic heart disease Treatment of acute suspected bacterial tonsilopharyngitis to prevent X X X X Sharing
rheumatic fever
621 Rheumatic heart disease Treatment of cases with rheumatic heart disease (with benzathine X X X Sharing
penicillin)
622 Rheumatic heart disease Management of Rheumatic Heart Disease complications (Heart failure, X X X Sharing
anticoagulation, Surgical Interventions)
623 Heart Failure Medical management of heart failure with diuretics, beta-blockers X X X X Sharing
ACE inhibitors, and mineralocorticoid antagonists
624 Asthma Asthma: Inhaled short acting beta agonist for intermittent asthma X X X X Sharing
625 Asthma Asthma: Low dose inhaled beclometasone + SABA X X X X Sharing
626 Asthma Asthma: High dose inhaled beclometasone + SABA X X X X Sharing
627 Asthma Asthma: Theophylline + High dose inhaled beclometasone + SABA X X X X Sharing
628 Asthma Asthma: Oral Prednisolone + Theophylline + High dose inhaled X X X X Sharing
beclometasone + SABA
121
629 Chronic respiratory disorders COPD: Smoking cessation X X X X X X Free

630 Chronic respiratory disorders COPD: Inhaled salbutamol X X X X Sharing
631 Chronic respiratory disorders COPD: Low-dose oral theophylline X X X X Sharing
632 Chronic respiratory disorders COPD: Ipratropium inhaler X X Sharing
633 Chronic respiratory disorders COPD: Exacerbation treatment with antibiotics X X X X Sharing
634 Chronic respiratory disorders COPD: Exacerbation treatment with oral prednisolone X X X X Sharing
635 Chronic respiratory disorders COPD: Exacerbation treatment with oxygen X X X X Sharing
636 Bronchiectasis Diagnosis, Management including rehabilitation for bronchiectasis X X X Sharing
(with Antibiotics, rehabilitative, preventive)
637 Occupational Lung Diseases Diagnosis, management and prevention of occupational lung diseases X X X Sharing
638 Diabetes mellitus treatment Targeted screening for type 2 diabetes X X X X X X Sharing
639 Diabetes mellitus treatment Healthy Life Style Counselling for management of diabetes (tobacco X X X X X X Free
cessation, brief interventions for problematic alcohol use, unhealthy
diet and physical inactivity)
640 Diabetes mellitus treatment Comprehensive Management of Type 2 DM X X X X Sharing
641 Diabetes mellitus treatment Diagnosis and Comprehensive Management of Type 1 DM X X X X Sharing
642 Diabetes mellitus treatment Screening of people with diabetes for microvascular X X X X Sharing
complications(retinopathy, nephropathy, neuropathy) at the time of
diagnosis for type 2 DM and 5years after diagnosis of type 1 DM
643 Diabetes mellitus treatment Screening of people with diabetes for macrovascular complications X X X X Sharing
(Coronary artery disease, Peripheral arterial disease and Cerebro-
vascular disease) at the time of diagnosis for type 2 DM
644 Acute renal failure Dialysis for acute, reversible kidney injury X sharing
645 Chronic Kidney Diseases Haemodialysis for chronic kidney failure X sharing
646 Chronic Kidney Diseases Peritoneal dialysis for chronic kidney failure X sharing
647 Chronic Kidney Diseases Screening for chronic kidney disease in high risk groups X X X X Sharing
122
648 Chronic Kidney Diseases Diagnosis and treatment of CKD; treat comorbid X X X Sharing
conditions; slow progression of CKD
649 Chronic Kidney Diseases Treatment of hypertension in kidney disease X X X X Sharing
650 Chronic Kidney Diseases Management of Complications of CKD X X X Sharing
651 Chronic Kidney Diseases Kidney transplantation X Sharing
652 Cataract Awareness creation and Screening for cataract X Free
653 Cataract Cataract surgery x X X Sharing
654 Refractive error Awareness creation of RE and Importance of eye glasses X Free
655 Refractive error School screening X Free
656 Refractive error Opportunistic screening for refractive errors in Adults in health X X X X Free
facilities
657 Refractive error Correction of Refractive error with eye glass X X Sharing
658 Glaucoma Awareness creation on glaucoma and screening for glaucoma for X Free
selected population groups
659 Glaucoma Medical and surgical treatment of glaucoma X X Sharing
Mental, Neurological and substance use disorders
660 MNSD: BCC and policy interventions BCC and awareness creation program on all MNSD X X X X X X Free
661 MNSD: BCC and policy interventions Enact mental health legislation X NA
662 MNSD: BCC and policy interventions Workplace stress reduction programs- physical exercise and cognitive X Free
and behavioural approaches such as problem-solving techniques,
meditation, and relaxation training
663 MNSD: BCC and policy interventions In school -mental health awareness among school children and X Free
structured physical activity, programs that advance positive thinking,
stress reduction programs, psychological and educational counselling
664 Depressive disorders Basic psychosocial treatment for mild depression X X X X Free
665 Depressive disorders Basic psychosocial treatment and anti-depressant medication of first X X X X Free
episode moderate-severe cases
123
666 Depressive disorders Intensive psychosocial treatment and anti-depressant medication of X Free
first episode moderate-severe cases
recurrent moderate-severe cases on an episodic basis
recurrent moderate-severe cases on a maintenance basis
669 Depressive disorders Psychosocial care for peri-natal depression X X X X Free
670 Psychotic disorders Diagnosis and management of psychosis with first generation and X X X X Free
second generation antipsychotics and CBT
671 Psychotic disorders Basic psychosocial support and anti-psychotic medication X X X X Free
672 Psychotic disorders CBT as adjunctive treatment for positive symptoms. Cognitive X X X X Free
remediation therapies, in early stages of the disorder.
Psychoeducation reduces relapse, readmission,
and length of hospital stay while encouraging
medication compliance
673 Psychotic disorders Basic psychosocial support and anti-psychotic medication X X X X Free
674 Psychotic disorders Psychosocial interventions to reducing the need X X X X Free
for antipsychotic medications
675 Psychotic disorders Intensive psychosocial support and anti-psychotic medication X Free
676 Psychotic disorders Continuing care of schizophrenia X X X X Free
677 Psychotic disorders Management of refractory psychosis with clozapine X Free
678 Bipolar disorder Basic psychosocial treatment, advice, and follow-up for bipolar X Free
disorder, plus mood-stabilizing medication
679 Bipolar disorder Intensive psychosocial intervention for bipolar disorder, plus mood- X Free
stabilizing medication
680 Anxiety disorders Basic psychosocial treatment for anxiety disorders (mild cases) X X X X Free
681 Anxiety disorders Basic psychosocial treatment and anti-depressant medication for X X X Free
anxiety disorders (moderate-severe cases)
124
682 Anxiety disorders Intensive psychosocial treatment and anti-depressant medication for X Free
anxiety disorders (moderate-severe cases)
683 Stress related disorders (PTSD) Non-trauma focused CBT and eye movement X Free
desensitization and reprocessing ,CBT (particularly trauma-focused
CBT)
684 Epilepsy Diagnosis and management of epilepsy X X X X Free
685 Epilepsy Epilepsy: Basic psychosocial support, advice, and follow-up, plus anti- X X X X Free
epileptic medication
686 Dementia Diagnosis and management of dementia X X X X Free
687 Dementia Opportunistic screening for detection of dementia X X X X Free
688 Childhood and adolescent mental, Parenting programs in infancy to promote early child development X Free
behavioural & developmental disorders
689 Childhood and adolescent mental, Improve the quality of antenatal and perinatal care to reduce risk X X X X Free
behavioural & developmental disorders factors associated with intellectual disability
690 Childhood and adolescent mental, Screening for congenital hypothyroidism among infants X Free
behavioural & developmental disorders
691 Developmental Disorders Family psychoeducation X X X X Free
692 Behavioural Disorders Psychosocial interventions for treatment of behavioural disorders X X X X Free
693 ADHD Diagnosis and treatment of ADHD including Methylphenidate X X Free
694 ADHD Family psychoeducation (ADHD) X X X X X Free
695 Common Childhood Mental disorders Identification of children with MNS disorders in schools X Free
696 Emotional Disorders Psychosocial interventions, treatment of emotional disorders X X X X Free
697 Depression in Older children and adolescents Antidepressants among adolescents with moderate-severe depressive X X X X Free
disorder for whom psychosocial interventions have proven ineffective
698 Childhood and adolescent mental, Anxiety, post-traumatic stress disorder-Cognitive and behavioural X X X X sharing
behavioural & developmental disorders therapy
699 Alcohol use disorders Screening and brief interventions for alcohol use disorders X X X X sharing
125
700 Alcohol use disorders Management of alcohol withdrawal X X X sharing

701 Alcohol use disorders Relapse prevention medication for alcohol use/dependence X sharing
702 Opioid Use Disorder Opioid substitution therapy (methadone and buprenorphine) for X sharing
opioid dependence
703 Others drug use disorders (illicit, cannabis, Identification and assessment of new cases of drug use/dependence sharing
Khat, tobacco and others)
704 Others drug use disorders (illicit, cannabis, Brief interventions and follow-up for drug use/dependence X X X X sharing
705 Others drug use disorders (illicit, cannabis, Management of drug withdrawal X X X sharing
706 Others drug use disorders (illicit, cannabis, Management of tobacco (Nicotine) dependence X sharing
707 Suicide and self-harm Assess and care for person with self-harm X X X X sharing
708 Suicide and self-harm Basic psychosocial treatment, advice, and follow-up for self- X X X X sharing
harm/suicide
709 Suicide and self-harm Safer storage of pesticides in the community and farming households X sharing
710 Suicide and self-harm Emergency management of poisoning X X X X sharing
711 Suicide and self-harm Planned follow-up and monitoring of suicide attempters* X X X X X sharing
712 Suicide and self-harm Treatment of comorbid mood and substance use disorder* X X X X sharing
Surgical, emergency, and critical care
713 Surgical care: Gynaecology and obstetrics Caesarean section X X X X Free
conditions
714 Surgical care: Gynaecology and obstetrics Abdominal hysterectomy X X X Free
conditions
715 Surgical care: Gynaecology and obstetrics Repair of uterine perforation and rupture X X X Free
conditions
126
716 Surgical care: Gynaecology and obstetrics Surgical management of pelvic organ prolapse X X X Sharing
conditions
717 Surgical care: Gynaecology and obstetrics Conservative management of pelvic organ prolapse X X X Sharing
conditions
718 Surgical care: Gynaecology and obstetrics Repair of obstetric fistula X X Free
conditions
719 Surgical care: Gynaecology and obstetrics Cervical biopsy X X X Free
conditions
720 Surgical care: Gynaecology and obstetrics Endometrial biopsy X X Free
conditions
721 Surgical care: Gynaecology and obstetrics Surgical management of major benign gynaecological conditions X X X Sharing
conditions
722 Surgical care: Gynaecology and obstetrics Surgical management of major malignant gynaecological conditions X X Sharing
conditions
723 Surgical care: Gynaecology and obstetrics Female genital anomalies surgeries X X Sharing
conditions
724 Surgical care: Gynaecology and obstetrics Salpingo-ophorectomy X X Sharing
conditions
725 Surgical care: Gynaecology and obstetrics Colposcopy X X X Sharing
conditions
726 Surgical care: Gynaecology and obstetrics Hystero-salpingography X X X Sharing
conditions
727 Surgical care: Gynaecology and obstetrics Ectopic pregnancy laparotomy X X X Free
conditions
728 Surgical care: Gynaecology and obstetrics Destructive delivery X X X X Free
conditions
729 Surgical care: Gynaecology and obstetrics Laparotomy for gynaecologic emergency X X X Free
conditions
127
730 Surgical care: Gynaecology and obstetrics Diagnostic and therapeutic laparoscopy X X X Sharing
conditions
731 Surgical care: Trauma and injury Laceration repair and wound care X X X Sharing
732 Surgical care: Trauma and injury Air way procedures including Tracheostomy and crico-thyroideotomy X X X Sharing
733 Surgical care: Trauma and injury Tube thoracotomy for air or fluid collection in the pleura X X X Sharing
734 Surgical care: Trauma and injury Focused assessment of sonography for trauma (FAST) X X X Sharing
735 Surgical care: Trauma and injury Explorative laparotomy for trauma X X X Sharing
736 Surgical care: Trauma and injury Emergency thoracotomy for severe chest injury X X X Sharing
737 Surgical care: Trauma and injury Vascular exploration and repair/anastomosis for trauma X X X Sharing
738 Surgical care: Trauma and injury Neck exploration for severe neck injuries X X X X Sharing
739 Surgical care: Trauma and injury Cut down for vascular access X X X Sharing
740 Surgical care: Trauma and injury Non operative management of fracture and dislocation (pain X X X X Sharing
management, immobilization, POP application, traction, dislocation
reduction
741 Surgical care: Trauma and injury Operative management of fractures(internal and external fixations) X X X Sharing
742 Surgical care: Trauma and injury Non operative burns management ( resuscitation, oxygen delivering, X X X Sharing
pain management and wound care)
743 Surgical care: Trauma and injury Burn management: Escharotomy and Fasciotomy X X X Sharing
744 Surgical care: Trauma and injury Skin graft and flap x X X Sharing
745 Surgical care: Trauma and injury Management of acute hand trauma (tendon and neurovascular) X X X Sharing
746 Surgical care: Trauma and injury Trauma related amputation X X X Sharing
747 Surgical care: Trauma and injury Basic wound management including wound toilet, debridement repair x X X X Sharing
of lacerations and splinting of fractures
748 Surgical care: Trauma and injury Burr-hole and elevation of depressed skull fracture for head injuries X X Sharing
749 Surgical care: Trauma and injury Comprehensive intracranial pressure management/monitoring X X Sharing
750 Surgical care: Trauma and injury Cervical and back protection X X X X Sharing
751 Surgical care: Trauma and injury Post trauma extremity rehabilitation X X X Sharing
128
752 Surgical care: Non-trauma surgical conditions Draining superficial abscesses X X X X Sharing
753 Surgical care: Non-trauma surgical conditions Excision of small soft tissue tumours: cysts, lipoma and ganglion X X X recovery
754 Surgical care: Non-trauma surgical conditions Male circumcision X X X recovery
755 Surgical care: Non-trauma surgical conditions Hydrocelectomy X X X Sharing
756 Surgical care: Non-trauma surgical conditions Relieving acute urinary retention by catheterization, closed supra- X X X Sharing
pubic cystectomy
757 Surgical care: Non-trauma surgical conditions Orchidopexy X X X Sharing
758 Surgical care: Non-trauma surgical conditions Trans vesical prostatectomy (TVP) X X X Sharing
759 Surgical care: Non-trauma surgical conditions Trans urethral removal of bladder tumour (TURBT) X X Sharing
760 Surgical care: Non-trauma surgical conditions Cysto-lithotomy X X X Sharing
761 Surgical care: Non-trauma surgical conditions Rectal tube deflation for sigmoid volvulus X X X X Sharing
762 Surgical care: Non-trauma surgical conditions Management of intussusception X X X Sharing
763 Surgical care: Non-trauma surgical conditions Colostomy for ano-rectal malformation X X Sharing
764 Surgical care: Non-trauma surgical conditions Management of foreign body swallowing/aspiration X X X X X Sharing
765 Surgical care: Non-trauma surgical conditions Explorative laparotomy for acute abdomen (acute appendicitis, ectopic X X X X Sharing
pregnancy, ovarian torsion, perforation and trauma)
766 Surgical care: Non-trauma surgical conditions Laparoscopy Cholecystectomy and appendectomy X X Sharing
767 Surgical care: Non-trauma surgical conditions Biliary bypass procedures and T-tube insertion for hepato-biliary X X Sharing
pathologies
768 Surgical care: Non-trauma surgical conditions Repair of hernias: tissue repair and mesh repair X X X Sharing
769 Surgical care: Non-trauma surgical conditions Colostomy construction and reversal X X X Sharing
770 Surgical care: Non-trauma surgical conditions Hemicolectomies X X Sharing
771 Surgical care: Non-trauma surgical conditions Surgical management of peri-anal conditions: Haemorrhoids, fistula in X X X Sharing
anos, Anal fissures, peri-anal abscess)
772 Surgical care: Non-trauma surgical conditions Repair of cleft lip and palate X X Sharing
773 Surgical care: Non-trauma surgical conditions Shunt for hydrocephalus X X Sharing
774 Surgical care: Non-trauma surgical conditions Cardiac surgery for congenital heart disease X Sharing
129
775 Surgical care: Non-trauma surgical conditions Repair of neural tube defects X Sharing
776 Surgical care: Non-trauma surgical conditions Modified radical mastectomy X X Sharing
777 Surgical care: Non-trauma surgical conditions Thyroidectomy (all forms): STT, NTT, and TT X X Sharing
778 Surgical care: Non-trauma surgical conditions Gastrectomy X X Sharing
779 Surgical care: Non-trauma surgical conditions Esophactemies X X Sharing
780 Surgical care: Non-trauma surgical conditions Pulmonary resections and mediastinal procedures for chest X Sharing
pathologies
781 Surgical care: Non-trauma surgical conditions Tenotomy for club foot and ponsetti cast for club foot X X Sharing
782 Surgical care: Non-trauma surgical conditions Surgical management of Septic Arthritis, X X X Sharing
783 Surgical care: Non-trauma surgical conditions Surgical management of Osteomyelitis, X X Sharing
784 Surgical care: Non-trauma surgical conditions Surgical management of Pyomyositis X X X X Sharing
785 Surgical care: Non-trauma surgical conditions Surgical management of hand infection X X X Sharing
786 Surgical care: Non-trauma surgical conditions Complex orthopaedic trauma care including hemi arthroplasty, intra- X X Sharing
articular fractures, spine and pelvic fracture management)
787 Surgical care: Non-trauma surgical conditions Cardiac surgery for valvular heart disease X Sharing
788 Surgical care: Non-trauma surgical conditions Skin grafting x X X Sharing
789 Surgical care: Non-trauma surgical conditions Splenectomy X X Sharing
790 Surgical care: Non-trauma surgical conditions Pancreatic pseudo cyst operation X X Sharing
791 Surgical care: Non-trauma surgical conditions Cystocele repair X X Sharing
792 Surgical care: Non-trauma surgical conditions Diaphragmatic hernia repair X X Sharing
793 Surgical care: Non-trauma surgical conditions Antrectomy with vagotomy X X Sharing
794 Surgical care: Non-trauma surgical conditions Fistulectomy X X Sharing
795 Surgical care: Non-trauma surgical conditions Abdominal dehiscence repair X X Sharing
796 Surgical care: Non-trauma surgical conditions Small intestinal resection/ E-Anastomosis X X Sharing
797 Surgical care: Non-trauma surgical conditions Intestinal derotation X X X Sharing
798 Surgical care: Non-trauma surgical conditions Anterior resection X X Sharing
799 Surgical care: Non-trauma surgical conditions Abdominal perineal resection (APR) X X Sharing
130
800 Surgical care: Non-trauma surgical conditions Colectomy right or left X X Sharing
801 Surgical care: Non-trauma surgical conditions Total colectomy X X Sharing
802 Surgical care: Non-trauma surgical conditions Anal sphinicterotomy X X Sharing
803 Surgical care: Non-trauma surgical conditions Fistiulectomy x X Free
804 Surgical care: Non-trauma surgical conditions Cystic hygroma excision X X X Sharing
805 Surgical care: Non-trauma surgical conditions Mesenteric mass excision X X Sharing
806 Surgical care: Non-trauma surgical conditions Excision of retroperitoneal tumour X X Sharing
807 Surgical care: Non-trauma surgical conditions Meatotomy X X Sharing
808 Surgical care: Non-trauma surgical conditions Breast lump removal X X X Sharing
809 Surgical care: Non-trauma surgical conditions Gastroscopy with biopsy: UGIE X X Sharing
810 Surgical care: Non-trauma surgical conditions Pyelolithotomy X X Sharing
811 Surgical care: Non-trauma surgical conditions Ureterolithotomy X X Sharing
812 Surgical care: Non-trauma surgical conditions Nephrectomy X X Sharing
813 Surgical care: Non-trauma surgical conditions Urethroplasty X X Sharing
814 Surgical care: Non-trauma surgical conditions Thoracotomy X X Sharing
815 Surgical care: Non-trauma surgical conditions Pneumonectomy X X Sharing
816 Surgical care: Non-trauma surgical conditions Lobar pneumonectomy X X Sharing
817 Surgical care: Non-trauma surgical conditions Parotidectomy X X Sharing
818 Surgical care: Non-trauma surgical conditions Neck dissection for head and neck cancers X X Sharing
819 Surgical care: Non-trauma surgical conditions Uretroscopy X X Sharing
820 Surgical care: Non-trauma surgical conditions Trans urethral resection X X Sharing
821 Surgical care: Non-trauma surgical conditions Urinary diversion X X Sharing
822 Surgical care: Non-trauma surgical conditions Whipple's procedure X Sharing
823 Surgical care: Non-trauma surgical conditions Radical cystectomy X X Sharing
824 Surgical care: Non-trauma surgical conditions Decortication X X Sharing
825 Surgical care: Non-trauma surgical conditions Pyeloplasty X X Sharing
826 Surgical care: Non-trauma surgical conditions Hellers myotomy X X Sharing
131
827 Surgical care: Non-trauma surgical conditions Nissen's fundoplication X X Sharing

828 Surgical care: Non-trauma surgical conditions Inguinal orchiedectomy X X Sharing
829 Surgical care: Non-trauma surgical conditions Bronchoscopy with GA X X Sharing
830 Surgical care: Non-trauma surgical conditions UGIE and biopsy X X Sharing
831 Surgical care: Non-trauma surgical conditions Pericardial window X X Sharing
832 Surgical care: Non-trauma surgical conditions Pericadiectomy X Sharing
833 Surgical care: Non-trauma surgical conditions Kidney transplant surgery X Sharing
834 Surgical care: Non-trauma surgical conditions Pull through , pyloromyotomy, Paediatrics procedures X X Sharing
835 Surgical care: Dermatology procedures Dermatological curetting and electrosurgery X X Sharing
836 Surgical care: Dermatology procedures Crayotherapy X X X Sharing
837 Surgical care: Dermatology procedures Skin biopsy examination (punch, incisional or shave) X X Sharing
838 Surgical care: Dermatology procedures Patch test X X Sharing
839 Surgical care: Dermatology procedures Laser therapy X X Sharing
840 Surgical care: Dermatology procedures Narrow band UVB photo therapy X X Sharing
841 Surgical care: Dermatology procedures Slit skin smear for leishmaniasis X X X Sharing
842 Surgical care: Dermatology procedures Complex skin biopsy excision and repair X X Sharing
843 Surgical care: Dermatology procedures Electo cauterization X X X X Sharing
844 Surgical care: Dermatology procedures Punch biopsy X X Sharing
845 Surgical care: Dermatology procedures Skin snip for microfilaria X X X Sharing
846 Surgical care: Dermatology procedures Interalesional steroid injection X X Sharing
847 Surgical care: Oral and Dental procedures Extraction of primary and permanent tooth X X X X Sharing
848 Surgical care: Oral and Dental procedures Periodontal and dental abscess incision and drainage X X X X Sharing
849 Surgical care: Oral and Dental procedures Dental caries treatments and scaling X X X X Sharing
850 Surgical care: Oral and Dental procedures Management facial bone fractures and/or dislocation and injury to X X Sharing
dentition (inter-dental wiring, arch bar, IMF and open reduction)
851 Surgical care: Oral and Dental procedures Management of oro-facial infection X X X X Sharing
132
852 Surgical care: Oral and Dental procedures Management of common benign tumours and cyst of oral & X X Sharing
853 Surgical care: Oral and Dental procedures Management of common malignant tumours and cyst of oral & X X Sharing
854 Surgical care: Oral and Dental procedures Dental truam care X X X X Sharing
855 Surgical care: Ophthalmic procedures Cataract extraction and insertion of intraocular lens X X X Sharing
856 Surgical care: Ophthalmic procedures Eyelid surgery for trachoma (Tarsotomy) X X X X Sharing
857 Surgical care: Ophthalmic procedures Glaucoma surgery (Canaloplasty) X X Sharing
858 Surgical care: Ophthalmic procedures Corneal surgery X X Sharing
859 Surgical care: Ophthalmic procedures Corneal transplant X Sharing
860 Surgical care: Ophthalmic procedures Oculoplastic surgery X Sharing
871 Surgical care: Ophthalmic procedures Strabismus surgery X X Sharing
862 Surgical care: Ophthalmic procedures Retinal detachment repair X X Sharing
863 Surgical care: Ophthalmic procedures Vitrectomy X X Sharing
864 Surgical care: Ophthalmic procedures Eye enuclation X X Sharing
865 Surgical care: Ophthalmic procedures Eye irrigation X X X Sharing
866 Surgical care: Ophthalmic procedures Lasertherapy X X Sharing
867 Surgical care: ENT procedure Ear irrigation X X X Sharing
868 Surgical care: ENT procedure Hearing aid placement(including audiometery) X X Sharing
869 Surgical care: ENT procedure Myringotomy for otitis media X X Sharing
870 Surgical care: ENT procedure Management of nasal and ear obstruction (foreign body removal from X X X X Sharing
nose and ears)
871 Surgical care: ENT procedure polypectomy (Nose) X X Sharing
872 Surgical care: ENT procedure Tonsillectomy X X Sharing
873 Surgical care: ENT procedure Sleep disorder surgery X Sharing
874 Surgical care: ENT procedure Corrective breathing surgery X Sharing
875 Surgical care: ENT procedure Sinus surgery X X Sharing
133
876 Surgical care: ENT procedure Mastoidectomy and drainage X X Sharing

877 Surgical care: ENT procedure Laryngeal polyp excision X X Sharing
878 Surgical care: ENT procedure Thympanoplasty X X Sharing
879 Anaesthesia and critical care Local Anaesthesia X X X X Sharing
880 Anaesthesia and critical care General Anaesthesia with LMA; with intubation ETT (video or X X Sharing
glydoscope)
881 Anaesthesia and critical care Difficult intubation (Bugie, Stylet, Fibro, video/Glydoscope) X X Sharing
882 Anaesthesia and critical care Lumbar puncture X X X Sharing
883 Anaesthesia and critical care Spinal Anaesthesia X X X Sharing
884 Anaesthesia and critical care Caudal Anaesthesia/analgesia X X Sharing
885 Anaesthesia and critical care Epidural Anaesthesia/analgesia X X Sharing
886 Anaesthesia and critical care Peripheral nerve blocks X X Sharing
887 Anaesthesia and critical care Procedural sedation X X Sharing
888 Anaesthesia and critical care Central venous catheter insertion X X Sharing
889 Anaesthesia and critical care Arterial catheter insertion X Sharing
890 Anaesthesia and critical care Blood transfusion (including exchabge) X X X Sharing
891 Anaesthesia and critical care Intubation/ Extubation (single and duoubel lumen) X X X Sharing
892 Anaesthesia and critical care Fiberoptic bronchoscopy X X Sharing
893 Anaesthesia and critical care Mechanical ventilation non invasive - CPAP X X X Sharing
894 Anaesthesia and critical care Mechanical ventilation invasive X X Sharing
Emergence and critical care
895 Pre-hospital emergency care Initial syndrome-based management at scene and during transport for X X X X Sharing
difficulties in breathing, shock and altered mental status
896 Pre-hospital emergency care Initial syndrome-based management at scene and during transport for X X X X Sharing
polytrauma
134
897 Pre-hospital emergency care Basic initial assessment and management at scene and during X X X X Sharing
transport of labour, precipitous childbirth and complications of
pregnancy and childbirth
898 Pre-hospital emergency care Ambulance transport with direct provider monitoring and X X Sharing
management during transport (in procedures – structured handover to
hospital personnel)
899 Pre-hospital emergency care User-activated dispatch of basic ambulance services X X X X Sharing
900 Pre-hospital emergency care Basic initial assessment and management of acute pain (use existing X X Sharing
interventions)
901 Pre-hospital emergency care Advanced pre-hospital care X X X Sharing
902 Pre-hospital emergency care Community-based first aid delivery X X Sharing
903 Basic emergency care services Initial assessment and management of acute difficulties in breathing, X X Sharing
shock and altered mental status
904 Basic emergency care services Basic initial assessment and management of acute injury (BTLS, ATLS) X X X X Sharing
905 Advanced emergency care services Initial advanced assessment and management of acute difficulty in X X X Sharing
breathing, shock and altered mental status
906 Advanced emergency care services Initial assessment and management of wounds (including burns) X X Sharing
907 Advanced emergency care services Initial assessment and management of acute head injury X X X Sharing
908 Advanced emergency care services Initial assessment and management of acute thoracic injury X X X X Sharing
909 Advanced emergency care services Initial assessment and management of acute intra-abdominal injury X X X Sharing
(non-bony)
910 Advanced emergency care services Initial assessment and management of acute musculoskeletal injury X X X X X Sharing
(including fracture/dislocations)
911 Advanced emergency care services Initial assessment and management of acute neurologic injury X X X Sharing
912 Advanced emergency care services Initial management of cardiovascular emergencies (ischemia, failure, X X X X Sharing
arrhythmia, critical limb ischemia and stroke) including defibrillation,
pacing and synchronised cardioversion
135
913 Advanced emergency care services Initial management of gastrointestinal emergencies (including X X X X Sharing
obstruction, bleeding and peritonitis)
914 Advanced emergency care services Initial management of metabolic emergencies (glucose, thyroid, X x x Sharing
potassium, calcium and sodium)
915 Advanced emergency care services Advanced management of sepsis X x x Sharing
916 Advanced emergency care services Advanced management of acute pain X x x Sharing
917 Advanced emergency care services Management of acute toxic ingestions/exposures x x x X Sharing
918 Advanced emergency care services Management of ocular emergencies x x x x Sharing
919 Advanced emergency care services Management of urgent soft tissue conditions x x x x Sharing
920 Advanced emergency care services Management of ENT emergencies x x x X Sharing
921 Advanced emergency care services Management of acute urinary obstruction x x x x Sharing
922 Advanced emergency care services Management of acute infectious exposures (including sexual x x x X Sharing
exposures, needle stick, rabies and tetanus)
923 Advanced emergency care services Management of snake bite (in-procedures include wound care, x x x x Sharing
pressure dressing and anti-venin
924 Advanced emergency care services Management of acute psychosis x x x x Sharing
925 Advanced emergency care services Acute management of dental emergencies x x x X Sharing
926 Advanced emergency care services Advanced management of post-partum haemorrhage x x x x Sharing
927 Advanced emergency care services Management of ectopic pregnancy x x x Sharing
928 Advanced emergency care services Management of precipitous delivery x x X Sharing
929 Emergency and critical care: all Establish acuity based triage clinical checklist implementation x x x x NA
930 Emergency and critical care: all Establish rapid surge of service delivery capacity x x x x NA
931 Emergency and critical care: all Establish case based syndrome surveillance and reporting of emerging x x x x NA
and infectious diseases
932 Emergency and critical care: all Establish protocol for management of mass casualty and emerging x x x x x x NA
infectious disease surveillance
136
933 Emergency and critical care: all Mass casualty management (protocol-based) for rapid surge of service x x x x x x NA
delivery capacity
Multi-sectoral environmental health and Hygiene
934 HEH: Sanitation Promote proper/improved latrine construction in all households X X X Free
935 HEH: Sanitation Promote construction of hand washing facilities near/in the latrine X X X Free
936 HEH: Sanitation Construct communal latrines X NA
937 HEH: Sanitation Avail proper liquid waste collection and disposal mechanism X X X X X X Free
938 HEH: Sanitation Avail proper domestic solid waste collection and disposal services X X X Free
939 HEH: Personal hygiene Promote appropriate personal hygiene practice X X X X X X Free
940 HEH: Personal hygiene Create awareness on menstrual hygiene management X X X Free
941 HEH: Personal hygiene Avail communal cloth washing facilities X X X X X X Free
942 HEH: Personal hygiene Create awareness on proper face washing with soap X X X X X X Free
943 HEH: Personal hygiene Create awareness on proper oral hygiene practice X X X X X X Free
944 HEH: Water supply Promote proper water management at household level as per water X X X Free
safety plan
945 HEH: Water supply Avail improved adequate and potable water within the standard X Sharing
distance (30 min to 1 hr.)
946 HEH: Water supply Conduct water quality sanitary surveillance X X X Free
947 HEH: Water supply Household disinfection and storage for people living with HIV X X Free
948 HEH: Water supply Point use of water filter for HIV infected Adult X X Free
949 HEH: Water supply Point use of water filter X Free
950 HEH: Water supply Centralized water treatment system X Free
951 HEH: Water supply Source based protection OF Water supply X Free
952 HEH: Water supply Household chlorination X Free
953 HEH: Water supply Household filtration X Free
954 HEH: Water supply Household Solar disinfection X Free
955 HEH: Water supply Household flocculation X Free
137
956 HEH: Water supply Household connection with water supply X Sharing
957 HEH: Sanitation Sanitation promotion only X X Free
958 HEH: Sanitation Safe Sanitation facilities X X X X X X Free
959 HEH: Sanitation Wet pit latrine X X X X X X Free
960 HEH: Sanitation Social marketing and education on Hygiene alone X X X recovery
961 HEH: Sanitation Social marketing and education on top of existing hardware X X X recovery
962 HEH: Sanitation Social marketing and education, and hardware together X X X recovery
Health Education and Promotion
963 HEP: RMNCH/FP Family planning demand creation: IEC, BCC, advocacy, community X X X Free
dialogue, conduct counselling about family planning at household level
964 HEP: RMNCH/FP Develop tailored SBCC materials on FP X X X Free
965 HEP: RMNCH/FP Demonstrate FP methods X X X X Free
966 HEP: RMNCH/FP Conduct mass awareness on FP X X X Free
967 HEP: RMNCH/FP Conduct community mobilization on FP X X Free
968 HEP: Fertility Provision of counselling on fertility X X X X X X Free
969 HEP: Fertility Conduct community awareness creation against fertility related stigma X X X Free
and discrimination
970 HEP: Sexual and Reproductive Health Promote adolescent life skill interventions (in-schools, out-of schools, X X X X Free
community)
971 HEP: Sexual and Reproductive Health Create awareness on impacts of unsafe abortion X X X X Free
972 HEP: Sexual and Reproductive Health Strengthen AYSRH promotional services (in-schools, out-of schools, X X X X Free
community)
973 HEP: Sexual and Reproductive Health Promote provision of user friendly services X X X X X Free
974 HEP: Sexual and Reproductive Health Facilitate post-abortion counselling services X X X X Free
975 HEP: Cervical & Breast Cancer Promote cervical cancer screening X X X X X X Free
976 HEP: Cervical & Breast Cancer Promote cervical cancer vaccination X X X X X X Free
138
977 HEP: Cervical & Breast Cancer Promote self-examination and routine medical check-up for breast X X X X X X Free
cancer
978 HEP: Gender based violence Promote the impact of positive gender norms on health X X X X X X Free
979 HEP: Gender based violence promote life skill interventions on prevention gender based violence X X X X X X Free
980 HEP: Gender based violence create awareness on impact of gender based violence on health X X X X X X Free
981 HEP: Gender based violence Promote/strengthen psychosocial support for victims of GBV (one x X X Free
window service, hotlines)
982 HEP: Harmful traditional practices awareness creation on impacts of HTP X X X X Free
983 HEP: Harmful traditional practices conduct community dialogue and mobilization on HTP X X X X Free
984 HEP: Harmful traditional practices provide psychosocial support to victims of HTPs x x Free
985 HEP: Harmful traditional practices promote testimonials of HT practioners on the health impacts of HTP X X X Free
986 HEP: Prenatal care (pre-pregnancy) promote early ANC X X X X Free
987 HEP: Prenatal care (pre-pregnancy) Promote pregnancy readiness services X X X X Free
988 HEP: Antenatal care Promote the use of optimal ANC X X X X X Free
989 HEP: Skilled delivery Promote the use of delivery at health facilities X X X X Free
990 HEP: Postnatal care Provide postnatal counselling to create awareness on postnatal X X X X Free
danger signs
991 HEP: Postnatal care Conduct home visit to promote health services to Neonatal X X X X Free
992 HEP: Community based Neonatal care Create awareness on proper Neonatal care (washing, KMC, Exclusive X X X X Free
breast feeding)
993 HEP: Community based Neonatal care Conduct home visit to promote the impact of HTPs X X X X Free
994 HEP: Community based Neonatal care Create awareness on danger signs of Neonatal and measures to be X X X X Free
taken
995 HEP: Community based Neonatal care demonstrate Neonatal care (washing, KMC, Exclusive breast feeding) X X X X Free
996 HEP: Immunization Promote the importance of immunization X X X X Free
997 HEP: IMNCI Create awareness on signs and symptoms of childhood illness X X X X Free
998 HEP: IMNCI Promote early visit of health facilities X X X X Free
139
999 HEP: IMNCI Promote adherence to medical recommendations (treatment and X X X X Free
advices)
1000 HEP: IMNCI Promote supplementary feeding practices X X X X Free
1001 HEP: IMNCI Promote visit of U5 children to facilities for GMP , deworming , Vitamin X X X X Free
A supplementation and screening programs
1002 HEP: IMNCI Promote good feeding practice ( balanced diet, hygienic practice) X X X X Free
1003 HEP: IMNCI Conduct food demonstration for children with Severe Acute X X X X Free
Malnutrition (SAM)
1004 HEP: IMNCI Create awareness on the type of services provide at health facilities for X X X X Free
U5 children
1005 HEP: IMNCI Promote child care including personal hygiene (proper baby WASH) X X X X Free
1006 HEP: IMNCI Create awareness on prevention of childhood accidents, injuries X X X X Free
1007 HEP: IMNCI Create awareness on the reduction of HTPs X X X X Free
1008 HEP: Adolescent health and pre-conception Awareness creation on balanced diet X X X X Free
nutrition
1009 HEP: Adolescent health and pre-conception Promote healthy and hygienic feeding practices X X X X Free
nutrition
1010 HEP: Pregnant and Breastfeeding women Promote balanced diet and intake of micronutrients X X X X Free
nutrition
1011 HEP: Micronutrient supplementation and Promote use of fortified products X X X X Free
fortification
1012 HEP: all CVD, CRD, DM and RD Promote adherence to medications X X X X Free
1013 HEP: all CVD, CRD, DM and RD Promote healthy life style including physical exercise, feeding habits X X X X Free
1014 HEP: all CVD, CRD, DM and RD Promote reduction of use of Alcohol, tobacco, sweetened beverages X X X X Free
1015 HEP: all CVD, CRD, DM and RD Create awareness on impacts of saturated fat products X X X X Free
1016 HEP: all CVD, CRD, DM and RD Promote the use of unsaturated fat products X X X X Free
1017 HEP: all CVD, CRD, DM and RD Promote regular medical check-ups X X X X Free
140
1018 HEP: all CVD, CRD, DM and RD Promote establishment of support groups for substance abusers, X X X X X X Free
chronic patients
1019 HEP: all CVD, CRD, DM and RD Advocate for proper standards and protocols of products during X X X X X X Free
advertisement
141
References
1. Global Health Observatory Data Repository/World Health Statistics [Internet]. 2018
[cited March 30, 2018]. Available from: http://apps.who.int/ghodata/
2. Admassie A, Seid NA, John FM, Shelley M, Scott M. The Demographic Dividend:
An Opportunity for Ethiopia’s Transformation. Washington, DC: Population
Reference Bureau and Ethiopian Economics Association, 2015.
3. Federal Ministry of Health Ethiopia. Health sector transformation plan 2008 - 2012
EFY Addis Ababa: Federal Democratic Republic of Ethiopia Ministry of Health,
2015.
4. United Nations. Sustainable Development Goals New York. 2015. Available from:
https://sustainabledevelopment.un.org/?menu=1300.
5. United Nations Population Division. World Population Prospects: 2019 Revision.
New York: United Nations, 2019.
6. World Bank. Rural population (% of total population). 2018. Available from:
https://data.worldbank.org/indicator/sp.rur.totl.zs
7. Federal Democratic Republic of Ethiopia Ministry of Health. National Strategy for
Newborn and Child Survival in Ethiopia, 2015/16-2019/20. 2015.
8. Damtew ZA, Chekagn CT, Moges AS. The health extension program of Ethiopia.
Harvard Health Policy Review. December 2016. Available at:
https://www.hhpronline.org/articles/2016/12/17/the-health-extension-program-of-
ethiopia
9. Wang H, Tesfaye R, Ramana GNV, Chekagn CT. Ethiopia health extension program.
An institutionalized community approach for universal health coverage. Washington,
DC: World Bank, 2016. Available at:
https://openknowledge.worldbank.org/bitstream/handle/10986/24119/9781464808159
.pdf;sequence=2
10. Misganaw A, Haregu TN, Deribe K, Tessema GA, Deribew A, Melaku YA, et al.
National mortality burden due to communicable, non-communicable, and other
diseases in Ethiopia, 1990–2015: findings from the Global Burden of Disease Study
2015. Population Health Metrics. 2017; 15(1):29.
11. Ethiopia Central Statistical Agency, International ICF. Ethiopia demographic and
health survey 2016. Addis Ababa, Ethiopia; Calverton, Md.: Central Statistical
Agency; ICF International, 2016.
12. Ethiopia Central Statistical Agency, International ICF. Ethiopia: demographic and
health survey, 2011. Addis Ababa, Ethiopia; Calverton, Md.: Central Statistical
Agency; ICF International, 2012.
13. Federal Ministry of Health of Ethiopia. Addressing the impact of noncommunicable
diseases and injuries in Ethiopia. Addis Ababa; 2018.
14. Liranso GS, Mohan SS. Mental Health Care and Children Wellbeing in Ethiopia.
Journal of Neurology and Neurological Disorders. 2017; 3(1).
15. Federal Ministry of Health of Ethiopia. Ethiopian National Mental Health Strategy
2012-2016, 2012.
16. Memirie ST, Habtemariam MK, Asefa M, Deressa BT, Abayneh G, Tsegaye B,
Abraha MW, Ababi G, Jemal A, Rebbeck TR, Verguet S. Estimates of cancer in
Ethiopia in 2015 using population-based registry data. Journal of Global Oncology.
2018; 4:1-11.
17. Federal Democratic Republic of Ethiopia. Ethiopia Sixth Health Accounts 2013/2014.
Statistical report. August 2017. Addis Ababa, Ethiopia.
142
18. Federal Democratic Republic of Ethiopia. Health Sector Transformation Plan:
2015/16-2019/20. August 2015. Addis Ababa, Ethiopia.
19. WHO-CHOICE. Available at: https://www.who.int/choice/en/
20. World Health Organization. Making fair choices on the path to universal health
coverage. Final report of WHO Consultative Group on Equity and Universal Health
Coverage. Geneva: World Health Organization, 2014.
21. Roberts MJ, Hsiao W, Berman P, Reich MR. Getting health reform right – A guide to
improving performance and equity. Oxford, UK: Oxford University Press, 2008.
22. Glassman A, Giedion U, Smith P, editors. What's in, what's out: designing benefits for
universal health coverage. Washington DC: Brookings Institution Press, 2017.
23. Verguet S, Jamison DT. Benefits beyond health: evaluating financial risk protection
and equity through extended cost-effectiveness analysis. In: Glassman A, Giedion U,
Smith P, editors. What's in, what's out: designing benefits for universal health
coverage. Washington DC: Brookings Institution Press, 2017.
24. Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for
the economic evaluation of health care programmes. Fourth edition. Oxford, United
Kingdom; New York, NY, USA: Oxford University Press, 2015.
25. World Health Organization, Tan-Torres Edejer T, Baltussen R, Adam T, Hutubessy
R, Acharya A, Evans DB, Murray CJL, editors. Making choices in health. WHO
guide to cost-effectiveness analysis. Geneva: World Health Organization, 2003.
Available at:
https://www.who.int/choice/publications/p_2003_generalised_cea.pdf?ua=1
26. Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, et al.
Consolidated Health Economic Evaluation Reporting Standards (CHEERS)--
explanation and elaboration: a report of the ISPOR Health Economic Evaluation
Publication Guidelines Good Reporting Practices Task Force. Value Health. 2013;
16(2):231-50.
27. Drummond M, Barbieri M, Cook J, Glick HA, Lis J, Malik F, et al. Transferability of
economic evaluations across jurisdictions: ISPOR Good Research Practices Task
Force report. Value Health. 2009; 12(4):409-18.
28. Kiros M, Dessie E, Jbaily A, Tolla MT, Johansson KA, Norheim OF, Memirie ST,
Verguet S. The burden of household out-of-pocket health expenditures in Ethiopia:
estimates from a nationally representative survey (2015-16). September 2019.
29. Verguet S, Kim JJ, Jamison DT. Extended cost-effectiveness analysis for health
policy assessment: a tutorial. Pharmacoeconomics. 2016; 34(9):913-923.
30. World Health Organization. One Health Tool. Available at:
https://www.who.int/choice/onehealthtool/en/
31. Horton S, Gelband H, Jamison D, Levin C, Nugent R, Watkins DA. Ranking 93
health interventions for low- and middle-income countries by cost-effectiveness.
PLoS ONE. 2017; 12(8):e0182951.
32. Daniels N, Sabin JE. Setting limits fairly: can we learn to share medical resources?
Second edition. Oxford: Oxford University Press, 2008.
33. Gruskin S, Daniels N. Process is the point: justice and human rights: priority setting
and fair deliberative process. American Journal of Public Health. 2008; 98(9):1573-7.
34. Baltussen R, Jansen MPM, Bijlmakers L, Grutters J, Kluytmans A, Reuzel RP, et al.
Value Assessment Frameworks for HTA Agencies: The Organization of Evidence-
Informed Deliberative Processes. Value Health. 2017; 20(2):256-60.
35. Stenberg, K., et al., Financing transformative health systems towards achievement of
the health Sustainable Development Goals: a model for projected resource needs in 67
143
low-income and middle-income countries. Lancet Glob Health, 2017. 5(9): p. e875-
e887.
36. Federal Ministry of Health, Envisioning Ethiopia’s path towards universal health
coverage through strengthening primary health care. Draft-2. 2015, Federal Ministry
of Health: Addis Ababa.
37. Federal Democratic Republic of Ethiopia Ministry of Health, Health Care Financing
Strategy 2017 – 2025. 2017: Addis Ababa.
38. Tandon, A.C., C., Assessing Public Expenditure on Health From a Fiscal Space
Perspective. Health, Nutrition and Population (HNP) Discussion Paper. . 2010, World
Bank: Washington DC.
39. WHO. WHO Global Health Observatory. 2016 June 23, 2016]; Available from:
http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html.
40. The World Bank. Ethiopia 2019 [cited 2019 November 1]; Available from:
https://data.worldbank.org/country/ethiopia.
41. McIntyre, D. and F. Meheus, Fiscal Space for Domestic Funding of Health and Other
Social Services. Chatham Working Group on Financing, Paper 5. 2014, Chatham
House (The Royal Institute of International Affairs): London.
42. Røttingen, J.A., et al., Shared responsibilities for health: a coherent global framework
for health financing. 2014, Chatham House: London.
43. World Health Organization, The World Health Report 2010. Health systems
financing: The path to universal coverage. 2010: Geneva.
44. Federal Democratic Republic of Ethiopia Ministry of Health, Ethiopia Seventh Health
Accounts 2016/2017. 2019: Addis Ababa, Ethiopia.
144

Essential Health Services Package of Ethiopia 2019

Uploaded by

Copyright:

Available Formats

Essential Health Services Package of Ethiopia 2019

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Essential Health Services Package of Ethiopia 2019

Uploaded by

Copyright:

Available Formats

Essential Health Services

Table 13 Essential NTD intervention for Ethiopia ……………………………… 57

Figure 1 Outpatient department visit per capita by region in 2010 EC …………… 11

Figure 2 Admission rate per 1,000 population by region in 2010 EC ………….. 12

Figure 3 Financial arrangement for Ethiopia’s EHSP ……………………………. 70

Figure 4 Theory of change for the monitoring and evaluation of EHSP 79

Figure 7 Per capita total health expenditure projections, 2020-2030 (low, 85

Figure 9 Required resources compared with expected available resources for 88

ACER Average Cost-Effectiveness Ratio

Amir Aman (MD, MPH)

The main objectives of the EHSP are as follows:

 To reduce ‘high BoD in Ethiopia’ by availing affordable, high-priority interventions.

1. Reproductive, maternal, neonatal, child and adolescent health

 Chapter I: presents the context (demographics, socioeconomic situation, health status

1.2. Demographic and socioeconomic situation

1.3. Health status: mortality and morbidity

Reproductive, maternal, neonatal and child health

Table 1: Indicators related to maternal, neonatal and child health (MNCH)

Indicator Values Source

Table 2: Indicators related to major immunisation

Indicators Values (2010 EFY) Source of data

Major communicable diseases

Table 3: Status of the indicators of major communicable diseases in Ethiopia

Indicators Values Sources

Non-communicable diseases (NCDs)

Table 4: Status of NCD-related indicators

Indicators Values Source

Table 5: Nutrition-related indicators for Ethiopia, 2016

Nutritional indicators Values Source

1.5. Health service utilisation

1.6. Ethiopia’s health system

Health financing system

As a pooling mechanism, community-based health insurance and social health insurance

Human resources for health

Table 7: Current health workforce in Ethiopia for EFY 20104

Governance of the health system

2.2. Values and guiding principles for Ethiopia’s EHSP

 Value for money

 To reduce high BoD in Ethiopia by availing affordable high-priority interventions

2.4. Scope of Ethiopia’s EHSP

3.1 Defining the scope of the EHSP revision

3.2 Selecting the EHSP interventions

3.2.2 Setting prioritisation criteria and evidence synthesis

Criterion 1: Burden of disease

Criterion 4: Financial risk protection (FRP)

Criteria 6: Public acceptability

Criterion 7: Political acceptability

3.2.3 Compute ‘priority score’ and ranking of interventions

3.3 Estimation of costs and fiscal space analysis

Costing of the EHSP

Fiscal space analysis

3.4 Deliberation process

4.1 Reproductive, maternal, neonatal, child health and nutrition interventions

4.2 Major communicable diseases

Table 9: Essential HIV/AIDS, TB and malaria interventions

IC Sub-programme Essential HIV/AIDS, TB and malaria interventions Priority

4.3. Non-communicable diseases (NCDs)

Table 10: Essential NCD interventions for Ethiopia

IC Sub-programme Essential NCD interventions for Ethiopia Priority

4.4. Surgery and injury care

5 Infectious diseases TB treatment   TB cases detected and cured WHO