Submission ID 117003
| Issue/Objective | More than 75 million people in Ethiopia are at risk of at least one Neglected Tropical Disease (NTD). Climate change has expanded breeding sites and conditions for vector borne NTDs, increasing the risk of their transmission. Donors provide more than 90% of NTD funding in Ethiopia. Ethiopia recognizes the need to achieve NTD elimination goals and increasing domestic resources to sustain NTD services. Ethiopia's essential health service package has 1,019 interventions - 56% of the interventions are exempted health services (EHS) provided free of charge at public health facilities, 38% are provided through health insurance, and 6% are charged user fees. NTDs were not explicitly listed in the EHS and community-based health insurance benefit package. This posed challenges with implementation and access to services because NTDs lacked a reliable domestic source of funding. The submission will present Ethiopia's process of evidence-based advocacy for inclusion of NTDs in both EHS and health insurance benefit package in order to increase domestic resources for NTDs. I share valuable insights, lessons learned, and best practices for creating sustainable and inclusive health systems and promoting health equity. |
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| Methodology/Approach | The proposed submission focuses on sharing Ethiopia's experience in advocating for sustainable NTD financing through health care financing reform. The submission highlights three main areas of focus: a) Utilize the policy window opportunity: In 2023, a policy window opened to meet aspirations for a sustainable NTD response. The Ministry of Health established a Health Financing Technical Working Group (HF-TWG) to revise and standardize the EHS and define a Health Insurance Benefit Package (HIBP), taking into consideration the country's fiscal space, disease burden, service utilization, addressing implementation challenges and cost-effectiveness. The NTD Control Program and NTD stakeholders participated in the HF-TWG, and used NTD prevalence and morbidity data, to justify the inclusion of NTDs in the EHS and HIBP. b) Aligning interventions between EHS and HIBP: The submission emphasizes the collaboration between the HF-TWG and the Ethiopian Health Insurance Service on alignment and ensuring the inclusion of NTDs in both the EHS and HIBP. c) Advocacy strategies for benefit package reform and NTD resource mobilization: Ethiopia has drafted a legal framework to mobilize resources for the Essential Health Service by increasing budgets at the federal, regional, and city administration levels and from innovative financing through the new resilient and equity health fund. |
| Results | Six NTDs were included in the EHS (trachoma surgery, lymphatic filariasis, podoconiosis, scabies, guinea worm, and leishmaniasis, and another six NTDs in the HIBP (Trachoma case management, schistosomiasis, soil-helminthiasis, onchocerciasis, leprosy, and rabies), improving access to care and reducing financial hardship for people affected by NTDs. Ethiopia has drafted a legal framework to mobilize resources for EHS by increasing federal, regional and city administration budgets, and from innovative financing through the new resilient and equity health fund. |
| Discussion/Conclusion | The submission provides insights into the process of advocating for sustainable NTD financing through health care financing reform. It offers lessons learned, best practices, and challenges faced, which can be valuable for peers working in sustainable health systems. Overall, we present Ethiopia's experience and lessons leveraging the EHS and HIBP policy window, focusing on (a) the process of standardization, prioritization, and cost estimation of services (b) aligning interventions between EHS and HIBP (c) advocacy strategies for benefit package reform and NTD resource mobilization. The experiences and strategies shared in the submission can inspire and guide other countries facing similar challenges related to NTD financing. Policymakers, government officials, and implementing partners can draw from Ethiopia's example to replicate or adapt these approaches to their own contexts, promoting more sustainable and inclusive health systems. Overall, the proposed submission contributes to the dissemination of knowledge and experiences regarding NTD financing and inclusion in health insurance benefit packages and exempted health services, fostering dialogue and action towards addressing the funding gap and promoting health equity. |
| Presenters and affiliations | Alemu Chekole Kahssay Results for Development (R4D) Fikre Seife Ethiopian Ministry of Health |
