በአፍሪካ ጠንካራ የጤና ስርዓት ከገነቡት ሀገራት መካከል ደቡብ አፍሪካ ቀዳሚ ስትሆን እነ ኬንያ ፣ ቱኒዚያ እና አልጀሪያ የመሳሰሉት ሀገራት ተከታዩን ደረጃ ይዟል (Numbeo's Health Care Index, 2024)።

እነዚህ ሀገራት ጠንካራ የጤና ስርዓት የገነቡበት ምስጥር በየጊዜው በሚያወጧቸው ሀገር በቀል አዋጆች እና መመሪያዎች ብቻ ሳይሆን አሁን ዓለም የደረሰበትን ተለዋዋጭ የሆነውን የጤናውን ስርዓት የሚስማማ ፖሊሲ እና ስትራቴጂ በመንደፍ ጭምር ነው።

ለዚህም ትልቁ ማሳያ ጤና ባለሙያዎቹን እንደ ሀብት ቆጥረው ዘመኑን የሚመጥን ክፍያ በመክፈል እና በየጊዜው ለሚያነሱት ጥያቄ ተገብ ምላሽ በመስጠት ጭምር ነው።

ጤና ባለሙያውን ያገለለ የትኛውም ፖሊሲ እና ስትራቴጂ ውጤታማ አይሆንምና። ሀገራት WHO በሚሰጠው ምክሬ ሀሳብ ተንተርሶ UHC (Universal Health Coverage)ን ለማሳካት ውጥረት ላይ ናቸው።

እትዮጵያም የዚያው አካል እስከሆነች ድረስ አሁን እየተነሳ ያለውን የጤና ባለሙያዎች ጥያቄ ወደ ጎን ከማለት ይልቅ ጥያቄዎቹ እቅዶቹን (SDG) ለማሳካት ግብዓትም ጭምር ናቸውና ከማታለል ይልቅ ጤና ባለሙያውን በአጭር ጊዜ ውስጥ ተጠቃም የሚያደርግ ስርዓት ብትዘረጋ የተሻለ ነው።

References

1. https://www.numbeo.com/health-care/rankings_by_country.jsp?title=2024&region=002

2. https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)

Desalegn Zekarias, Public health Expert

@HakimEthio

Vacancy from Agew Midir General Hospital

@HakimEthio

📌A Call for Sustainable Reform in Ethiopia’s Healthcare System

Improving Ethiopia’s healthcare system requires more than just vision—it demands substantial investment, alongside strong, competent leadership that genuinely values both healthcare workers and the communities they serve.

Globally, sustainable and equitable healthcare systems are not self-funded; they are supported through consistent government investment and strategic subsidies to ensure fair access for all citizens.

In our context, one of the most fundamental challenges is the lack of adequate financial resources. This limitation affects not only infrastructure and services, but most importantly, the wellbeing of healthcare professionals who dedicate their lives to serving others. While we may not yet afford the salaries seen in wealthier nations, we must at least strive to provide dignified, livable incomes for our public servants.

The crux of the problem lies not only in limited national revenue, but also in the chronic mismanagement, corruption, and inefficiency that erode what little is available. This injustice affects everyone—patients, providers, and the nation at large.

To begin addressing these issues, we can take several meaningful steps:

1. Fair Allocation of National Revenue: Profitable sectors of the economy should contribute more equitably to support essential services. Until our economy grows enough to provide comfortably for all, we must ensure that income is distributed in a way that allows every government worker, in every sector, to live with dignity.

2. Reforming Cost-Sharing in Healthcare: While we must protect the most vulnerable, a system in which all services are provided entirely free is not financially sustainable. It is reasonable for patients to contribute to the cost of their care, in a way that is proportionate to the national income level. This ensures resources are used more efficiently and responsibly.

3. Mandatory Health Insurance: Introducing mandatory health insurance for all employers is critical. A shared contribution model would help ensure that health services are properly funded and that healthcare workers are compensated fairly for their essential work.

The path to a better healthcare system in Ethiopia will not be easy, but it is achievable. With wise leadership, a commitment to justice, and collective effort, we can build a system that serves the people with integrity and compassion.

Dr. Abdulkadir MD, Former SPHMMC surgical Resident, waiting for ECFMGE Certification

@HakimEthio

One of my senior physician friends asked me on how the health system should be reformed to improve the income of the health workforce in it. I may not be the most qualified person to answer this question. I will try to forward few ideas:

1. The health system should improve its financial capacity.

This can be done in multiple ways. The health system should convince the government to improve the budget share as compared to the the total budget to, at least, the Abuja declaration (15%). This will dramatically increase the fund that flows to the health system. Historically, Ethiopian health system is known for being under funded. (Any interested person can refer the Ethiopian national health accounts)

2. The other thing the government may do is enhancing the decentralized financing systems, such as community-based health insurance and social health insurance.

This will definitely improve the money pool and also relief the service recipients from point of care burden of payment. Additionally, the facilities will collect money through fee revision. I recognize the government's current effort on this. Nonetheless, it should go for it unapologetically.

3. The government and stakeholders may also reduce the inefficiency everywhere in the system.

I am not sure if we are aware of the inefficiency happening throughout the system. This is a paradox - underfunded and inefficient system.

4. Coming to the the health professionals payment, the government may see modes of payment other than the traditional salary-based scheme.

This may include hourly payment, fee-for-service, capitation, performance-based payment and so on. This can happen only when the above three and other fund enhancing mechanisms are in place. The health system should have money first. Then it can pay for its most priorities. If there is no money, you cannot talk any thing about payment.

These all are clearly written in textbooks of healthcare financing and in the Ethiopian Healthcare Financing documents.

In order these to happen, a well-intentioned and focused actions are important. Easier said than done, though!

Mengistu Hagazi: Assistant Professor of Health Systems

@HakimEthio

🔎 የስራ ቅጥር ማስታወቂያ🔎
ድርጅታችን ኦንኮ የፓቶሎጂ ምርመራ ማዕከል ከዚህ  በታች ለተገለፀው ክፍት የስራ መደብ  ብቁ የሆኑ አመልካቾችን በማወዳደር መቅጠር ይፈልጋል፡፡

ክፍት የስራ መደብ መጠሪያ:
- የጤና  ላብራቶሪ ባለሙያ

የስራ ቦታ: አዲስ አበባ

የተፈለገው ባለሙያ ብዛት፡  1

ደሞዝ፧ በስምምነት

የስራ ማስታወቂያ ዝርዝር መስፈርቶች ከተያያዘው ፋይል ላይ ይገኛሉ።

  መስፈርቶችን የምታሟሉ  አመልካቾች  ዋናውን የትምህርት ማስረጃችሁንና የስራ ልምድ ማስረጃችሁን   ተመላሽ ከማይደረግ  ኮፒ ጋር  በመያዝ  በአካል በመምጣት መመዝገብ ትችላላችሁ፡፡ በአካል መምጣት የማትችሉ በቴሌግራም ወይም በኢ.ሜል  አድራሻችን  መረጃችሁን በመላክ መመዝገብ ይቻላል፡፡

1.የምዝገባ ጊዜ  22/09/2017ዓ.ም-30/09/2017 በስራ ቀንና ሰዓት ቅዳሜን ጨምሮ፤
2.የመመዝገቢያ ቦታ ፡- የሰው ሀብት አስተዳደር ቢሮ በአካል በመቅረብ ወይም /በቴሌግራም እና በኢሜል በመላክ መመዝገብ ይቻላል፤
3.የፈተና ቀን ፡-በድርጅቱ  ቴሌግራም የሚገለፅ ይሆናል፡፡

የቴሌግራም ቁጥር https://www.tg-me.com/oncopath2019
ኢሜል [email protected]
አድራሻ፡-
ኦንኮ የፓቶሎጂ  ምርመራ  ማዕከል  አድራሻ  አ.አ እንቁላል  ፋብሪካ  ኖክ ነዳጅ ማደያ አጠገብ
ስልክ ቁጥር 0901085242

ዒድ ሙባረክ Eid Mubarak عيد مبارك

@HakimEthio

Why should doctors and nurses take examinations and additional trainings when they migrate to another country?

Doctors and nurses are often required to take examinations and undergo additional training when they migrate to another country to practice. This requirement is a global standard, applied regardless of the quality of training in their country of origin, including Ethiopia.

The requirement is not necessarily a judgment on the quality of training in their home country, nor is it simply about mistrust. Rather, it is rooted in a complex mix of patient safety, differences in health systems, regulatory harmonization, language and communication, and legal accountability.

Here are some of the rationales behind these requirements, supported by scientific literature, global guidelines, and regulatory frameworks.

1️⃣Ensuring patient safety and quality of care

Ensuring that foreign-trained doctors and nurses are competent in local healthcare practices is crucial for patient safety. A review by Maben and Griffiths (2008) found that differences in education and clinical experience may lead to variable competencies, which could impact care quality, particularly in high-risk settings like ICUs. In the UK, the General Medical Council (GMC) and Nursing and Midwifery Council (NMC) require exams like PLAB (Professional and Linguistic Assessments Board) or OSCEs (Objective Structured Clinical Examinations) to test minimum standards for safe practice.

2️⃣Differences in health systems and clinical guidelines

Health systems, disease profiles, and clinical guidelines vary widely across countries. For instance, a doctor trained in Ethiopia may have strong clinical acumen in infectious diseases like HIV, TB, and malaria but may lack familiarity with protocols for managing diseases like cystic fibrosis or advanced geriatric care common in the UK or US. Besides, countries often have specific local policies.

For instance, The European Commission’s Directive 2005/36/EC on the recognition of professional qualifications permits EU countries to test applicants on their knowledge of national health laws and practices. Furthermore, there are obvious practice variations between countries. The use of electronic health records, multidisciplinary team-based care, or end-of-life protocols may be drastically different between countries.

3️⃣Language proficiency and communication standards

Effective communication is essential to avoid errors, obtain informed consent, and ensure good patient outcomes. The Joint Commission in the U.S. identifies communication failure as the root cause in over 70% of sentinel events (serious adverse events). Hence, countries often require proof of language proficiency (e.g., IELTS or OET for English-speaking countries).

4️⃣Legal and ethical frameworks vary

Every country has unique legal and ethical obligations that healthcare providers must understand and follow. For example, consent laws, scope of practice, mandatory reporting requirements, and malpractice regulations differ significantly. The American Medical Association and the UK’s GMC both include country-specific ethical codes. Understanding local medical-legal contexts is essential to practicing safely and lawfully.

5️⃣Standardization and benchmarking

Regulatory bodies need a standardized, objective benchmark to compare the competence of healthcare workers from diverse training backgrounds. The Educational Commission for Foreign Medical Graduates (ECFMG) in the US assesses whether IMGs (International Medical Graduates) are “ready to enter residency or fellowship programs” using USMLE Step exams, which are based on standardized core competencies. This doesn’t imply that IMGs are less competent, but rather that training standards vary, and national boards cannot assess every global curriculum individually.

6️⃣Public trust and professional accountability

Health professionals are among the most trusted professions, and regulatory processes aim to preserve that trust. For example, The UK's Health and Care Professions Council (HCPC) and NMC emphasize that registration exams help assure the public that health workers meet national expectations for knowledge, professionalism, and patient care. Transparency and accountability are easier to maintain when there’s a clear, replicable pathway for verifying and benchmarking competence.

7️⃣Cultural competence and professional integration

Health professionals must integrate into new cultural contexts and institutional norms. In its Global Code of Practice on the International Recruitment of Health Personnel, the WHO notes the need for orientation programs to aid adaptation to local customs and patient expectations. A study by Alexis et al. (2007) on internationally educated nurses in the UK revealed that lack of cultural training contributed to misunderstandings and barriers in patient care and inter-professional collaboration.

8️⃣Compensating for variability in accreditation and quality assurance

Global accreditation systems are not uniform, and quality assurance mechanisms differ between countries. A medical school accredited in one country may not meet the standards required by regulatory bodies elsewhere. The World Federation for Medical Education (WFME) has established global standards, and by 2024, the ECFMG requires that all applicants graduate from a WFME-accredited medical school to take the USMLE – this is part of global efforts to harmonize training standards.

In conclusion, requiring additional examinations or training for internationally educated doctors and nurses is not an act of mistrust, nor does it necessarily reflect negatively on the education in their home country. Instead, it is a multifactorial, evidence-based approach designed to:
✅Safeguard patient safety
✅Address differences in healthcare systems and disease profiles
✅Ensure communication and legal competence
✅Build public trust in the health system
✅Maintain consistent professional standards across borders

[I used multiple sources (WHO, GMC, NMC, ECFMG, EU Directive, US Joint Commission) and generative AI to prepare this article.]

Professor Esayas Kebede Gudina, is a professor of Medicine at the Department of Internal Medicine, Institute of Health, Jimma University

@HakimEthio

The 8th and final session of the ERAS lecture web series, happening at 7:00 PM tonight!

We will hear from Dr. Zoe Garoufalia a colorectal surgery and minimally invasive surgery fellow from Cleveland clinic.

Join us

@HakimEthio

Role of Community pharmacy and pharmacist during public holidays.

Community pharmacy, also known as retail pharmacy, is the most common type of pharmacy that allows the public access to their medications and advice about their health.

Community pharmacists are considered to be the most accessible health professional to the public, as they are available to provide personalized advice about health and medicine on a walk-in basis, without the need for an appointment.

Community pharmacy and pharmacist is Paramount during holidays as on these days most of the public institutions is not accessible and not fully serve, except an emergency case.

During holiday .i.e either Christian, Muslim, cultural or national most of healthy professional needs rest time and have no interest to serve, especially these who works for non-profit organization.

Besides this on holiday they are many derangement in society, especially disease like diarrhea and AFI children the which looks minor ailments but leads to death if not properly managed at an appropriate time.

The role of community pharmacy and clinics is paramount for the above issues especially dispensing OTC medication without needing especial investigation and clinician. in developing countries like Ethiopia 🇪🇹 even though people perception against these organization merely business center but the opposite is true.

The health professional working in the private is crucial for public health and they need thanks always.
👏👏👏👏👏👏

Ayub Jemal: Pharmacist

@HakimEthio

Kaposi sarcoma in an HIV-infected patient with high CD4 count: a case report and literature review

Kedir Negesso Tukeni*, Merid Lemma Kebede, Elias Ababulgu Abadiko, Tamirat Godebo Woyimo, Abdo Kedir Abafogi , Amare Hailu Ashine, and Esayas Kebede Gudina
https://doi.org/10.3389/fmed.2025.1496863

To send your papers use @HakimAds

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