To make progress toward universal health coverage, countries should define the type and mix of health services that respond to their populations' needs. Ethiopia revised its essential health services package (EHSP) in 2019. This paper describes the process, methodology and key features of the new EHSP. A total of 35 consultative workshops were convened with experts and the public to define the scope of the revision, develop a list of health interventions, agree on the prioritization criteria, gather evidence and compare health interventions. Seven prioritization criteria were employed: disease burden, cost effectiveness, equity, financial risk protection, budget impact, public acceptability and political acceptability. In the first phase, 1,749 interventions were identified, including existing and new interventions, which were regrouped and reorganized to identify 1,442 interventions as relevant. The second phase removed interventions that did not match the burden of disease or were not relevant in the Ethiopian setting, reducing the number of interventions to 1,018. These were evaluated further and ranked by the other criteria. Finally, 594 interventions were classified as high priority (58%), 213 as medium priorities (21%) and 211 as low priority interventions (21%). The current policy is to provide 570 interventions (56%) free of charge while guaranteeing the availability of the remaining services with cost-sharing (38%) and cost-recovery (6%) mechanisms in place. In conclusion, the revision of Ethiopia's EHSP followed a participatory, inclusive and evidence-based prioritization process. The interventions included in the EHSP were comprehensive and were assigned to health care delivery platforms and linked to financing mechanisms.
Background: Management of menstruation as a biological occurrence for women of reproductive age and men’s role is determined by socio-cultural factors. There is dearth of evidence on men in general and boys support on menstrual hygiene and management. This study aims to identify school based menstrual hygiene and management interventions and the role of boys in Oromia region, Ethiopia.Method: The study was carried out in 2017-18 academic year in eight Oromia Development Association (ODA) supported public schools with sport for life interventions. Schoolboys and girls aged 12-15, parents and school teachers participated in the study. Focus Group Discussion with boys, girls, and key informant interviews with parents were completed. Data were transcribed and translated into English and themes were developed following the objectives. Interpretation and presentation of the findings were substantiated with quoted shared opinions. Result: Finding shows that after two years of school based sport for life intervention, study participants invariably recognized menstruation as a natural occurrence and is a blessing rather than a curse. Girls who used to shy and abstain from school for fear of bullying and teasing attended their classes regularly and became competitors in their academic performance. Common arguments by all participants alike show that ‘We learnt that menstruation is a mark of healthy growth of girls. The absence of it that should be the source of concern’ . With dedicated room and availability of water and sanitary napkin; and support from boys and schoolteachers and management of menstrual hygiene has improved at school level. Boys not only stopped teasing girls but also started contributing money to purchase sanitary napkins. Liaising such school level intervention with parents has extended support to girls at home level. Conclusion: School level non-curricular intervention that has involved not only students but also the school community and parents have brought fundamental change to the way menstruation was understood and its implications. Menstruation is no more a source of shame and reason to tease and bully girls with its far reaching implication on the school performance of girls. Further study using mixed method may help document specific changes and sustainability.
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