Country context

Ethiopia has a population of 73.9 million. It is Africa’s oldest independent country but remains one of the world’s poorest, although progress has been made in recent years. Child mortality has fallen, access to healthcare has improved and advances have been made in primary education, in part due to the commitment to the United Nations Millennium Development Goals. The Government has also introduced a number of Poverty Reduction Strategy Programmes.

Yet the United Nations still ranks Ethiopia 169 out of 177 countries in terms of human development. Life expectancy is only 51.8 years. 77.8 per cent of all Ethiopians live on less than US$2 a day and 23 per cent live on less than US$1. There are large discrepancies between rural and urban people. The country also suffers regularly from drought, which affects up to 13 million people. Many families are unable to buy or grow enough food to feed themselves, and so need food aid each year to survive.

The effects on children are devastating.

  • Most of Ethiopia’s children remain very poor and continue to live with ‘not enough’ in terms of household assets, food and goods, basic services and opportunities.
  • One in every 13 children dies before reaching their first birthday, while one in every eight does not survive until they are 5 years old.
  • Nearly one in two children under 5 are stunted (short for their age), 11 per cent are wasted (thin for their height), and 38 per cent are underweight. Despite significant investment to increase enrolment in primary schools, they are often poorly staffed and equipped. There are large differences in children’s attendance between urban and rural locations, between boys and girls, and between and within regions. Overall literacy is low, at 31 per cent for rural and 74 per cent for urban residents.

Since the current Ethiopian government came to power in 1991, the country has made significant structural changes in terms of economic and political reforms including Proclamation no.7/1992 that provided the legal framework for establishing regional self-governments in 1992 and Proclamation no.33/1992 which was the most important instrument for fiscal decentralisation.

Ethiopia has implemented two Poverty Reduction Strategy Programmes (PRSPs), and is currently starting the implementation of the third - the Growth and Transformation Plan (GTP) - with ambitious plans and targets for the next five years (2010/11-2014/15).

Ethiopia has reported double-digit economic growth rate (about 11 per cent on average) since 2003/4 for about six years. This growth is broad-based and pro-poor as more than 60 per cent of the government spending goes on education, health, road, water and agriculture. The growth rate of GDP per capita declined slightly from 2004 till 2008 but has been increasing again since then. The per capita income (adjusted for inflation) was US$235 in 2010, a significant increase from its low level of US$100 in the previous decade, but still remains below the sub-Saharan average. Yet despite the growth recorded in the recent past, the country has experienced low levels of income and savings and low productivity in the agricultural sector, limited implementation capacity, unemployment and a narrow modern industrial sector base (Ethiopia: 2010 MDG Report).

There has been a notable achievement in poverty reduction from its previously high level; 46 per cent of the population were under the poverty line in 1995/6, in 2004/5 it was about 39 per cent. The incidence of poverty is higher in rural areas than in urban areas and the contribution of rural poverty to the national level poverty is also higher than that of urban poverty (partly due to the fact that the majority of the poor are living in rural areas). However, the rural incidence of poverty is declining compared to urban poverty (MoFED, 2008). Urban poverty has been rising with inequality and increased urbanisation. Poverty and inequity are underlying contributors to many maternal, newborn and child deaths, and evidence shows that the poor are more than twice at risk of mortality than the rich (HDR, 2010).

The problem of pervasive food insecurity and vulnerability to shocks remains, despite the strong economic growth in the past seven years. Droughts combined with land shortage and constraints on agricultural production make Ethiopia's economy vulnerable to climatic changes. Within the Young Lives sample, rural children were more vulnerable to economic shocks than urban children (Woldehanna, 2010).  Shocks affect household wealth and assets and sources of livelihood in general (particularly in rural areas), impacting child growth. Economic shocks at birth have lasting impacts on children’s health several years after the shock (Woldehanna, 2010) and are likely to affect family opportunities, thereby perpetuating poverty for generations.

There has been a massive expansion of social services, particularly in the health and education sectors as well as in infrastructure and communications notably roads, water, sanitation, telecommunication and electricity services. Previous sectoral programmes (education, health, road sector development programmes etc.) focused more on access, and this will continue even under GTP, but with an increased emphasis on quality and reaching the underserved areas.

The 20-year Health Sector Development Programme (HSDP) was developed in 1996/7 with a series of four medium-term implementation plans and investment programmes. Currently, the HSDP is in its fourth phase, to be implemented during in the GTP period. Both the National Health Policy and the HSDP focus primarily on maternal and child health programmes (reproductive health and immunisation), communicable diseases (especially malaria, TB and HIV/AIDS), and malnutrition. These are reflected in the GTP which states the main objectives as: reduction of under-5 child and infant mortality, improvement in maternal health, and the fight against HIV/AIDs, TB and malaria.  Due to investments in health facilities all over the country, the proportion of the population living less than 10km away from a health post has increased and primary health coverage has also reached 89 per cent from its level of 30 per cent in 2005. The Health Extension Programme (HEP) was started in 2002/3 under HSDP II in order to achieve universal primary health care (PHC) coverage in all rural areas of the country.

Based on the 20-year Education and Training Policy prepared in 1994, successive five-year nationwide Education Sector Development Programmes (up to ESDP III) have been implemented. All accorded high priority to the expansion of basic education as reflected in the national plans.  More recent ESDPs, however, have given increasing relative weight to other subsectors (technical and vocational education and training and now especially to tertiary education), though the declared political commitment to basic/primary education remains clear.  The massive expansion of higher education over the last five years has taken the largest proportion of the education budget. Under the GTP the government is intending to expand higher learning institutions (with quality improvement) with a special focus on science and technology.

Sources: Tassew Woldehanna et al. (2011) Understanding Changes in the Lives of Poor Children: Initial Findings from Ethiopia, Young Lives Round 3 Survey Report; UNDP (2011) Human Development Report 2011; UNICEF (2012) State of the World’s Children 2012; Changing Lives in a Changing World, Young Lives (2012)