REACHING THE PEOPLE: SOME ISSUES IN THE UTILIZATION OF SELECTED HOSPITALS IN ADDIS ABABA

Abstract

ABSTRACT In Ethiopia, as in many countries, health care resources (institutions, manpower and money) are concentrated in a few major cities, and especially in hospital services. Such concentration increases the difficulties of providing accessibility to adequate medical care for the majority of the population as well as of developing a functional referral system. The study reviewed medical records and interviewed outpatients at eight of the thirteen civilian hospitals in Addis Ababa to determine who used the hospitals and how well the referral system worked. The data showed that between 70% and 76% of the outpatients attending these hospitals were from Addis Ababa itself and a further 14% were from Shoo Administrative Region. Numbers of referral were also low, despite the fact that hospitals in the capital are intended to be referral institutions. On the other hand, Addis Ababa health facilities absorb 33% of the country's recurrent health budget, 28% of the hospital beds, 51% of all physicians and 58% of all medical specialists. Contrary to the principles of primary health care, the hospitals are not reaching out to the people, rather, the people are trying to reach the hospitals. If this situation continues, achievement of "Health for All by the Year 2000" will be in question.