*** EXECUTIVE SUMMARY: ETHIOPIA Health Statistics Report*** This report is part of a series of Country Health Profiles produced by the Center for International Health Information (CIHI). Each profile contains statistical data on current health conditions, population dynamics, health and family planning behavior, and health and population trends in a given developing country. Information is compiled from CIHI's health statistics database, which draws data from a diverse range of sources listed at the end of this profile. Hard-copy editions of CIHI's profiles, available from our publications department, include visual presentation of data through tables and graphs. The intent of these text-only profiles is to convey the same information without the graphic presentation. Facsimiles of the hard copy editions will soon be available on this website (www.cihi.com) in Portable Document Format (.pdf). Because PDF files require special viewing software, these text-only editions will also remain on the CIHI website. Any feedback you may have on the content or presentation of this report would be greatly appreciated. We would also appreciate receiving any more recent, more accurate, or more representative information. Contact us at one of the following addresses: *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** Center for International Health Information (CIHI) 1601 N. Kent St., Suite 1001 Arlington, VA 22209 U.S.A. E-mail address: info@cihi.com Phone: 703/524-5225 FAX: 703/243-4669 *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** The Center for International Health Information (CIHI), a USAID project managed by Information Management Consultants, Inc. (IMC), with the International Science and Technology Institute (ISTI) and The Futures Group (FUTURES), prepared this document under the Data for Decision Making Project, 936-5991.05 (CIHI-II), contract number HRN-5991-C-003041-00, with the Office of Health and Nutrition, Center for Population, Health and Nutrition, Bureau for Global Programs, Field Support and Research, U.S. Agency for International Development (USAID). *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** CIHI Health Statistics Report: *** ETHIOPIA Table of Contents January 1996 I: Health & Demographic Overview Current Demographic and Health Indicators Trends in Selected Demographic and Health Indicators Population Estimates Trends in Selected Health and Child Survival Indicators Vaccination Coverage Rates ORS Access, ORS and/or RHF Use Rates Contraceptive Prevalence Rate Access to Potable Water Access to Adequate Sanitation Comparative Indicators Comparative IMR Rates Comparative Vaccination Coverage Rates Comparative ORS Access, ORS and/or RHF Use Rates II: Data Notes III: Sources *** *** *** *** *** *** *** NOTE on SOURCES *** *** *** *** *** *** Sources in this profile are referred to by a seven-digit code. Generally, the first three letters refer to an organization, agency, etc., and the first two numbers indicate the year of the publication or other source document. A complete list of sources appears at the end of the profile. *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** *** --------------------------------------------------------------- I. A. Current Demographic and Health Indicators: ETHIOPIA 1/22/96 DEMOGRAPHIC INDICATORS VALUE YEAR SOURCE Total Population (000s) 58,710 1994 BUC9401 Urban Percent 13 1994 UNP9400 Women Ages 15-49 (000s) 12,692 1994 CAL9604 Infant Mortality Rate 104 1994 JEE9503 Under 5 Mortality Rate 178 1994 BUC9302 Life Expectancy At Birth 53 1994 BUC9401 Number Of Births (000s) 2,643 1994 CAL9602 Annual Infant Deaths (000s) 275 1994 CAL9603 Total Fertility Rate 6.9 1994 UNP9400 CHILD SURVIVAL INDICATORS VALUE YEAR SOURCE BCG 46 1993 WHE9403 DPT 3 28 1993 WHE9403 Measles 22 1993 WHE9403 Polio 3 28 1993 WHE9403 TT 2+ 13 1993 WHE9403 ORS access rate 50 1993 WHD9401 ORT use rate 68 1993 WHD9401 CPR, Modern Methods 3 1990 BUC9401 CPR, All Methods 4 1990 BUC9401 OTHER HEALTH INDICATORS VALUE YEAR SOURCE Adult HIV prevalence (%) 2.49 1994 WHO9601 Access to potable water, urban 91 1991 JMP9301 Access to potable water, rural 19 1991 JMP9301 Access to sanitation, urban 76 1991 JMP9301 Access to sanitation, rural 7 1991 JMP9301 Deliveries/trained attendant (%) 21 1988 WHM9137 ________________________________________________________________________________ I. B. Trends in selected Demographic and Health Indicators: ETHIOPIA 1/22/96 UNDER CRUDE CRUDE AVG ANNUAL TOTAL INFANT FIVE BIRTH DEATH GROWTH FERTILITY MORTALITY MORTALITY RATE RATE RATE RATE 1960 154 267 51 28 2.2 6.9 1965 146 254 50 26 2.4 6.9 1970 140 243 50 24 2.3 6.8 1975 135 233 49 23 2.3 6.8 1980 136 236 50 23 2.4 6.9 1985 129 223 49 22 2.7 7.0 1990 112 192 49 19 2.9 7.0 1995 103 175 47 17 3.0 6.8 2000 94 159 44 15 2.9 6.3 SOURCE JEE9503 BUC9302 UNP9400 UNP9400 UNP9400 UNP9400 ________________________________________________________________________________ I. C. Population Estimates: ETHIOPIA 1/22/96 YEAR VALUE SOURCE 1960 25,864,000 BUC9401 1965 28,621,000 BUC9401 1970 31,826,000 BUC9401 1975 35,673,000 BUC9401 1980 38,967,000 BUC9401 1985 43,406,000 BUC9401 1990 51,507,000 BUC9401 1995 60,642,000 BUC9401 2000 70,340,000 BUC9401 ________________________________________________________________________________ I. D. BCG Vaccination Coverage: ETHIOPIA 1/22/96 YEAR PERCENT SOURCE 1980 1981 1982 1983 1984 1985 1986 13 WHE9100 1987 28 WHE9100 1988 27 WHE9100 1989 30 WHE9100 1990 57 WHE9100 1991 1992 22 WHE9301 1993 46 WHE9403 1994 ________________________________________________________________________________ I. E. DPT 3 Vaccination Coverage: ETHIOPIA 1/22/96 YEAR PERCENT SOURCE 1980 1981 1982 1983 1984 1985 6 WHE8801 1986 7 WHE9100 1987 16 WHE9100 1988 16 WHE9100 1989 17 WHE9100 1990 44 WHE9100 1991 1992 13 WHE9301 1993 28 WHE9403 1994 ________________________________________________________________________________ I. F. Measles Vaccination Coverage: ETHIOPIA 1/22/96 YEAR PERCENT SOURCE 1980 1981 1982 1983 1984 1985 12 WHE8801 1986 10 WHE9100 1987 13 WHE9100 1988 15 WHE9100 1989 16 WHE9100 1990 37 WHE9100 1991 1992 12 WHE9301 1993 22 WHE9403 1994 ________________________________________________________________________________ I. G. Polio 3 Vaccination Coverage: ETHIOPIA 1/22/96 YEAR PERCENT SOURCE 1980 1981 1982 1983 1984 1985 6 WHE8801 1986 7 WHE9100 1987 16 WHE9100 1988 16 WHE9100 1989 17 WHE9100 1990 44 WHE9100 1991 1992 13 WHE9301 1993 28 WHE9403 1994 ________________________________________________________________________________ I. H. Tetanus Toxoid 2+ (TT2+) Vaccination Coverage: ETHIOPIA 1/22/96 YEAR PERCENT SOURCE 1980 1981 1982 1983 1984 1985 4 WHE8801 1986 5 WHE9100 1987 7 WHE9100 1988 10 WHE9100 1989 20 WHE9100 1990 43 WHE9100 1991 1992 9 WHE9301 1993 13 WHE9403 1994 ________________________________________________________________________________ I. I. ORS Access, ORS and/or RHF Use Rates: ETHIOPIA 1/22/96 ORS ORT/RHF YEAR ACCESS SOURCE USE SOURCE 1980 1981 1982 1983 1984 1985 22 WHD8500 11 WHD8500 1986 23 WHD8600 1987 50 WHD8700 22 WHD8700 1988 50 WHD9100 38 WHD8800 1989 32 WHD9100 1990 1991 1992 50 WHD9300 68 WHD9300 1993 50 WHD9401 68 WHD9401 1994 ________________________________________________________________________________ I. J. Contraceptive Prevalence Rate: ETHIOPIA 1/22/96 ALL MODERN YEAR METHODS SOURCE METHODS SOURCE 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 4 BUC9401 3 BUC9401 1991 1992 1993 1994 ________________________________________________________________________________ I. K. Access to Potable Water: ETHIOPIA 1/22/96 YEAR RURAL SOURCE URBAN SOURCE 1980 1981 1982 1983 1984 1985 9 WHO9101 69 WHO9101 1986 1987 1988 11 WHO9101 70 WHO9101 1989 1990 1991 19 JMP9301 91 JMP9301 1992 1993 1994 ________________________________________________________________________________ I. L. Access to Adequate Sanitation: ETHIOPIA 1/22/96 YEAR RURAL SOURCE URBAN SOURCE 1980 1981 1982 1983 1984 1985 96 WHO9101 1986 1987 1988 7 WHO9101 97 WHO9101 1989 1990 1991 7 JMP9301 76 JMP9301 1992 1993 1994 ________________________________________________________________________________ I. M. Cross Country Comparisons Infant Mortality Rates: ETHIOPIA 1/22/96 COUNTRY 1960 SOURCE 1995 SOURCE ETHIOPIA 154 JEE9503 103 JEE9503 SUB-SAHARAN AFRICA 166 CAL9512 103 CAL9512 LOW INCOME COUNTRIES 164 CAL9512 103 CAL9512 DEVELOPING COUNTRIES 146 CAL9512 67 CAL9512 ________________________________________________________________________________ I. N. Cross Country Comparisons Vaccination Coverage Rates: ETHIOPIA 1/22/96 Median values for country groupings: (CAL9512) Vaccination ETHIOPIA SUB-SAHARAN LOW INCOME DEVELOPING Coverage Year Source AFRICA COUNTRIES COUNTRIES BCG 46 1993 WHE9403 77 80 85 DPT3 28 1993 WHE9403 57 60 74 MEASLES 22 1993 WHE9403 57 58 71 POLIO3 28 1993 WHE9403 57 61 78 TT2+ 13 1993 WHE9403 45 45 47 ________________________________________________________________________________ I. O. Cross Country Comparisons ORS Access, ORS and/or RHF Use Rates: ETHIOPIA 1/22/96 ORT ORS COUNTRY USE YEAR ACCESS YEAR ETHIOPIA 68 1993 50 1993 SOURCE WHD9401 WHD9401 Median values for country groupings: SUB-SAHARAN AFRICA 48 1994 65 1994 LOW INCOME COUNTRIES 45 1994 69 1994 DEVELOPING COUNTRIES 52 1994 80 1994 SOURCE CAL9512 ________________________________________________________________________________ II. Data Notes NOTE ON MORTALITY ESTIMATION Various organizations produce mortality estimates for the developing countries and regions. The three major sources are the United Nations Population Division, the World Bank, and the United States Bureau of the Census. CIHI's Health Statistics Database draws upon the work of these three larger organizations as well as other sources in order to reconcile the various estimates and provide the most reasonable current and historical estimates available. CIHI has also created a comprehensive time series of under-five mortality estimates for all developing countries. This has been accomplished by developing mathematical equations from empirical data that describe the relationship between infant and under-five mortality. Using these equations it is possible to make estimates of under-five mortality from infant mortality or vice-versa. More details regarding CIHI's methodology for specific data sets are provided in the source references. DEFINITIONS DEMOGRAPHIC INDICATORS Total Population: The mid-year estimate of the total number of individuals in a country. Urban Percent: Percentage of population living in urban areas as defined according to the national definiton used in the most recent population census. Infant Mortality Rate: The estimated number of deaths in infants (children under age one) in a given year per 1,000 live births in that same year. This rate may be calculated by direct methods (counting births and deaths) or by indirect methods (applying well-established demographic models). Under 5 Mortality Rate: The estimated number of children born in a given year who will die before reaching age five per thousand live births in that same year. This rate may also be calculated by direct or indirect methods. Maternal Mortality Rate: The estimated number of maternal deaths per 100,000 live births where a maternal death is one which occurs when a woman is pregnant or within 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy or its management. Although commonly referred to as a rate, this measure is actually a ratio because the unit of measurement of the numerator (women) is different than that of the denominator (births). Extremely difficult to measure, maternal mortality can be derived from vital registration systems (usually underestimated), community studies and surveys (requires very large sample sizes) or hospital registration (usually overestimated). Life Expectancy At Birth: An estimate of the average number of years a newborn can expect to live. Life expectancy is computed from age-specific death rates for a given year. It should be noted that low life expectancies in developing countries are, in large part, due to high infant mortality. Number of Births: An estimate of the number of births occurring in a given year. Annual Infant Deaths: An estimate of the number of deaths occurring to children under age one in a given year. Total Fertility Rate: An estimate of the average number of children a woman would bear during her lifetime given current age- specific fertility rates. Crude Birth Rate: An estimate of the number of live births per 1,000 population in a given year. Crude Death Rate: An estimate of the number of deaths per 1,000 population in a given year. Average Annual Rate of Growth: An estimate of the rate at which a population is increasing (or decreasing) in a given year. CHILD SURVIVAL INDICATORS Vaccination Coverage Rate (vcr %) in Children: An estimate of the proportion of living children between the ages of 12 and 23 months who have been vaccinated before their first birthday -- three times in the cases of polio and DPT and once for both measles and BCG. Vaccination coverage rates are calculated in two ways. Administrative estimates are based on reports of the number of inoculations of an antigen given during a year to children who have not yet reached their first birthday divided by an estimate of the pool of children under one year of age eligible for vaccination. Survey estimates are based on samples of children between the ages of 12 and 23 months. Vaccination Coverage Rate (vcr %) in Mothers, Tetanus Toxoid 2+ (TT2+): An estimate of the proportion of women in a given time period who have received two doses of tetanus toxoid during their pregnancies. This indicator is being changed in many countries to account for the cumulative effect of tetanus toxoid boosters. A woman and her baby are protected against tetanus when a mother has had only one or, perhaps, no boosters during a given pregnancy so long as the woman had received the appropriate number of boosters in the years preceding the pregnancy in question. (The appropriate number of boosters required during any given pregnancy varies with number received previously and the time elapsed.) The revised indicator is referred to as TT2+. Rates are computed using administrative methods or surveys. DPT Drop-out Rate: An estimate of the proportion of living children between the ages of 12 and 23 months who received at least one DPT vaccination but who did not receive the entire series of three vaccinations before their first birthdays. Oral Rehydration Salts (ORS) Access Rate: An estimate of the proportion of the population under age five with reasonable access to a trained provider of oral rehydration salts who receives adequate supplies. This is a particularly difficult indicator to measure and, therefore, it may fluctuate dramatically from year to year as improved methods of estimation are devised. Oral Rehydration Therapy (ORT) Use Rate: An estimate of the proportion of all cases of diarrhea in children under age five treated with ORS and/or a recommended home fluid. ORT use may be determined using administrative means or surveys. In general, administrative estimates are based on estimates of the number of episodes of diarrhea in the target population for a given year and the quantity of ORS available. Thus, changes in the estimates of the frequency of diarrhea episodes can alter the ORT use rate as well as real changes in the pattern of use. Surveys are more precise in that they focus on the actual behavior of mothers in treating diarrhea in the two-week period prior to the survey. Contraceptive Prevalence Rate (CPR): An estimate of the proportion of women, aged 15 through 44 (or, in some countries, 15 through 49), in union or married, currently using a method of contraception. Where sources fail to distinguish modern and traditional methods, the combined rate is shown. Adequate Nutritional Status: An individual child of a certain age is said to be adequately nourished if his/her weight is greater than the weight corresponding to two Z-scores (two standard deviations) below the median weight achieved by children of that age. The median weight and the distribution of weights around that median in a healthy population are taken from a standard established by the National Center for Health Statistics, endorsed by the World Health Organization (WHO). The indicator for the population as a whole is the proportion of children 12 through 23 months of age who are adequately nourished. Exclusive Breastfeeding: An estimate of the proportion of infants less than four months (120 days) of age who receive no foods or liquids other than breast milk. Complementary Feeding: An estimate of the proportion of infants six to nine months of age (181 days to 299 days) still breastfeeding but also receiving complementary weaning foods. Continued Breastfeeding: An estimate of the proportion of children breastfed for at least one year. In this report, all values presented for this indicator are the proportion of children 12 to 15 months of age at the time of the survey still receiving breast milk. OTHER HEALTH INDICATORS Adult HIV prevalence: An estimate of the proportion of the living adult population who are infected with one or more strains of the HIV virus. Access to Potable Water, Urban: An estimate of the proportion of all persons living in urban areas (defined roughly as population centers of 2,000 or more persons) who live within 200 meters of a stand pipe or fountain source of water. Access to Potable Water, Rural: An estimate of the proportion of all persons not living in urban areas with a source of water close enough to home that family members do not spend a disproportionate amount of time fetching water. Access to Sanitation, Urban: An estimate of the proportion of all persons living in urban areas with sanitation service provided through sewer systems or individual in-house or in-compound excreta disposal facilities (latrines). Access to Sanitation, Rural: An estimate of the proportion of all persons not living in urban areas with sanitation coverage provided through individual in-house or in-compound excreta disposal facilities (latrines). Deliveries By Trained Attendants: An estimate of the proportion of deliveries attended by at least one physician, nurse, midwife, or trained traditional birth attendant. Comparative Tables. Unless otherwise specified, indicator values for country groupings are median values for the countries in each aggregate grouping for which data are available. Regional groupings may include: (1) Sub-Saharan Africa which includes the 47 countries comprising USAID's Africa Region; (2) No. Africa & Mideast which corresponds to USAID's Near East Sub-region, and includes 21 countries from Morocco in the west to Afghanistan in the east; (3) Asia which corresponds to USAID's Asia Sub-region and includes 24 developing countries from Pakistan eastward; (4) Latin Am. & Carib. which includes 46 countries of Central and South America and the Caribbean and corresponds to USAID's Latin American and Caribbean region. Income groupings are based on the classifications used by the United Nations' Human Development Report, 1994 which are defined as: (1) Low Income Countries (GNP/capita =$650 or less), (2) Middle Income Countries (GNP/capita $651-$6,000); (3) High income countries (GNP/capita >$6,000). "Developing Countries" indicators pertain to those 152 countries which are not regarded as "Established Market Economies" by the World Bank's World Development Report, 1993. ________________________________________________________________________________ III. Sources BUC9302 Time series estimates of Infant Mortality generated by applying the ratio of the BUCEN estimate for 1992 to the World Population Prospects estimate for 1992 to the annual values dating back to 1950 as estimated in the World Population Prospects. Under 5 BUC9401 U.S. Bureau of the Census (BUCEN). International Data Base. Version dated March, 1994. BUC9501 U.S. Bureau of the Census (BUCEN). International Data Base. Version dated December, 1994. CAL9512 Calculated medians for aggregates of countries using best available data from the CIHI Health Statistics Database CAL9602 Calculations of the annual number of live births based on the preferred estimates of total population and crude birth rat CAL9603 Calculations of the annual number of infant and/or under five deaths based on the preferred estimates of total population and infant and/or under five mortality rates. CAL9604 Calculations of the annual number of women in the population ages 15-49. For each country, a percentage was derived from UN data on total population and women 15-49 and the percentage was then applied to the preferred estimate of total popul tion. JEE9503 Infant Mortality Rate (1Q0) calculated from Under Five Mortality Rate (1Q0) using Other Sub-Saharan Africa equation: 1Q0 = 0.76248*((5Q0)^0.94896) JMP9301 WHO/UNICEF Joint Monitoring Programme. Water Supply and Sanitation Sector Monitoring Report 1993. Sector Status as of December 1991. WHO and UNICEF. August, 1993. UNP9400 Department of International Economic and Social Affairs, United Nations. World Population Prospects 1994. (Tape) New York: UN, 1994. WHD8500 World Health Organization. Programme for Control of Diarrhoeal Diseases: Fourth Programme Report 1983-1984. (WHO/CDD/85.13) Geneva: WHO, 1985. WHD8600 World Health Organization. Programme for Control of Diarrhoeal Diseases: Fifth Programme Report 1984-1985. (WHO/CDD/86.16) Geneva: WHO, 1986. WHD8700 World Health Organization. Programme for Control of Diarrhoeal Diseases: Interim Programme Report 1986. (WHO/CDD/87.26) Geneva: WHO, 1987. WHD8800 World Health Organization. Programme for Control of Diarrhoeal Diseases: Sixth Programme Report 1986-1987. (WHO/CDD/88.28) Geneva: WHO, 1988. WHD9100 World Health Organization. Programme for Control of Diarrhoeal Diseases: Interim Programme Report 1990. (WHO/CDD/91.36) Geneva: WHO, 1991. WHD9300 World Health Organization, Programme for Control of Diarrhoeal Diseases; provisional data for Annex 1 of the Ninth Programme Report. Received by personal communication, February 16, 1993. WHD9401 Advanced Copy of Annex 1 of the WHO/CDR Annual Report, Received by facsimile, March 29, 1994. WHE8801 World Health Organization. Expanded Programme on Immunization Information System Report, July 1988. Geneva: WHO, 1988. WHE9100 World Health Organization. Expanded Programme on Immunization Information System Report, April 1991. (WHO/EPI/CEIS/91.1) Geneva: WHO, 1991. WHE9301 Facsimile from WHO/EPI of the pages in the 9/93 report of the WHO EPI Information System containing the most current vaccination coverage rates. September 24, 1993. WHE9403 Download of WHO/EPI vaccination coverage files from INTERNET, August 29, 1994. WHM9117 World Health Organization. Global Strategy for Health for All by the Year 2000: Second Report on Monitoring Progress. Add. 1, 1988 (WHO document EB83/2) as cited in Division of Family Health, World Health Organization. Maternal Mortality: A Global Factbook. (WHO/MCH/MSM/91.3) Geneva: World Health Organization. 1991. WHM9137 World Health Organization. African Regional Office. Evaluation of the strategy for the health for all by the year 2000. Seventh report on the world health situation. Vol 2. Brazzaville 1987, as cited in Division of Family Health, World Health Organization. Maternal Mortality: A Global Factbook. (WHO/MCH/MSM/91.3) Geneva: World Health Organization. 1991 WHO9101 World Health Organization. World Health Organization Disk: Water Supply and Sanitation Service Coverage. Geneva: WHO, October 29, 1991. WHO9601 World Health Organization, Global Programme on AIDS. The Current Global Situation of the HIV/AIDS Pandemic, 15 December 1995.