Africa-Press – Eritrea. Earlier this week, local media outlets featured an extended interview with Dr. Martins Obeverdjo, the World Health Organization (WHO) Country Representative in Eritrea, as he completed his tour of duty in the nation. The wide-ranging conversation touched upon a range of development-related topics and also shared his reflections on his nearly five years of time and work in Eritrea.
The following article delves a bit deeper into some of the important issues raised in the recent interview, offering further insights and details.
A closer look at universal health coverage
One topic highlighted by Dr. Martins was universal health coverage (UHC). In particular, he noted that Eritrea has “recorded a very notable improvement [in this area]” over the years.
UHC is about ensuring that all people have access to the full range of quality health services that they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course. UHC is particularly important in terms of its underlying significance to overall health, which represents both an outcome and indicator of the social, economic, and environmental dimensions of sustainable development.
Looking at the case of Eritrea, the country’s national health policy aims to maximize the health and well-being of all citizens at all ages and seeks to ensure equity and access to essential health services at an affordable cost, utilizing primary health care as a key strategy and consistent with UHC principles.
Since 2016, a wide set of interventions, including the Essential Health Care Package, have been developed and implemented by the Ministry of Health (among others) to expand access and improve care for all.
Importantly, in line with Eritrea’s longstanding commitments to social justice, equality, inclusion, and leaving no one behind, health service continues to be heavily subsidized, with patients required to make only nominal payments (which are wholly waived in cases of financial need). Furthermore, a wide range of essential health services are provided completely free of charge, including all public and preventive services, such as immunization and growth monitoring, pre- and post-partum care, nutrition and supplementation, and health education. In addition, all patients with chronic diseases and other disorders, such as tuberculosis (TB), HIV/AIDS, hypertension, diabetes, and mental disorders, among several others, are provided with free care and prescribed medications.
Alongside the above, accessibility, the expansion of health infrastructure, and human resource development have also been areas of major focus over the years, with the country constructing and renovating many hospitals, health centres, health stations, and clinics, as well as considerably increasing the number of doctors and health professionals. There are now nearly 350 health facilities distributed across the country (comprising hospitals, health centres, health stations, and clinics) – which represents a nearly fourfold increase from 1991. What is more, at present, slightly over 80 percent of the population lives within a 10 km radius of a health facility and more than 70 percent within a 5 km radius, representing major improvements from just a few decades ago.
Eritrea has also considerably increased the number of doctors and health professionals. The number of doctors has been raised from 100 in 1997 to 291 by 2021, while across the same time period, the number of dentists rose from 6 to 59, nurses from 625 to 1,474, assistant nurses from 1,220 to 2,918, dental therapists from 11 to 165, pharmacists and pharmacy technicians from 97 to 486, laboratory technicians from 99 to 517, radiologists from 28 to 132, physiotherapy technicians from 6 to 140, and specialized doctors from 5 to 74. Notably, the government covers the full costs of education, training, and salaries for all health workers, and there are no recruitment ceilings or constraints.
Further insight into life expectancy, among the most commonly used measures of overall health
Another interesting point raised by Dr. Martins pertained to the topic of life expectancy. Speaking about the country’s progress in this area, he stated that Eritrea, “has achieved a phenomenal increase in life expectancy,” and pointed out “there are very few countries that have achieved such notable results.”
According to international organizations, such as the WHO, the World Bank, and many others, life expectancy is defined as the average number of years that a newborn could expect to live, if he or she were to pass through life exposed to the sex- and age-specific death rates prevailing at the time of his or her birth, for a specific year, in a given country, territory, or geographic area. More simply, it can be understood as the average life span of an individual.
In terms of research and analysis, life expectancy continues to be among the most commonly used indicators for population health, human welfare, and assessing the economic and social development of a country or a region. Its significance is also reflected in the fact that it is one of the measures that comprises the UN’s Human Development Index, while a large body of empirical work from around the world has compellingly shown that it is tightly intertwined with socioeconomic growth and development through a variety of pathways and mechanisms.
For most of human history, average life expectancy has steadily increased worldwide, with improvements in health care, access to water, hygiene and sanitary conditions, decreases in disease epidemics, and improved safety measures. Today, global life expectancy is slightly over 70 years, about double what it was just a couple of centuries ago.
With specific regard to Eritrea, life expectancy has soared from less than 50 at independence to about 67 last year, a relatively large improvement within a short period of time. To put this long-run progress into better context, the country now has the highest life expectancy in the Horn of Africa region. What is more, it is now among the leaders on the continent, and has gone from below to well above the average for Sub-Saharan Africa. Eritrea’s rapid improvement has also seen it considerably narrow the once yawning gap with the world average.
It is also worth keeping firmly in mind that not long after winning its independence, Eritrea was faced with a brutal two-year war of aggression. Launched by the belligerent, expansionist previous Ethiopian regime, the war directly aimed at effecting a violent extralegal change of government in Asmara and forcibly annexing most of the highlands and large parts of the eastern lowlands of Eritrea. In addition to all of its extremely destructive impacts and highly damaging consequences, the war halted much of the Eritrea’s early improvements in life expectancy, reversing its progress considerably.
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