ADDIS ABABA, 14 August 2012 (IRIN) - Ethiopia is preparing for a flood of medical doctors within "three to four years", an influx meant to save a public health system that has been losing doctors and specialists to internal and external migration.

"We are now implementing strategies that intend to increase the current below-World Health Organization [WHO] standard number of medical doctors and retaining them in public hospitals," Tedros Adhanom, Ethiopia's minister of health, told IRIN.

"We have now reached an enrolment rate of more than 3,100," he said. The rate of enrolment in the country's medical schools has increased tenfold from 2005, when it was below 300.

"In the next two, three years, it could go to six and eight thousand," said the minister, adding that once these students start to graduate, the problem regarding shortage of physicians in the country "will [have] considerably stabilized".

While WHO recommends countries have a minimum of one doctor per 10,000 people, Ethiopia has fewer than a fifth of that ratio, compared to a regional average of 2.2 physicians per 10,000 people.

"We have not [supplied] enough doctors despite the high demand," Tedros told IRIN.

A draft of the country's Human Resource for Health Strategic Plan shows an intended increase in the number of physicians to 1 per 5,000 people by 2020. The plan seems on course, with a report presented to parliament in May revealing 2,628 students had been enrolled in 22 universities over the previous nine months. Currently fewer than 200 doctors graduate annually.

But once the new students start to graduate, "We can succeed in easing the problem significantly within three to four years," the minister said. "Afterwards, we can also have more doctors that specialize in several sub-health fields."

Questions over quality

With the strong emphasis on health personnel numbers, experts have expressed concerns about the quality of medical education available.

"Of course, whenever emphasis is given to numbers, quality is compromised," said Milliard Derebew, a medical professor at Addis Ababa University. "Due attention should be given to quality as well," he said.
Tedros also admitted quality is a concern. "We go [for] high speed and high volume, and keeping the quality could be a problem", though it is one that "should be addressed soon". He said the country would look to others for support in terms of funding and experience.

Through the Medical Education Partnership Initiative (MEPI), the US is supporting Ethiopia's efforts to improve the quality of medical training.

Milliard said medical teachers at Addis Ababa University receive incentives to they take additional classes. The initiative has improved the medical school's ratio of books-to-students, from one book per 24 students to one per three.

"Besides [this], we are networking with known US universities through video conferencing so that the students learn from experience of others," he said.

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