The evolution of modern child healthcare in Ethiopia: A brief treatise

Abstract

Pediatrics is a relatively new medical specialty, which was first institutionalized in Europe and North America in the mid-19th century. It was delivered as part of the general medical service until the Ethio-Swedish Pediatric Clinic (ESPC) was established in Addis Ababa in 1959. Before that, child healthcare services were provided in the country in various pioneer general hospitals and lower-level health facilities. This continued after 1959, along with child healthcare services provided at maternal and child health clinics, and later in a few children-only facilities. The Ethio-Swedish Pediatric Clinic played a pivotal role in introducing and laying the foundation for the state-of-the-art services, training, and research in pediatric and child healthcare in Ethiopia.

The ESPC , along with the Children Nutrition Unit (later renamed the Ethiopian Nutrition Institute), is considered a historical landmark in the mapping of health and nutrition profiles of children in the country, and the initiation and development of pediatrics, including care for sick and malnourished children. Child healthcare services, training, and research continued to expand with the influx of Ethiopian pediatricians and nurses trained abroad, and the establishment of the Department of Pediatrics at the School of Medicine of Addis Ababa University, supplanting the ESPC. The increase in the number of institutions of higher education and public and private health facilities greatly contributed to the expansion of services to children in the country.

The pattern of diseases in children has remained similar to the pattern documented earlier (1959-1975), when pediatric services were initiated, although HIV/AIDS and Coronavirus Disease-2019 (COVID-19), have been major new developments. Common childhood illnesses have primarily included acute respiratory infections/pneumonia, diarrhea, fever, malaria, and malnutrition, which have been major contributors to the high child mortality and morbidity. Current reports show that Ethiopia has made major strides in reducing infant and childhood mortality. Under-five mortality has dropped from 202 to 67, and infant mortality from 129 to 64 per 1,000 live births, from 1990 to 2016, respectively.