First-time subnational burden of disease estimates in Ethiopia show nationwide improvements but lingering disparities

Subnational estimates 1990-2019

Over the last three decades, Ethiopia has made substantial improvements in health, particularly in reducing mortality and morbidity related to infectious diseases; maternal, neonatal, and nutritional deficiency diseases; and injuries. However, progress was not uniform across Ethiopia’s highly diverse, multi-ethnic, and predominantly rural population, requiring comparable estimates at the regional level to target interventions based on the burden of disease.  

Through the Ethiopia Subnational Burden of Disease project, a collaboration between the Ethiopian Public Health Institute, IHME, and a network of over 700 Ethiopian researchers and policymakers, we provide an analysis of the effects of 369 diseases and injuries and 87 risk factors on premature mortality, disability, and disability-adjusted life years for Ethiopia’s regions and chartered cities from 1990 to 2019.
At the national level, life expectancy at birth improved by 21.9 years, largely driven by decreased mortality due to HIV/AIDS, tuberculosis, diarrheal diseases, lower respiratory infections, and war and conflict. Despite widening socio-demographic disparities, inequality in life expectancy across the regions is decreasing. Regions could further increase life expectancy by targeting interventions that reduce the burden of non-communicable diseases.

By addressing social and economic determinants of health, especially in underserved regions, through improvements in equity and quality of health services; financing and efficiency; and reductions in poverty and unemployment, Ethiopia could catalyze the gains in health achieved since 1990. Health policymakers should tailor strategies, resources, and interventions to specific diseases, risk factors, and socio-demographic
factors in each region to reduce disparities between regions and improve health outcomes for all Ethiopians. 