Modeling trends of health and health related indicators in Ethiopia (1995-2008): a time-series study

BACKGROUND The Federal Ministry of Health of Ethiopia has been publishing Health and Health related indicators of the country annually since 1987 E.C. These indicators have been of high importance in indicating the status of health in the country in those years. However, the trends/patterns of these indicators and the factors related to the trends have not yet been investigated in a systematic manner. In addition, there were minimal efforts to develop a model for predicting future values of Health and Health related indicators based on the current trend. OBJECTIVES The overall aim of this study was to analyze trends of and develop model for prediction of Health and Health related indicators. More specifically, it described the trends of Health and Health related indicators, identified determinants of mortality and morbidity indicators and developed model for predicting future values of MDG indicators. METHODS This study was conducted on Health and Health related indicators of Ethiopia from the year 1987 E.C to 2000 E.C. Key indicators of Mortality and Morbidity, Health service coverage, Health systems resources, Demographic and socio-economic, and Risk factor indicators were extracted and analyzed. The trends in these indicators were established using trend analysis techniques. The determinants of the established trends were identified using ARIMA models in STATA. The trend-line equations were then used to predict future values of the indicators. RESULTS Among the mortality indicators considered in this study, it was only Maternal Mortality Ratio that showed statistically significant decrement within the study period. The trends of Total Fertility Rate, physician per 100,000 population, skilled birth attendance and postnatal care coverage were found to have significant association with Maternal Mortality Ratio trend. There was a reversal of malaria parasite prevalence in 1999 E.C from Plasmodium Falciparum to Plasmodium Vivax. Based on the prediction from the current trend, the Millennium Development Goal target for under-five mortality rate and proportion of people having access to basic sanitation can be achieved. CONCLUSION The current trend indicates the need to accelerate the progress of the indicators to achieve MDGs at or before 2015, particularly for Maternal Health and access to safe water supply.