25 years of public health leadership in Africa: the Ethiopian Public Health Association.

Mariam, Damen Haile ; Asnake, Mengistu

The Ethiopian Public Health Association (EPHA) is a national, autonomous, non-profit-making, voluntary public health association. EPHA was established in 1989 with the objective of attaining an optimal standard of health for the people of Ethiopia through the advancement of measures that promote health, prevent diseases, care for the sick and rehabilitate the disabled. The Association promotes high professional standards through advocacy, active involvement and networking. It grew out of the Health Officers Professional Association that was established in 1975 by the graduates of the former Gondar College of Public Health. Since that time, the training of Public Health Officers as well as other health professionals involved in public health has steadily grown in the country, creating the need for a stronger national public health association and leading thus to the founding of the EPHA. (1) This is particularly related to the initiation of the graduate training of physicians in public health that was started in 1988 in the country. Previously it was only public health officers who received graduate training (MPH) in public health, with very few other categories of professionals joining the field.

The Association was registered under the Ethiopian Law in 1991, with the revised Civil Society Organizations law in 2010 and has been a member of the World Federation of Public Health Associations since 1993.

The strategies outlined by the Association to meet its objective include: (2-4)

1. Bringing together persons who are trained in, working in, or interested in public health or public health-related professions;

2. Participating in and making recommendations on health policy, planning, training, management and practice of public health;

3. Promoting the professional standard and interest of its members and other public health personnel; advancing research in public health; establishing a forum for promoting communication among members and the public on matters of health. (5) For instance, EPHA works with health training institutions in the country for enhancing training in health research. As chair of the panel of assessors for health professionals within the Ministry of Health, it works to promote professional standards and has participated in the development of professional ethics as well as in the accreditation of private health colleges in the country;

4. Networking with similar associations and societies with similar professional aims within Africa as well as outside;

5. Publishing a scientific journal, a newsletter, a public health digest as well as other updates regularly to disseminate information to public health professionals and to the public;

6. Actively participating with sister organizations in the country in the strengthening of professional associations as well as in the promotion of health; and playing active advocacy roles on important national and international health issues.

Activities and achievements

The major activities of the Association include:

1. Maintaining the production of regular publications including a peer-reviewed scientific journal. One of these, The Ethiopian Journal of Health Development, is a multidisciplinary publication concerned with the broad field of health development. The Journal was launched in July 1984 with the rationale that "Ethiopia, and East Africa in general, lack such a forum for thorough articulation and exchange of ideas on policy, organizational and technical alternatives of the coming revolution in health". (6,7) The Journal celebrated its 25th anniversary in 2009. (8)

2. Holding regular annual conferences and creating a better recognition for EPHA among different government and NGO partners. In all its annual conferences, EPHA brings timely public health issues to the attention of its members and the wider public health community. In its recent conferences, the following major themes and subthemes were presented and discussed:

a) Maternal and newborn health in Ethiopia

b) Road traffic accidents as a major public health concern in Ethiopia

c) The Health Service Extension program in Ethiopia: Experiences and prospects

d) National nutrition policy, strategies and implementation

e) Tobacco control; International and national initiatives

f) Multisectoral response to HIV/AIDS; Strategies to meet the universal access targets.

3. Members of the EPHA leadership are also involved in different national policy-related committees and taskforces. For instance, EPHA is chair of the panel of assessors for the health professionals council, which oversees the registration, licensing and regulation of all health professionals in the country. EPHA is selected for this position by the Ministry of Health because of its wide base in membership and representation of a wide cross-section of public health fields.

4. Organizing different forums for policy dialogue with health sector officials, partner and civil service organizations and health professionals for advocacy and influencing policy directions. In the past few years, EPHA was engaged in policy dialogues related to malaria, HIV/AIDS, and the Health Extension Program involving the MOH, teaching institutions, multilateral and bilateral donor agencies and professional associations such as the Ethiopian Medical Association, Ethiopian Nurses Association and others.

5. Organizing periodic continuing education and research brief sessions to update professionals on recent developments and study findings in the major areas of public health.

6. Supporting the various public health training institutions in training research methodology and financing masters and doctoral level research activities.

Collaboration and networking

EPHA has maintained close working relationships with the health sector, health sector partners and non-government organizations. With other health professional associations in the country, it spearheaded the attempt to form a union of associations in 1999. (9) Membership in the EPHA is open for all graduates trained and practicing in public health and health-related fields. Currently (in 2010), EPHA is the largest membership association next to the Ethiopian Teachers Association. It has over 3,000 members with varying professional categories and levels of training. They serve private, government and non-government organizations distributed all over the country, occupying different levels of positions in the health care system. (10)

As part of the networking activity, the Canadian Public Health Association (CPHA), through its Strengthening of Public Health Associations (SOPHA) program, has played a leadership role by providing financial and technical support in the strengthening of EPHA from 1994 to 2003. During the 10-year period of this partnership, EPHA benefited from institutional capacity-building, direct support for projects including holding annual conferences, technical assistance to project initiatives and support to its members in attending international conferences. Through the various capacity-building activities of the SOPHA program, EPHA was able to establish a strong secretariat. EPHA "graduated" from the SOPHA program in 2003. The Association currently has 41 full-time technical and support staff managing the secretariat and helping with project and program activities.

Since 1993, EPHA has been an active member of the WFPHA, serving as a member of the Executive Board from 2003 to date by representing the African region members and serving as the chair of the nomination committee of the Federation.

Future prospects

All the above-mentioned activities and achievements of the Association have contributed to its being given the responsibility for hosting the 2012 World Congress on Public Health in Addis Ababa, Ethiopia.

It is also possible that the EPHA can serve as a role model for enhancing the development and performance of health professional associations in Africa and other developing countries so that they can have increasing influence in health policy and interventions within their respective countries. EPHA will continue its efforts toward establishing the African Public Health Association by bringing together national associations to achieve better public health in the continent and beyond.

REFERENCES

(1.) Ethiopian Public Health Association (EPHA). The Ethiopian Public Health Association: A profile. Addis Ababa: EPHA, 1996.

(2.) EPHA. Constitution, First Edition. Addis Ababa: EPHA, 1991.

(3.) EPHA. Constitution, Second Edition. Addis Ababa: EPHA, 1998.

(4.) EPHA. Constitution, Third Edition. Addis Ababa: EPHA, 2005.

(5.) EPHA. Strategic Planning Document for 2010-2014. Addis Ababa: EPHA, 2009.

(6.) Anonymous. Editorial. Ethiop J Health Dev 1984;1(1):15.

(7.) Anonymous. Health development and primary health care: Editorial note. Ethiop J Health Dev 1984;1(1):1-29.

(8.) Kitaw Y, Desta A. Editorial. Ethiop J Health Dev 2009;23(Special (Silver Jubilee) Issue):172-73.

(9.) EPHA. 2nd Strategic Plan, 2005-2009. Addis Ababa: EPHA, 2005.

(10.) EPHA. 3rd Strategic Plan, 2010 - 2014. Addis Ababa: EPHA, 2010.

Damen Haile Mariam, MD, MPH, PhD, [1] Mengistu Asnake, MD, MPH [2]

Author Affiliations

[1.] President, Ethiopian Public Health Association, 2002-2005; Professor of Public Health, Addis Ababa University

[2.] President, Ethiopian Public Health Association, 2006-2009; Deputy Country Director, Pathfinder-International

This commentary was invited in honour of the 20th anniversary (in 2009) of the Ethiopian Public Health Association (a graduate of CPHA's Strengthening of Public Health Associations [SOPHA] program) and of the 25th anniversary of the Ethiopian journal of Health Development.