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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 1, January/February 2021
AFRICA
37
Cardiovascular Topics
Ethiopi Co ntry Report
PASCAR and WHF Cardiovascular Diseases Scorecard
project
Dejuma Yadeta, Wubaye Walelgne, Jean M Fourie, Wihan Scholtz, Oana Scarlatescu, George Nel,
Mussie Gebremichael
Abstract
Data collected for the World Heart Federation’s Scorecard
project regarding the current state of cardiovascular disease
prevention, control and management, along with related
non-communicable diseases in Ethiopia are presented.
Furthermore, the strengths, threats, weaknesses and priori-
ties identified from these data are highlighted in concur-
rence with related sections in the accompanying infographic.
Information was collected using open-source data sets from
the World Bank, the World Health Organization, the Institute
for Health Metrics and Evaluation, the International Diabetes
Federation and relevant government publications.
Cardiovasc J Afr
2021;
32
: 37–46
www.cvja.co.zaDOI: 10.5830/CVJA-2021-001
Onbehalf of theWorldHeartFederation (WHF), thePan-African
Society of Cardiology (PASCAR) co-ordinated data collection
and reporting for the country-level Cardiovascular Diseases
Scorecard to be used in Africa.
1-3
Ethiopia, with assistance from
the Society of Cardiac Professionals in Ethiopia (Ethiopian
professional society) and non-communicable diseases (NCD)
advisors/experts at the Ministry of Health of Ethiopia, was
included as one of the countries to collate and verify the data.
In this report, we summarise Ethiopia’s strengths, threats,
weaknesses and priorities identified from the collected data,
along with needs to be considered in conjunction with the
associated sections in the accompanying infographic. Data sets
that were used included open-source data from the World Bank,
the World Health Organization (WHO), the Institute for Health
Metrics and Evaluation, the International Diabetes Federation
(IDF) and government publications.
Part A: Demographics
According to the World Bank (2018), Ethiopia is a low-income
country (LIC) with 79% of its people living in rural areas.
4
In 2015,
almost 30.8% of the population was living below the US$1.9-a-
day ratio. Life expectancy at birth in 2018 was 64 and 68 years
for men and women, respectively. The general government health
expenditure was 1.4% of the gross domestic product (GDP), with
the total health expenditure as a percentage of the GDP remaining
stable and decreasing slightly to 4.2% in 2016/17.
5
The total
expenditure on health in 2016/17 was US$3 102 527 667, while
that on NCD was US$344.67 million.
5
The total expenditure on
NCD as a percentage of health expenditure is 11.11%, of which
50.4% is government expenditure.
5
The country’s GDP per capita
was US$857.5 in 2019.
6
Part B: National cardiovascular disease
epidemic
The national burden of cardiovascular disease
(CVD) and NCD risk factors
In 2017, the number of people affected by CVD in Ethiopia was
2 838 767.
7
One-third (33.7%) of these cases was rheumatic heart
disease (RHD), followed by ischaemic heart diseases (IHD)
(22.5%) and stroke (11.4%).
7
The estimated age-standardised
mortality rate for Ethiopia in 2017 was 519/100 000 [95%
uncertainty intervals (UI): 479–551] of the population, of which
CVD was 182/100 000 (95% UI: 165–204).
7
Currently, IHD
(45%), stroke (34%) and hypertensive heart disease (HHD) (11%)
are the three leading causes of CVD deaths in Ethiopia, with
about 170 Ethiopians dying each day.
8
Diet and systolic blood
pressure (SBP) were the most predominant risk factors for CVD,
accounting for over 50% of CVD-related disability-adjusted life
years (DALYs), followed by air pollution.
7
The trend in CVD-related death rate (age standardised)
in Ethiopia is consistent with that of Kenya, Tanzania and
Uganda, however, the prevalence is consistent with Tanzania
The Society of Cardiac Professionals in Ethiopia, Federal
Democratic Republic of Ethiopia
Dejuma Yadeta, MD
Department of Global Health and Social Medicine, Harvard
Medical School, Boston, United States
Wubaye Walelgne, MD
Pan-African Society of Cardiology, Cape Town, South Africa
Jean M Fourie, MPhil
Wihan Scholtz, MSc,
wihan@medsoc.co.zaGeorge Nel, MSc
World Heart Federation, Geneva, Switzerland
Oana Scarlatescu
Diseases Prevention and Control Directorate, Ministry of
Health, Federal Democratic Republic of Ethiopia
Mussie Gebremichael, MD