The national health strategy for Ethiopia emphasizes the provision of effective health promotion and disease prevention services at the community level. Substantial progress has been made in recent years in expanding coverage of community health services and reducing infant and child mortality rates in the country. The prevention and control of major communicable diseases, such as HIV/AIDS, tuberculosis and malaria has also received considerable attention and action. The significant progress in tackling the major communicable diseases, however, can potentially be spoiled by the steady rise in the burden of chronic physical and mental diseases within Ethiopia, and elsewhere in the developing world.
As deaths from infection decline and people live longer, so their vulnerability to the chronic non-communicable diseases of old age increases. Chronic conditions such as cardiovascular diseases, diabetes, obstructive lung disease and cancers are on the increase all over the world, but particularly in low- and middle-income countries. For example, more than half of the 8 million deaths from cancers every year and over 80% of the 17 million deaths from heart disease and strokes now occur in developing countries. Also increasing across the world are the numbers of deaths and injuries from traffic accidents and violence: over 90% of the 1.3 million traffic-related deaths and 20-30 million serious injuries from collisions with a vehicle occur in developing countries; the poorer parts of the world are also disproportionately affected by injuries requiring emergency care as a result of other accidents and interpersonal violence. Mental health conditions are also responsible for high levels of mortality and disability, accounting for 8.8% of the deaths and 16.6% of the total burden of disease in low- and middleincome countries.
Taking these trends into consideration, the Ethiopian Federal Ministry of Health has included this Module on Non-Communicable Diseases, Emergency Care and Mental Health in the education and training of its Health Extension Practitioners, who provide health promotion and diseases prevention services throughout the rural areas of the country. In addition to addressing chronic conditions such as cardiovascular diseases, diabetes, cancers, and lung disease, Part 1 of this Module also covers oral disease, cataracts and injuries to the eyes and ears, and the provision of first-aid life supportive care for emergencies such as head injuries and abdominal obstruction. Part 2 focuses on the immediate and longer-term effects of common mental health problems such as depression, psychosis, and substance abuse, and the early detection and community support for adults and children whose lives are affected by mental disorders. The aim is to focus equal attention and action to improve the mental health and wellbeing of community members as on sustaining their physical health. The Module ends by discussing community-based rehabilitation of some common physical and mental disabilities. Effective diagnosis, treatment, referral and prevention of all these non-communicable conditions is vital to reducing the death and disability rate, which in turn reduces the burden on the national economy, individuals, families and the local community.