R4D Ethiopia

R4D leverages market shaping approaches to align priorities and incentives of key market actors, including policymakers, procurers, manufacturers and financiers at the global and country levels, to improve access to key services and commodities. R4D has supported the government of Ethiopia since 2014 to reduce-child-deaths-from-pneumonia through improving access to amoxicillin dispersible tablets, the antibiotic recommended as the first-line treatment for pneumonia. In addition to improving access to amoxicillin dispersible tablets, R4D has supported the Ministry of Health in developing an evidence-informed, costed roadmap for the expansion and scale-up of Multiple Micronutrient Supplements (MMS) in Ethiopia. R4D is supporting the Ethiopian Pharmaceutical Supply Service (EPSS) on developing in-house market shaping capacity in order to play a market manager role — proactively identifying and addressing key market shortcomings and then working to ensure uninterrupted availability of high-quality and affordable health and nutrition products. Ethiopia is also part of R4D’s multi-country maternal, newborn and child health commodity access initiative.

R4D has also conducted a comprehensive commodity financing landscaping assessment, providing evidence-informed recommendations on the need to connect three core health system domains — supply systems, market shaping, and health care financing — to strengthen realistic budgeting, adequate allocation, and efficient use of commodity financing resources.

R4D works at the global and country level to help change agents finance and meet ambitious nutrition targets. R4D has collaborated with the Ministry of Health to track funding for nutrition in Ethiopia across sectors and is currently supporting the government with the development of a roadmap, investment plan and financing/resource mobilization strategy for the expansion and scale-up phases of the Seqota Declaration, which cites nutrition as integral to reaching the country’s health goals. In addition, R4D is generating evidence and guidance on the integration of wasting (low weight for height) treatment into routine health care and developing strategies to increase access to ready-to-use therapeutic food (RUTF) to address wasting. These efforts are intended to lead to improved ownership of wasting programs by the MoH and subsequent increased treatment and prevention of wasting.

Between 2023 and 2025, DataDENT — a collaboration between R4D and Johns Hopkins University — worked in close partnership with the Ministry of Health’s Seqota Declaration Team to complete a multisectoral food and nutrition data system scoping assessment. The assessment aimed to build a shared understanding among key stakeholders of the gaps and challenges in Ethiopia’s food and nutrition data systems, and to provide actionable recommendations for addressing them.

R4D’s innovation work in Ethiopia focuses on building the ecosystem and capacity needed to operationalize and institutionalize innovation scaling pathways across the Ethiopian health system. This work supports government partners in identifying, testing, and scaling promising innovations — helping to embed them sustainably within existing structures rather than as standalone initiatives.

R4D, in collaboration with Big Win Philanthropy, undertook a landscape analysis to support the Addis Ababa City Administration’s plan to establish a Centre of Excellence (COE) for early childhood development (ECD) in the city. The Centre will advance ECD policy and practices with the goal of ensuring universal access of comprehensive ECD services to all children in Ethiopia and on the Africa continent.

R4D promotes sustainable health financing by supporting domestic resource mobilization, public financial management, costing and the strategic purchasing of health services from public and private providers. R4D is working to identify feasible options in Ethiopia for allocating additional resources to health programs and supporting the National Health Insurance Agency with strategic purchasing of health care and commodities. R4D has also supported the Federal Ministry of Health to address neglected tropical diseases through the design and implementation of sustainable financing mechanisms. These efforts have contributed to significant progress in the Ethiopian government’s efforts to ensure efficient, high-quality and equitable health care services.

Between 2021 and 2024, R4D supported the FMOH with strengthening systems for rehabilitation services with a primary focus to integrate and strengthen the rehabilitation service into routine health care delivery system.

R4D is a globally recognized leader in designing and leading Collaborative Learning Networks — communities of policymakers and practitioners who tackle common challenges by exchanging knowledge and co-developing practical solutions to achieve sustainable progress in health, education and nutrition. Starting in 2008, R4D engaged with Ethiopia’s Ministry of Health through the Ministerial Leadership Initiative — a platform that brought together the Ministries of Health of five African countries. In 2014, R4D expanded its relationship with the Ministry of Health through the Joint Learning Network for Universal Health Coverage. The JLN, as it is called, is a network of 34 countries sharing expertise and knowledge with each other. Through a JLN partnership with the Health Systems Strengthening Accelerator, Ethiopia’s Ministry of Health and other government leaders in the COVID-19 response have benefited from cross-country knowledge-sharing and problem solving to improve their multi-sectoral and multi-level coordination of the country’s pandemic response. In addition, Ethiopia has been a member of the JLN’s Primary Healthcare Financing and Payment Collaborative since 2019 and hosted fourteen countries in February 2020 for the collaborative’s in-person meeting in Addis Ababa showcasing their Community Based Health Insurance and lessons learned over ten years of implementation. (Listen to Dereje Mengistu from the Ethiopia Health Insurance Agency share insights in The Provider Payment Mechanism Podcast.)

In collaboration with USAID Ethiopia and the Government of Ethiopia, R4D designed a plan to generate evidence and feedback loops needed to support adaptations of ongoing social protection initiatives across sectors (including safety nets and community-based health insurance) for integrated resilience programming, with the goal of enhancing the resilience of households to financial shocks in the medium to long term.