Throughout the 1990s, the government, as part of its reconstruction program, devoted ever-increasing amounts of funding to the social and health sectors, which brought corresponding improvements in school enrolments, adult literacy, and infant mortality rates. These expenditures stagnated or declined during the 1998-2000 war with Eritrea, but in the years since, outlays for health have grown steadily. In 2000-2001, the budget allocation for the health sector was approximately $144 million; health expenditures per capita were estimated at $4.50, compared with $10 on average in sub-Saharan Africa. In 2000 the country counted one hospital bed per 4,900 population and more than 27,000 people per primary healthcare facility. The physician to population ratio was 1:48,000, the nurse to population ratio, 1:12,000. Overall, there were 20 trained health providers per 100,000 inhabitants. These ratios have since shown some improvement. Healthcare is disproportionately available in urban centres; in rural areas where the vast majority of the population resides, access to healthcare varies from limited to non-existent. As of the end of 2003, the United Nations reported that 4.4% of adults were infected with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS); other estimates of the rate of infection ranged from a low of 7% to a high of 18%. Whatever the actual rate, the prevalence of HIV/AIDS has contributed to falling life expectancy since the early 1990s. According to the Ministry of Health, one-third of current young adult deaths are AIDS-related. Malnutrition is widespread, especially among children, as is food insecurity. Because of growing population pressure on agricultural and pastoral land, soil degradation, and severe droughts that have occurred each decade since the 1970s, per capita food production is declining. According to the UN and the World Bank, Ethiopia at present suffers from a structural food deficit such that even in the most productive years, at least 5 million Ethiopians require food relief.
In 2002 the government embarked on a poverty reduction program that called for outlays in education, health, sanitation and water. A polio vaccination campaign for 14 million children has been carried out, and a program to resettle some 2 million subsistence farmers is underway. In 2003, the government launched the Health Extension Program which will provide universal primary healthcare coverage by 2009. This includes placing two government-salaried female Health Extension Workers (HEW) in every kebele, with the aim of shifting the emphasis of healthcare to prevention. About 2,700 HEWs completed their training by the end of 2004 at 11 technical and vocational education centres, while 7,000 HEWs were still in training in 2005, and over 30,000 HEWs were expected to complete their training by 2009. However, these trainees encountered a lack adequate facilities, which included classrooms, libraries, water and latrines. The selection of trainees was flawed, with most being urban inhabitants and not from the rural villages they would be working in. Reimbursement was haphazard as trainees in some regions did not receive stipends while those in other regions did. In January 2005, the government began distributing anti-retroviral drugs, hoping to reach up to 30,000 HIV-infected adults.
According to the head of the World Bank's Global HIV/AIDS Program, Ethiopia has only 1 medical doctor per 100,000 people. However, the World Health Organisation in its 2006 World Health Report gives a figure of 1936 physicians (for 2003), which comes to about 2.6 per 100,000. There are 119 hospitals (12 in Addis Ababa alone) and 412 health centres in Ethiopia. Globalisation is said to affect the country, with many educated professionals leaving Ethiopia for a better economic opportunity in better-developed countries.
Ethiopia's main health problems are said to be communicable diseases caused by poor sanitation and malnutrition. These problems are exacerbated by the shortage of trained manpower and health facilities. Ethiopia has a relatively low average life expectancy of 45 years. Only 20% of children nationwide have been immunised against all six vaccine-preventable diseases: tuberculosis, diphtheria, whooping cough, tetanus, polio and measles. Rates of immunisation are less than 3% of children in Afar and Somali Regions and less than 20% in Amhara, Benishangul-Gumuz and Gambela. In contrast, almost 70% of children have received all vaccinations in Addis Ababa and 43% in Dire Dawa; children in urban areas are three times as likely to be fully immunised as children living in rural areas.
Infant mortality rates are relatively very high, with a nationwide average of 77 infant deaths per 1,000 live births in the five years before the 2005 Ethiopian Demographic and Health Survey; at least half of these deaths occurred in the infants’ first month of life. Infant mortality is most common in the Amhara and Gambela Regions at 94 and 92 deaths per 1,000 live births, respectively, while Addis Ababa experiences the lowest rate at 45 deaths per 1,000 live births. Further, birth-related complications such as obstetric fistula affect many of the nation's women. HIV is also prevalent in the country.