Surgical, emergency, and critical care: where each service is provided in Ethiopia, and who pays
177 services in the Surgical, emergency, and critical care programme of Ethiopia’s Essential Health Services Package, of which 10 are free of charge. A tick means that level of facility is expected to provide the service.
Source: Essential Health Services Package of Ethiopia (November 2019), Annex II, Table 19 — Ministry of Health of Ethiopia. These are the services the package says should be available at each level of the public health system, and how they are paid for. Availability at a particular facility can differ and fees change: confirm before you travel. BinaSmart is an information service, not a medical provider.
| Service | Health post | Health centre | Primary hospital | General hospital | Tertiary hospital | Payment |
|---|---|---|---|---|---|---|
| Caesarean section Surgical care: Gynaecology and obstetrics | · | ✓ | ✓ | ✓ | ✓ | Free |
| Abdominal hysterectomy Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Free |
| Repair of uterine perforation and rupture Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Free |
| Surgical management of pelvic organ prolapse Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Conservative management of pelvic organ prolapse Surgical care: Gynaecology and obstetrics | · | ✓ | ✓ | ✓ | · | Cost sharing |
| Repair of obstetric fistula Surgical care: Gynaecology and obstetrics | · | · | · | ✓ | ✓ | Free |
| Cervical biopsy Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Free |
| Endometrial biopsy Surgical care: Gynaecology and obstetrics | · | · | · | ✓ | ✓ | Free |
| Surgical management of major benign gynaecological conditions Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Surgical management of major malignant gynaecological conditions Surgical care: Gynaecology and obstetrics | · | · | · | ✓ | ✓ | Cost sharing |
| Female genital anomalies surgeries Surgical care: Gynaecology and obstetrics | · | · | · | ✓ | ✓ | Cost sharing |
| Salpingo-ophorectomy Surgical care: Gynaecology and obstetrics | · | · | · | ✓ | ✓ | Cost sharing |
| Colposcopy Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Hystero-salpingography Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Ectopic pregnancy laparotomy Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Free |
| Destructive delivery Surgical care: Gynaecology and obstetrics | · | ✓ | ✓ | ✓ | ✓ | Free |
| Laparotomy for gynaecologic emergency Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Free |
| Diagnostic and therapeutic laparoscopy Surgical care: Gynaecology and obstetrics | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Laceration repair and wound care Surgical care: Trauma and injury | · | ✓ | ✓ | ✓ | · | Cost sharing |
| Air way procedures including Tracheostomy and crico-thyroideotomy Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Tube thoracotomy for air or fluid collection in the pleura Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Focused assessment of sonography for trauma (FAST) Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Explorative laparotomy for trauma Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Emergency thoracotomy for severe chest injury Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Vascular exploration and repair/anastomosis for trauma Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Neck exploration for severe neck injuries Surgical care: Trauma and injury | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Cut down for vascular access Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Operative management of fractures(internal and external fixations) Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Burn management: Escharotomy and Fasciotomy Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Skin graft and flap Surgical care: Trauma and injury | · | · | · | ✓ | ✓ | Cost sharing |
| Management of acute hand trauma (tendon and neurovascular) Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Trauma related amputation Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Basic wound management including wound toilet, debridement repair Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Burr-hole and elevation of depressed skull fracture for head injuries Surgical care: Trauma and injury | · | · | · | ✓ | ✓ | Cost sharing |
| Comprehensive intracranial pressure management/monitoring Surgical care: Trauma and injury | · | · | · | ✓ | ✓ | Cost sharing |
| Cervical and back protection Surgical care: Trauma and injury | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Post trauma extremity rehabilitation Surgical care: Trauma and injury | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Draining superficial abscesses Surgical care: Non-trauma surgical conditions | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Excision of small soft tissue tumours: cysts, lipoma and ganglion Surgical care: Non-trauma surgical conditions | · | ✓ | ✓ | ✓ | · | Cost recovery |
| Male circumcision Surgical care: Non-trauma surgical conditions | · | ✓ | ✓ | ✓ | · | Cost recovery |
| Hydrocelectomy Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Relieving acute urinary retention by catheterization, closed supra- Surgical care: Non-trauma surgical conditions | · | ✓ | ✓ | ✓ | · | Cost sharing |
| Orchidopexy Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Trans vesical prostatectomy (TVP) Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Trans urethral removal of bladder tumour (TURBT) Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Cysto-lithotomy Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Rectal tube deflation for sigmoid volvulus Surgical care: Non-trauma surgical conditions | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Management of intussusception Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Colostomy for ano-rectal malformation Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Management of foreign body swallowing/aspiration Surgical care: Non-trauma surgical conditions | ✓ | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Laparoscopy Cholecystectomy and appendectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Biliary bypass procedures and T-tube insertion for hepato-biliary Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Repair of hernias: tissue repair and mesh repair Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Colostomy construction and reversal Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Hemicolectomies Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Surgical management of peri-anal conditions: Haemorrhoids, fistula in Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Repair of cleft lip and palate Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Shunt for hydrocephalus Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Cardiac surgery for congenital heart disease Surgical care: Non-trauma surgical conditions | · | · | · | · | ✓ | Cost sharing |
| Repair of neural tube defects Surgical care: Non-trauma surgical conditions | · | · | · | · | ✓ | Cost sharing |
| Modified radical mastectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Thyroidectomy (all forms): STT, NTT, and TT Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Gastrectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Esophactemies Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Pulmonary resections and mediastinal procedures for chest Surgical care: Non-trauma surgical conditions | · | · | · | · | ✓ | Cost sharing |
| Tenotomy for club foot and ponsetti cast for club foot Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Surgical management of Septic Arthritis, Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Surgical management of Osteomyelitis, Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Surgical management of Pyomyositis Surgical care: Non-trauma surgical conditions | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Surgical management of hand infection Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Complex orthopaedic trauma care including hemi arthroplasty, intra- Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Cardiac surgery for valvular heart disease Surgical care: Non-trauma surgical conditions | · | · | · | · | ✓ | Cost sharing |
| Skin grafting Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Splenectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Pancreatic pseudo cyst operation Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Cystocele repair Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Diaphragmatic hernia repair Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Antrectomy with vagotomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Fistulectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Abdominal dehiscence repair Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Small intestinal resection/ E-Anastomosis Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Intestinal derotation Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Anterior resection Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Abdominal perineal resection (APR) Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Colectomy right or left Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Total colectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Anal sphinicterotomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Fistiulectomy Surgical care: Non-trauma surgical conditions | · | · | · | · | ✓ | Free |
| Cystic hygroma excision Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Mesenteric mass excision Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Excision of retroperitoneal tumour Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Meatotomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Breast lump removal Surgical care: Non-trauma surgical conditions | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Gastroscopy with biopsy: UGIE Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Pyelolithotomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Ureterolithotomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Nephrectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Urethroplasty Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Thoracotomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Pneumonectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Lobar pneumonectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Parotidectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Neck dissection for head and neck cancers Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Uretroscopy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Trans urethral resection Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Urinary diversion Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Whipple's procedure Surgical care: Non-trauma surgical conditions | · | · | · | · | ✓ | Cost sharing |
| Radical cystectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Decortication Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Pyeloplasty Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Hellers myotomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Nissen's fundoplication Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Inguinal orchiedectomy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Bronchoscopy with GA Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| UGIE and biopsy Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Pericardial window Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Pericadiectomy Surgical care: Non-trauma surgical conditions | · | · | · | · | ✓ | Cost sharing |
| Kidney transplant surgery Surgical care: Non-trauma surgical conditions | · | · | · | · | ✓ | Cost sharing |
| Pull through , pyloromyotomy, Paediatrics procedures Surgical care: Non-trauma surgical conditions | · | · | · | ✓ | ✓ | Cost sharing |
| Dermatological curetting and electrosurgery Surgical care: Dermatology procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Crayotherapy Surgical care: Dermatology procedures | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Skin biopsy examination (punch, incisional or shave) Surgical care: Dermatology procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Patch test Surgical care: Dermatology procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Laser therapy Surgical care: Dermatology procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Narrow band UVB photo therapy Surgical care: Dermatology procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Slit skin smear for leishmaniasis Surgical care: Dermatology procedures | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Complex skin biopsy excision and repair Surgical care: Dermatology procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Electo cauterization Surgical care: Dermatology procedures | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Punch biopsy Surgical care: Dermatology procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Skin snip for microfilaria Surgical care: Dermatology procedures | · | ✓ | ✓ | ✓ | · | Cost sharing |
| Interalesional steroid injection Surgical care: Dermatology procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Extraction of primary and permanent tooth Surgical care: Oral and Dental procedures | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Periodontal and dental abscess incision and drainage Surgical care: Oral and Dental procedures | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Dental caries treatments and scaling Surgical care: Oral and Dental procedures | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Management facial bone fractures and/or dislocation and injury to Surgical care: Oral and Dental procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Management of oro-facial infection Surgical care: Oral and Dental procedures | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Management of common benign tumours and cyst of oral & Surgical care: Oral and Dental procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Management of common malignant tumours and cyst of oral & Surgical care: Oral and Dental procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Dental truam care Surgical care: Oral and Dental procedures | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Cataract extraction and insertion of intraocular lens Surgical care: Ophthalmic procedures | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Eyelid surgery for trachoma (Tarsotomy) Surgical care: Ophthalmic procedures | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Glaucoma surgery (Canaloplasty) Surgical care: Ophthalmic procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Corneal surgery Surgical care: Ophthalmic procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Corneal transplant Surgical care: Ophthalmic procedures | · | · | · | · | ✓ | Cost sharing |
| Oculoplastic surgery Surgical care: Ophthalmic procedures | · | · | · | · | ✓ | Cost sharing |
| Strabismus surgery Surgical care: Ophthalmic procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Retinal detachment repair Surgical care: Ophthalmic procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Vitrectomy Surgical care: Ophthalmic procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Eye enuclation Surgical care: Ophthalmic procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Eye irrigation Surgical care: Ophthalmic procedures | · | ✓ | ✓ | ✓ | · | Cost sharing |
| Lasertherapy Surgical care: Ophthalmic procedures | · | · | · | ✓ | ✓ | Cost sharing |
| Ear irrigation Surgical care: ENT procedure | · | ✓ | ✓ | ✓ | · | Cost sharing |
| Hearing aid placement(including audiometery) Surgical care: ENT procedure | · | · | · | ✓ | ✓ | Cost sharing |
| Myringotomy for otitis media Surgical care: ENT procedure | · | · | · | ✓ | ✓ | Cost sharing |
| polypectomy (Nose) Surgical care: ENT procedure | · | · | · | ✓ | ✓ | Cost sharing |
| Tonsillectomy Surgical care: ENT procedure | · | · | · | ✓ | ✓ | Cost sharing |
| Sleep disorder surgery Surgical care: ENT procedure | · | · | · | · | ✓ | Cost sharing |
| Corrective breathing surgery Surgical care: ENT procedure | · | · | · | · | ✓ | Cost sharing |
| Sinus surgery Surgical care: ENT procedure | · | · | · | ✓ | ✓ | Cost sharing |
| Mastoidectomy and drainage Surgical care: ENT procedure | · | · | · | ✓ | ✓ | Cost sharing |
| Laryngeal polyp excision Surgical care: ENT procedure | · | · | · | ✓ | ✓ | Cost sharing |
| Thympanoplasty Surgical care: ENT procedure | · | · | · | ✓ | ✓ | Cost sharing |
| Local Anaesthesia Anaesthesia and critical care | · | ✓ | ✓ | ✓ | ✓ | Cost sharing |
| Difficult intubation (Bugie, Stylet, Fibro, video/Glydoscope) Anaesthesia and critical care | · | · | · | ✓ | ✓ | Cost sharing |
| Lumbar puncture Anaesthesia and critical care | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Spinal Anaesthesia Anaesthesia and critical care | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Caudal Anaesthesia/analgesia Anaesthesia and critical care | · | · | · | ✓ | ✓ | Cost sharing |
| Epidural Anaesthesia/analgesia Anaesthesia and critical care | · | · | · | ✓ | ✓ | Cost sharing |
| Peripheral nerve blocks Anaesthesia and critical care | · | · | · | ✓ | ✓ | Cost sharing |
| Procedural sedation Anaesthesia and critical care | · | · | · | ✓ | ✓ | Cost sharing |
| Central venous catheter insertion Anaesthesia and critical care | · | · | · | ✓ | ✓ | Cost sharing |
| Arterial catheter insertion Anaesthesia and critical care | · | · | · | · | ✓ | Cost sharing |
| Blood transfusion (including exchabge) Anaesthesia and critical care | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Intubation/ Extubation (single and duoubel lumen) Anaesthesia and critical care | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Fiberoptic bronchoscopy Anaesthesia and critical care | · | · | · | ✓ | ✓ | Cost sharing |
| Mechanical ventilation non invasive - CPAP Anaesthesia and critical care | · | · | ✓ | ✓ | ✓ | Cost sharing |
| Mechanical ventilation invasive Anaesthesia and critical care | · | · | · | ✓ | ✓ | Cost sharing |