To ask the Secretary of State for International Development if he will take steps to facilitate the provision of healthcare free at the point of access in (a) Ethiopia and (b) Liberia. (144757)

DFID is committed to helping countries that want to remove charges at the point of delivery. In the recent DFID White Paper we made a commitment to help partner governments abolish user fees for basic health services and help them tackle other barriers to access, including discrimination against women.

In 2003, as part of transition arrangements, user fees for health services in Liberia were suspended. At the end of the transition period on 31 March 2006, the President accepted the Minister of Health’s recommendation that healthcare should continue to be free. We support this policy, although it is essential that it is implemented in the context of wider health sector reform, including financing, human resources, institutions, and procurement/supply chains.

DFID has agreed to extend its support to Save the Children UK in Liberia which is playing a leading role in assisting the Government with the development of pro poor policies and health financing. DFID will jointly fund the placement of an SCF-UK Technical Director for Health to work specifically on co-ordination, policy and advocacy, including on access to free healthcare.

User fees are one of several constraints to access to health care in Ethiopia, others being distance to health facilities and availability of drugs. Since more than one in five Ethiopians lives more than 10 km (or two hours walk) from a health care facility, Ethiopia’s Health Sector Development Plan focuses on expanding access to primary health care services, especially preventive services, most of which are provided free. DFID helps to fund the delivery of these services through its contributions to the Protection of Basic Services grant, which supports recurrent costs of health and other services at local level and procurement of essential commodities such as vaccines, malaria drugs, bednets and contraceptives.

To ask the Secretary of State for International Development what support his Department provided to health systems in (a) Liberia and (b) Ethiopia in each of the last five years. (144758)

As outlined in the new DFID health strategy “Working together for Better health”, assisting countries to strengthen their health services is a UK priority.

In Ethiopia, DFID provided direct budget support to the Government in support of its poverty reduction strategy from January 2003 to March 2005. This included £2.9 million for strengthening of the national health system and delivery of health care. Between June 2006 and end March 2007, DFID provided a grant of £8.7 million for the Protection of Basic Services, to help fund the recurrent costs of delivering basic health care services and the procurement of key commodities including vaccines, malaria drugs, bednets and contraceptives. Since 2005, DFID has committed a total of £145,000 to a multi-donor fund to cover costs of technical assistance, studies, consultations and meetings that are crucial to the implementation of Ethiopia’s Health Sector Development Programme.

In Liberia DFID has been providing humanitarian support for health services since 2003 through Save the Children, Merlin and other NGOs. They have focused on providing basic services, working closely with Country Health Teams. These Teams will take on increasing responsibility for health service management and delivery through training and carrying out joint supervision of health facilities. DFID’s support to NGOs in Liberia is structured around supporting public healthcare systems to be delivered free to the patient. As well as building capacity to strengthen systems, the support ensures payment of staff and provision of drugs.

DFID will provide up to £8 million over the next two years for building and strengthening systems at the central level. This includes support to the Ministry of Health to establish strong financial management and contributing to a proposed multi-donor fund to support Liberia to strengthen its health systems under its National Health Plan. DFID will continue to support NGOs to cover critical gaps in the provision of healthcare with increasing focus on transfer of leadership to the Government.

In Liberia, DFID bilateral expenditure on health in 2002-03 to 2006-07 was:

This is expected to increase to around £3-£4 million for 2007-08 and 2008-09.