Abstract for: Evaluating Ethiopia’s Healthcare Financing Reform: A Systems Approach to Improving NCD Care

In Ethiopia, noncommunicable diseases (NCDs) account for 42% of deaths. Despite healthcare reforms initiated in 1998 to improve primary healthcare services and financial systems, improvements in service quality and accessibility of health services remain minimal. We are developing a model in collaboration with Ethiopian public health experts, incorporating a literature review and iterative interviews to ensure it aligns with real-world dynamics and local healthcare priorities. Our initial model identifies key factors influencing treatment uptake among individuals with NCDs. Concurrently, our partners in Ethiopia are collecting data to inform the development of a refined quantitative model. Initial findings reveal three balancing feedback loops and one reinforcing loop affecting treatment uptake. Increased treatment rates overwhelm healthcare capacity, leading to decreased patient satisfaction and higher mortality, which reduce utilization and prompt capacity expansion. Simultaneously, improved insurance coverage makes access more attractive, increasing overall treatment rates. This study contextualizes the relationships among factors and feedback loops influencing treatment uptake for NCD patients in Ethiopia and will provide actionable insights to enhance resource allocation and policy implementation.