Unique among African countries, the ancient Ethiopian monarchy maintained its freedom from colonial rule, one exception being the Italian occupation of 1936-41. In 1974 a military junta, the Derg, deposed Emperor Haile Selassie (who had ruled since 1930) and established a socialist state.²² In spite of the rapid expansion of primary care, community participation was hampered by the protracted war and centralized, urban-based, bureaucratic approaches and attitudes that failed to promote an enabling environment for community participation. The socialist government, although implementing various community programs and expanding the rural health services, did not succeed in revolutionizing the health services.²³ During the 1980s Ethiopia experienced the effects of conflict, drought and famine on a scale far greater than many other complex political emergencies (CPEs) - a major humanitarian, political, social and economic crisis, with war and poverty as fundamental components. Its root causes were linked to political marginalisation, socio-economic stress, and to ethnic identity and grievances, with the basic lesson that failure to address these would ensure the recurrence of conflict. In May 1991, after the decisive defeat of the military dictatorship of Mengistu Haile Mariam by the Ethiopian Peoples' Revolutionary Democratic Front (EPRDF) and after decades of civil war, drought and famine, Ethiopia faced the prospects of peace and of much needed development.²⁴

In the face of dramatically changed international circumstances, the EPRDF moderated embraced the free market, achieved a measure of economic progress, and took large steps towards state decentralisation and smaller ones towards democratisation.²⁵ A constitution was adopted in 1994 and Ethiopia's first multiparty elections were held in 1995. A two and a half year border war with Eritrea ended with a peace treaty on 12 December 2000.

Ethiopia's poverty-stricken economy is based on agriculture, which accounts for half of GDP, 60% of exports, and 80% of total employment. The agricultural sector suffers from frequent drought and poor cultivation practices. Coffee is critical to the Ethiopian economy with exports of some $156 million in 2002, but historically low prices have seen many farmers switching to qat to supplement income. The war with Eritrea in 1998-2000 and recurrent drought have buffeted the economy, in particular coffee production. In November 2001 Ethiopia qualified for debt relief from the Highly Indebted Poor Countries (HIPC) initiative. Under Ethiopia's land tenure system, the government owns all land and provides long-term leases to the tenants; the system continues to hamper growth in the industrial sector as entrepreneurs are unable to use land as collateral for loans. Drought struck again late in 2002, leading to a 2% decline in GDP in 2003. Return to normal weather patterns late in 2003 helped agricultural and GDP growth recover in 2004. The government estimates that annual growth of 7% is needed to reduce poverty.²⁶

GDP per capita is Intl $382. This falls within the range of $8,272 ( Libya) and $346 ( Democratic Republic of the Congo) in the countries of Africa (Table 5).

Table 5 GDP per capita (Intl $): countries of Africa, 2001

Source: Who