Seeing Firsthand Eritrea’s Integrated Approach to Health Systems Strengthening

Asmara - Efforts to build a stronger, more resilient health system are taking shape across Eritrea, driven by a clear focus on integration and sustainability. During engagements from 12 to 15 June 2026, WHO Regional Director for Africa, Dr Mohamed Janabi, connected with national authorities, health workers and WHO staff, gaining firsthand insight into how investments in primary health care, diagnostics, local production, and community-based services are working together to improve health outcomes and strengthen self-reliance.

At Orotta National Referral Hospital in Asmara and Keren city hospital, Dr Janabi witnessed the dedication and professionalism of frontline health workers delivering essential and lifesaving services. He noted ongoing efforts to enhance clinical care, expand access to quality services, and maintain continuity of care in a changing health landscape. These engagements highlighted the indispensable role of the health workforce in advancing universal health coverage and ensuring that quality care reaches communities across the country.

"The strength of any health system lies in its people. What impressed me most was the commitment of health workers at every level of the system and their determination to provide quality care despite challenges," said Dr Janabi.

The Regional Director also engaged with teams at the National Health Laboratory, where expanding diagnostic and genomic capacity is supporting more timely detection of diseases and strengthening evidence-based public health action. Robust laboratory systems remain essential for surveillance, preparedness, and response, forming a cornerstone of health security in Eritrea and across the African Region.

The importance of self-reliance in health systems was also evident during his engagement at Azel Pharmaceutical Manufacturing Company in Keren. There, Dr Janabi observed progress in strengthening local production of essential medicines. Expanding domestic manufacturing capacity contributes to improved availability of key health products, reduced dependence on imports, and stronger national capacity to respond to health needs.

At community level, Eritrea's barefoot doctors initiative provided a compelling illustration of the impact of primary health care. Dr Janabi saw how community health workers are extending the reach of essential services, promoting healthy behaviours, and supporting disease prevention in remote and underserved areas. Their work continues to play a fundamental role in reducing health inequities and ensuring that no community is left behind.

"What I saw in Eritrea demonstrates how a strong focus on primary health care, combined with investments in diagnostics and local production, can drive meaningful progress. These are critical foundations for stronger and more responsive health systems across our Region," said Dr Janabi.

WHO Representative in Eritrea, Dr Mary Stephen, highlighted the coherence of these efforts across different levels of the health system. "What stands out in Eritrea is the emphasis on integration-from community-based care to laboratory systems and local production. These are not isolated initiatives, but interconnected investments that reinforce one another and contribute to a stronger and more sustainable health system," she said.

The engagement also carried special significance for WHO staff in Eritrea. The President of the Staff Association welcomed the opportunity to connect with the Regional Director, noting that it marked the first visit by a WHO Regional Director to Eritrea in nearly 20 years. "We are truly pleased to welcome our Regional Director to Eritrea. His visit is a strong signal of support and recognition for the work being carried out by WHO staff in the country. It reaffirms the importance of our collective efforts to support national health priorities and improve the lives of the people we serve," said Eyob Frezghi Berhe on behalf of staff.

Reflecting on these observations, Dr Janabi emphasized the value of learning directly from country experiences. "Countries like Eritrea demonstrate that lasting progress comes from investing across the entire health system. There is much we can learn from these experiences as we work together to advance health for all in Africa," he said.

Taken together, the observations highlight the importance of integrated approaches that connect service delivery, diagnostics, workforce development, and access to essential medicines. Eritrea's experience illustrates how steady and coordinated investments across these areas can strengthen national capacity and support long-term health gains.

For WHO teams across the African Region, the lessons from Eritrea reinforce the value of building health systems anchored in primary health care, strengthened by robust diagnostic capacity, supported by a skilled workforce, and complemented by local production. These priorities remain central to advancing universal health coverage, improving health security, and ensuring that no one is left behind.