What must an employer pay for in Ethiopia?
| Duty | What it covers | In the law |
|---|---|---|
| Pre-employment medical exam | Paid by the employer when the work requires it; never an HIV test | Art. 92, Proclamation 1156/2019 |
| Exams for hazardous jobs | Paid by the employer | Art. 92 |
| Work injury | Medical and surgical care, hospital, medicines, prosthetic or orthopaedic appliances | Art. 105 |
| Sick leave | Up to 6 months: 1 on full pay, 2 on half pay, 3 unpaid | Art. 85 |
| Safety | Safety officer, safety and health committee, protective equipment, accident reports | Art. 92 |
Is health insurance mandatory for employees in Ethiopia?
Not yet for most private employers. Social health insurance (SHI) for formal-sector workers, planned since 2010, provides for a contribution of 3% of salary from the employee and 3% from the employer. Its rollout has been postponed several times.
The Ethiopian Health Insurance Service (EHIS) started with public health-sector staff and runs an online portal for employers. Ask EHIS whether, and when, your company must register.
Community-based health insurance (CBHI) is for households in the informal sector, not for salaried staff.
Which cover should you choose for your staff?
These options stack: the law first, then insurance or a programme. In Addis Ababa, Medyc builds company health programmes: video consultations, appointments at partner facilities, medicines and tests, with services and budget agreed in writing.
| Option | What it pays for | Watch out for |
|---|---|---|
| Legal minimum only | Hiring exams, work-injury care, sick pay | Staff pay for everyday care themselves |
| SHI, once it applies | Care at contracted facilities | 3% + 3% of salary; check with EHIS |
| Private group medical insurance | Outpatient and hospital care, within limits | Limits, exclusions, existing conditions |
| Company health programme | Quick access to a doctor, check-ups, chronic care, lab tests | Adds to insurance, does not replace legal duties |
How do you check that an insurer is licensed?
The National Bank of Ethiopia supervises insurers and publishes the list of licensed companies. It includes Awash, Nyala, Nile, Africa, Oromia and Zemen Insurance, National Insurance Company of Ethiopia and Ethiopian Insurance Corporation.
Ask every insurer, or a licensed broker, the same questions and get the answers in writing:
- Who is covered: staff only, or spouses and children too?
- Which limits and exclusions apply, including existing conditions?
- Which hospitals and labs in Addis Ababa bill the insurer directly?
- What is the price per employee, and how does it change at renewal?
- What reports does the company get? Usage figures, never diagnoses.
Your questions, answered
Do private companies have to insure their employees in Ethiopia?
Not yet in practice: social health insurance for formal-sector staff is still being rolled out. Hiring exams, work-injury care and sick pay are compulsory now.
What is the social health insurance contribution rate in Ethiopia?
A planned 6% of monthly salary: 3% paid by the employee and 3% by the employer.
Who pays for a pre-employment medical exam in Ethiopia?
The employer, when the nature of the work calls for it. The exam may not include an HIV test.
How much sick leave does an employee get in Ethiopia?
Up to six months with a medical certificate: the first month on full pay, the next two on half pay, the last three unpaid.
Sources & further reading
- Ministry of Justice of Ethiopia: Labour Proclamation No. 1156/2019
- Ministry of Justice of Ethiopia: Social Health Insurance Proclamation No. 690/2010
- Ministry of Health Ethiopia: Ethiopian health insurance
- Ethiopian Health Insurance Service: CBHI and SHI
- EHIS: social health insurance portal
- National Bank of Ethiopia: licensed insurers
- Commonwealth Fund: Ethiopia health system profile (2026)
- Capital: social health insurance rollout
- Ethiopian Red Cross Society: ambulance services (907)
- Medyc: employee health in Addis Ababa
This guide explains how to organise care. It does not provide a diagnosis or individual medical advice. How we write our guides
