For the purposes of the SHI scheme, “formal sector” refers to enterprises that employ more than ten individuals, a definition which excludes a large proportion of the population. Total expenditure increased steadily from ETB 0.1 million in 2012/13 to ETB 47.9 million in 2015/16. Management and administration initially accounted for the majority of expenditure but the system development’s share of spending increased after 2014/15 and accounted for over 57% of total SHI expenditure in 2015/16.