Publication:
Ethiopia : Improving Health Service Delivery

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dc.contributor.authorKebede, Sosena
dc.contributor.authorEl-Saharty, Sameh
dc.contributor.authorOlango Dubusho, Petros
dc.contributor.authorSiadat, Banafsheh
dc.date.accessioned2013-05-30T17:17:25Z
dc.date.available2013-05-30T17:17:25Z
dc.date.issued2009-08
dc.description.abstractThis case study aims to identify how Ethiopia has adopted and implemented strategies to improve health services, including the factors that enabled and inhibited success across a meaningful range of health services for the period 1996-2006. Particular emphasis has been given to the impact of utilized strategies on the poor. This case study reviewed one 'primary strategy', decentralization in the form of devolution of authority to the regional level in 1996 and to the district (woreda) level in 2002, and seven 'corollary strategies' in the context of decentralization implemented at the subnational level. The study concludes that decentralization in the health sector is likely to be more effective when it is implemented as part of a broader government decentralization policy across sectors. Sequencing in implementing Ethiopia's decentralization strategy made decentralization more manageable, although decentralization was rolled out prematurely. Moreover, the effectiveness of implementation was found to be driven largely by the institutional and management capacity at the subnational level. At the subnational level, decentralization was found to be more effective in those regions that increasingly strengthened their management and institutional capacity and where regional governments set priorities and adapted the strategies to local needs. However, decentralization was often influenced by the 'clientelistic' center, region power relationship, a problem compounded by the lack of community voice, making the available resources at risk of political capture by the local elite. Overall, the key lesson for implementing improvements in health service delivery (HSD) is that the lack of any critical inputs (facilities, health workers, and drugs) inevitably limits the overall impact of the strategy, and that the implementation of such key inputs should be carefully coordinated and properly synchronized.en
dc.identifierhttp://documents.worldbank.org/curated/en/2009/08/12315410/ethiopia-improving-health-service-delivery
dc.identifier.doi10.1596/13695
dc.identifier.urihttps://hdl.handle.net/10986/13695
dc.languageEnglish
dc.language.isoen_US
dc.publisherWorld Bank, Washington, DC
dc.relation.ispartofseriesHealth, Nutrition and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectABORTION
dc.subjectADULT MORTALITY
dc.subjectAIDS RELIEF
dc.subjectALLOCATIVE EFFICIENCY
dc.subjectANTENATAL CARE
dc.subjectBASIC HEALTH SERVICES
dc.subjectBEREAVEMENT
dc.subjectBURDEN OF DISEASE
dc.subjectCAESAREAN SECTION
dc.subjectCAPACITY BUILDING
dc.subjectCHILD BIRTH
dc.subjectCHILD HEALTH
dc.subjectCHILD HEALTH SERVICES
dc.subjectCHILD NUTRITION
dc.subjectCHILD SURVIVAL
dc.subjectCITIES
dc.subjectCITIZENS
dc.subjectCLINICS
dc.subjectCOMMUNICABLE DISEASES
dc.subjectCOMMUNITY HEALTH
dc.subjectCOMMUNITY HEALTH SERVICES
dc.subjectCONTRACEPTIVE METHODS
dc.subjectCONTRACEPTIVES
dc.subjectCOUNSELING
dc.subjectDEATHS
dc.subjectDEBT
dc.subjectDECENTRALIZATION OF AUTHORITY
dc.subjectDECISION MAKING
dc.subjectDEMOCRACY
dc.subjectDEVELOPING COUNTRIES
dc.subjectDEVELOPMENT POLICY
dc.subjectDIPHTHERIA
dc.subjectDRINKING WATER
dc.subjectEDUCATIONAL ATTAINMENT
dc.subjectEMERGENCY PLAN
dc.subjectEMPLOYMENT
dc.subjectEQUITABLE ACCESS
dc.subjectESSENTIAL DRUGS
dc.subjectFAMILY PLANNING
dc.subjectFAMILY PLANNING SERVICES
dc.subjectFEMALE CHILDREN
dc.subjectFERTILITY DECLINE
dc.subjectFINANCIAL MANAGEMENT
dc.subjectFINANCIAL NEEDS
dc.subjectGENERAL PRACTITIONERS
dc.subjectGLOBAL HEALTH
dc.subjectGOOD GOVERNANCE
dc.subjectGOVERNMENT POLICIES
dc.subjectGRASS-ROOTS
dc.subjectGROSS DOMESTIC PRODUCT
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE COVERAGE
dc.subjectHEALTH CARE FACILITIES
dc.subjectHEALTH CARE FINANCING
dc.subjectHEALTH CARE SPENDING
dc.subjectHEALTH CARE UTILIZATION
dc.subjectHEALTH CARE WORKERS
dc.subjectHEALTH CENTERS
dc.subjectHEALTH COMMUNICATION
dc.subjectHEALTH EDUCATION
dc.subjectHEALTH EXPENDITURE
dc.subjectHEALTH EXPENDITURES
dc.subjectHEALTH EXTENSION
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH FINANCING
dc.subjectHEALTH INDICATORS
dc.subjectHEALTH INFORMATION
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH MANAGEMENT
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH POLICIES
dc.subjectHEALTH POLICY
dc.subjectHEALTH POSTS
dc.subjectHEALTH PROGRAMS
dc.subjectHEALTH PROVIDERS
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICE
dc.subjectHEALTH SERVICE DELIVERY
dc.subjectHEALTH SERVICE PROVIDERS
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SPECIALIST
dc.subjectHEALTH STATUS
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEMS
dc.subjectHEALTH WORKERS
dc.subjectHIGH FERTILITY
dc.subjectHIGH FERTILITY RATE
dc.subjectHIV
dc.subjectHIV INFECTION
dc.subjectHIV/AIDS
dc.subjectHOSPITAL
dc.subjectHOSPITAL ADMISSION
dc.subjectHOSPITAL ADMISSIONS
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCE DEVELOPMENT
dc.subjectHUMAN RESOURCE MANAGEMENT
dc.subjectHUMAN RESOURCES
dc.subjectHUMAN RESOURCES DEVELOPMENT
dc.subjectHYGIENE
dc.subjectILLNESS
dc.subjectIMMUNIZATION
dc.subjectINCOME
dc.subjectINFANT
dc.subjectINFANT MORTALITY
dc.subjectINFANT MORTALITY RATE
dc.subjectINFANT MORTALITY RATES
dc.subjectINFORMATION SYSTEM
dc.subjectINFORMATION SYSTEMS
dc.subjectINSTITUTIONAL CAPACITY
dc.subjectINSURANCE SCHEMES
dc.subjectINTERNATIONAL COMPARISONS
dc.subjectINTERNATIONAL ORGANIZATIONS
dc.subjectLABOR FORCE
dc.subjectLACK OF CAPACITY
dc.subjectLAWS
dc.subjectLEGAL STATUS
dc.subjectLIFE EXPECTANCY
dc.subjectLIVE BIRTHS
dc.subjectLOCAL COMMUNITY
dc.subjectLOCAL GOVERNMENTS
dc.subjectLOW -INCOME COUNTRIES
dc.subjectLOW-INCOME COUNTRIES
dc.subjectLOW-INCOME COUNTRY
dc.subjectMALARIA
dc.subjectMALNUTRITION AMONG CHILDREN
dc.subjectMASS MEDIA
dc.subjectMATERNAL MORTALITY
dc.subjectMATERNAL MORTALITY RATIO
dc.subjectMEASLES
dc.subjectMEDICAL DOCTORS
dc.subjectMEDICAL EDUCATION
dc.subjectMEDICAL EQUIPMENT
dc.subjectMEDICAL SUPPLIES
dc.subjectMEDICAL TECHNOLOGY
dc.subjectMEDICINES
dc.subjectMIDWIFE
dc.subjectMIDWIVES
dc.subjectMIGRATION
dc.subjectMILLENNIUM DEVELOPMENT GOALS
dc.subjectMINISTRY OF HEALTH
dc.subjectMORBIDITY
dc.subjectMORTALITY
dc.subjectMOSQUITO NET
dc.subjectMULTILATERAL ORGANIZATIONS
dc.subjectNATIONAL DRUG
dc.subjectNATIONAL GOALS
dc.subjectNATIONAL HEALTH POLICY
dc.subjectNATIONAL LEVEL
dc.subjectNATIONAL POLICY
dc.subjectNATIONAL POPULATION
dc.subjectNATIONAL POPULATION POLICY
dc.subjectNATIONAL STRATEGY
dc.subjectNEONATAL MORTALITY
dc.subjectNUMBER OF CHILDREN
dc.subjectNUMBER OF DEATHS
dc.subjectNURSE
dc.subjectNURSES
dc.subjectNUTRITION
dc.subjectNUTRITIONAL STATUS
dc.subjectPATIENTS
dc.subjectPHARMACIES
dc.subjectPHYSICIAN
dc.subjectPHYSICIANS
dc.subjectPOLICY MAKERS
dc.subjectPOLIO
dc.subjectPOPULATION CENSUS
dc.subjectPOPULATION SIZE
dc.subjectPOSTNATAL CARE
dc.subjectPREGNANCY
dc.subjectPRIMARY CARE
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIMARY HEALTH CARE SERVICES
dc.subjectPRIVATE PHARMACIES
dc.subjectPROGRESS
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH EXPENDITURES
dc.subjectPUBLIC HEALTH SERVICES
dc.subjectPUBLIC HEALTH SPENDING
dc.subjectPUBLIC POLICY
dc.subjectPUBLIC SERVICE
dc.subjectPUBLIC SERVICES
dc.subjectPUBLIC SPHERE
dc.subjectQUALITY OF CARE
dc.subjectQUALITY OF HEALTH
dc.subjectRADIO
dc.subjectREHABILITATION
dc.subjectREPRODUCTIVE HEALTH
dc.subjectREPRODUCTIVE HEALTH SERVICES
dc.subjectRESPECT
dc.subjectRULE OF LAW
dc.subjectRURAL AREAS
dc.subjectRURAL DEVELOPMENT
dc.subjectSANITATION
dc.subjectSERVICE UTILIZATION
dc.subjectSEXUALLY TRANSMITTED DISEASES
dc.subjectSKILLED PROFESSIONALS
dc.subjectSKILLED STAFF
dc.subjectSOCIAL SERVICES
dc.subjectSURGERY
dc.subjectSUSTAINABLE DEVELOPMENT
dc.subjectTB CONTROL
dc.subjectTELEVISION
dc.subjectTETANUS
dc.subjectTUBERCULOSIS
dc.subjectUNDER FIVE MORTALITY
dc.subjectUNDER-FIVE MORTALITY
dc.subjectURBAN AREAS
dc.subjectURBAN POPULATION
dc.subjectURBANIZATION
dc.subjectURBANIZED COUNTRIES
dc.subjectUSE OF CONTRACEPTION
dc.subjectVACCINATION
dc.subjectWASTE
dc.subjectWOMAN
dc.subjectWORKERS
dc.subjectWORKING CONDITIONS
dc.subjectWORLD HEALTH ORGANIZATION
dc.titleEthiopia : Improving Health Service Deliveryen
dspace.entity.typePublication
okr.crosscuttingsolutionareaGender
okr.date.doiregistration2025-05-05T12:37:02.134084Z
okr.doctypePublications & Research::Working Paper
okr.doctypePublications & Research
okr.docurlhttp://documents.worldbank.org/curated/en/2009/08/12315410/ethiopia-improving-health-service-delivery
okr.globalpracticeHealth, Nutrition, and Population
okr.guid376001468252882515
okr.identifier.externaldocumentum000333037_20100525033338
okr.identifier.internaldocumentum12315410
okr.identifier.report54630
okr.language.supporteden
okr.pdfurlhttp://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2010/05/25/000333037_20100525033338/Rendered/PDF/546300WP0Ethio10Box349423B01PUBLIC1.pdfen
okr.region.administrativeAfrica
okr.region.countryEthiopia
okr.topicHealth, Nutrition and Population::Population Policies
okr.topicHealth Economics and Finance
okr.topicHealth Monitoring and Evaluation
okr.topicHealth Systems Development and Reform
okr.topicGender::Gender and Health
okr.unitHuman Development Network
okr.volume1 of 1
relation.isAuthorOfPublication57583414-120b-579d-afb9-8245151f9cf0
relation.isAuthorOfPublication.latestForDiscovery57583414-120b-579d-afb9-8245151f9cf0
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