Ethiopia : Improving Health Service Delivery

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collection.link.221
https://openknowledge.worldbank.org/handle/10986/12995
collection.name.221
Health, Nutrition and Population (HNP) Discussion Papers
dc.contributor.author
El-Saharty, Sameh
dc.contributor.author
Kebede, Sosena
dc.contributor.author
Olango Dubusho, Petros
dc.contributor.author
Siadat, Banafsheh
dc.date.accessioned
2013-05-30T17:17:25Z
dc.date.available
2013-05-30T17:17:25Z
dc.date.issued
2009-08
dc.date.lastModified
2017-12-13T12:28:10Z
dc.description.abstract
This 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.identifier
http://documents.worldbank.org/curated/en/2009/08/12315410/ethiopia-improving-health-service-delivery
dc.identifier.uri
http://hdl.handle.net/10986/13695
dc.language
English
dc.language.iso
en_US
dc.publisher
World Bank, Washington, DC
dc.relation.ispartofseries
Health, Nutrition and Population (HNP) discussion paper;
dc.rights
CC BY 3.0 IGO
dc.rights.holder
World Bank
dc.rights.uri
http://creativecommons.org/licenses/by/3.0/igo/
dc.subject
ABORTION
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ADULT MORTALITY
dc.subject
AIDS RELIEF
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ALLOCATIVE EFFICIENCY
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ANTENATAL CARE
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BASIC HEALTH SERVICES
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BEREAVEMENT
dc.subject
BURDEN OF DISEASE
dc.subject
CAESAREAN SECTION
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CAPACITY BUILDING
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CHILD BIRTH
dc.subject
CHILD HEALTH
dc.subject
CHILD HEALTH SERVICES
dc.subject
CHILD NUTRITION
dc.subject
CHILD SURVIVAL
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CITIES
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CITIZENS
dc.subject
CLINICS
dc.subject
COMMUNICABLE DISEASES
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COMMUNITY HEALTH
dc.subject
COMMUNITY HEALTH SERVICES
dc.subject
CONTRACEPTIVE METHODS
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CONTRACEPTIVES
dc.subject
COUNSELING
dc.subject
DEATHS
dc.subject
DEBT
dc.subject
DECENTRALIZATION OF AUTHORITY
dc.subject
DECISION MAKING
dc.subject
DEMOCRACY
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DEVELOPING COUNTRIES
dc.subject
DEVELOPMENT POLICY
dc.subject
DIPHTHERIA
dc.subject
DRINKING WATER
dc.subject
EDUCATIONAL ATTAINMENT
dc.subject
EMERGENCY PLAN
dc.subject
EMPLOYMENT
dc.subject
EQUITABLE ACCESS
dc.subject
ESSENTIAL DRUGS
dc.subject
FAMILY PLANNING
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FAMILY PLANNING SERVICES
dc.subject
FEMALE CHILDREN
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FERTILITY DECLINE
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FINANCIAL MANAGEMENT
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FINANCIAL NEEDS
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GENERAL PRACTITIONERS
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GLOBAL HEALTH
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GOOD GOVERNANCE
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GOVERNMENT POLICIES
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GRASS-ROOTS
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GROSS DOMESTIC PRODUCT
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HEALTH CARE
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HEALTH CARE COVERAGE
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HEALTH CARE FACILITIES
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HEALTH CARE FINANCING
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HEALTH CARE SPENDING
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HEALTH CARE UTILIZATION
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HEALTH CARE WORKERS
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HEALTH CENTERS
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HEALTH COMMUNICATION
dc.subject
HEALTH EDUCATION
dc.subject
HEALTH EXPENDITURE
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HEALTH EXPENDITURES
dc.subject
HEALTH EXTENSION
dc.subject
HEALTH FACILITIES
dc.subject
HEALTH FINANCING
dc.subject
HEALTH INDICATORS
dc.subject
HEALTH INFORMATION
dc.subject
HEALTH INSURANCE
dc.subject
HEALTH MANAGEMENT
dc.subject
HEALTH ORGANIZATION
dc.subject
HEALTH OUTCOMES
dc.subject
HEALTH POLICIES
dc.subject
HEALTH POLICY
dc.subject
HEALTH POSTS
dc.subject
HEALTH PROGRAMS
dc.subject
HEALTH PROVIDERS
dc.subject
HEALTH SECTOR
dc.subject
HEALTH SERVICE
dc.subject
HEALTH SERVICE DELIVERY
dc.subject
HEALTH SERVICE PROVIDERS
dc.subject
HEALTH SERVICES
dc.subject
HEALTH SPECIALIST
dc.subject
HEALTH STATUS
dc.subject
HEALTH SYSTEM
dc.subject
HEALTH SYSTEMS
dc.subject
HEALTH WORKERS
dc.subject
HIGH FERTILITY
dc.subject
HIGH FERTILITY RATE
dc.subject
HIV
dc.subject
HIV INFECTION
dc.subject
HIV/AIDS
dc.subject
HOSPITAL
dc.subject
HOSPITAL ADMISSION
dc.subject
HOSPITAL ADMISSIONS
dc.subject
HOSPITALS
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HUMAN DEVELOPMENT
dc.subject
HUMAN RESOURCE DEVELOPMENT
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HUMAN RESOURCE MANAGEMENT
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HUMAN RESOURCES
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HUMAN RESOURCES DEVELOPMENT
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HYGIENE
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ILLNESS
dc.subject
IMMUNIZATION
dc.subject
INCOME
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INFANT
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INFANT MORTALITY
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INFANT MORTALITY RATE
dc.subject
INFANT MORTALITY RATES
dc.subject
INFORMATION SYSTEM
dc.subject
INFORMATION SYSTEMS
dc.subject
INSTITUTIONAL CAPACITY
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INSURANCE SCHEMES
dc.subject
INTERNATIONAL COMPARISONS
dc.subject
INTERNATIONAL ORGANIZATIONS
dc.subject
LABOR FORCE
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LACK OF CAPACITY
dc.subject
LAWS
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LEGAL STATUS
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LIFE EXPECTANCY
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LIVE BIRTHS
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LOCAL COMMUNITY
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LOCAL GOVERNMENTS
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LOW -INCOME COUNTRIES
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LOW-INCOME COUNTRIES
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LOW-INCOME COUNTRY
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MALARIA
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MALNUTRITION AMONG CHILDREN
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MASS MEDIA
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MATERNAL MORTALITY
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MATERNAL MORTALITY RATIO
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MEASLES
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MEDICAL DOCTORS
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MEDICAL EDUCATION
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MEDICAL EQUIPMENT
dc.subject
MEDICAL SUPPLIES
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MEDICAL TECHNOLOGY
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MEDICINES
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MIDWIFE
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MIDWIVES
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MIGRATION
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MILLENNIUM DEVELOPMENT GOALS
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MINISTRY OF HEALTH
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MORBIDITY
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MORTALITY
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MOSQUITO NET
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MULTILATERAL ORGANIZATIONS
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NATIONAL DRUG
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NATIONAL GOALS
dc.subject
NATIONAL HEALTH POLICY
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NATIONAL LEVEL
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NATIONAL POLICY
dc.subject
NATIONAL POPULATION
dc.subject
NATIONAL POPULATION POLICY
dc.subject
NATIONAL STRATEGY
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NEONATAL MORTALITY
dc.subject
NUMBER OF CHILDREN
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NUMBER OF DEATHS
dc.subject
NURSE
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NURSES
dc.subject
NUTRITION
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NUTRITIONAL STATUS
dc.subject
PATIENTS
dc.subject
PHARMACIES
dc.subject
PHYSICIAN
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PHYSICIANS
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POLICY MAKERS
dc.subject
POLIO
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POPULATION CENSUS
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POPULATION SIZE
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POSTNATAL CARE
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PREGNANCY
dc.subject
PRIMARY CARE
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PRIMARY HEALTH CARE
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PRIMARY HEALTH CARE SERVICES
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PRIVATE PHARMACIES
dc.subject
PROGRESS
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PUBLIC HEALTH
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PUBLIC HEALTH EXPENDITURES
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PUBLIC HEALTH SERVICES
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PUBLIC HEALTH SPENDING
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PUBLIC POLICY
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PUBLIC SERVICE
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PUBLIC SERVICES
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PUBLIC SPHERE
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QUALITY OF CARE
dc.subject
QUALITY OF HEALTH
dc.subject
RADIO
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REHABILITATION
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REPRODUCTIVE HEALTH
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REPRODUCTIVE HEALTH SERVICES
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RESPECT
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RULE OF LAW
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RURAL AREAS
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RURAL DEVELOPMENT
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SANITATION
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SERVICE UTILIZATION
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SEXUALLY TRANSMITTED DISEASES
dc.subject
SKILLED PROFESSIONALS
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SKILLED STAFF
dc.subject
SOCIAL SERVICES
dc.subject
SURGERY
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SUSTAINABLE DEVELOPMENT
dc.subject
TB CONTROL
dc.subject
TELEVISION
dc.subject
TETANUS
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TUBERCULOSIS
dc.subject
UNDER FIVE MORTALITY
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UNDER-FIVE MORTALITY
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URBAN AREAS
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URBAN POPULATION
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URBANIZATION
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URBANIZED COUNTRIES
dc.subject
USE OF CONTRACEPTION
dc.subject
VACCINATION
dc.subject
WASTE
dc.subject
WOMAN
dc.subject
WORKERS
dc.subject
WORKING CONDITIONS
dc.subject
WORLD HEALTH ORGANIZATION
dc.title
Ethiopia : Improving Health Service Delivery
en
okr.crosscuttingsolutionarea
Gender
okr.doctype
Publications & Research :: Working Paper
okr.doctype
Publications & Research
okr.docurl
http://documents.worldbank.org/curated/en/2009/08/12315410/ethiopia-improving-health-service-delivery
okr.globalpractice
Health, Nutrition, and Population
okr.googlescholar.linkpresent
yes
okr.identifier.externaldocumentum
000333037_20100525033338
okr.identifier.internaldocumentum
12315410
okr.identifier.report
54630
okr.language.supported
en
okr.pdfurl
http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2010/05/25/000333037_20100525033338/Rendered/PDF/546300WP0Ethio10Box349423B01PUBLIC1.pdf
en
okr.region.administrative
Africa
okr.region.country
Ethiopia
okr.topic
Health, Nutrition and Population :: Population Policies
okr.topic
Health Economics and Finance
okr.topic
Health Monitoring and Evaluation
okr.topic
Health Systems Development and Reform
okr.topic
Gender :: Gender and Health
okr.unit
Human Development Network
okr.volume
1 of 1

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