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| Author | : Adgo Maru Tessew |
| Publisher | : |
| Total Pages | : |
| Release | : 2005 |
| Genre | : |
| ISBN | : |
| Author | : Marito Garcia |
| Publisher | : World Bank Publications |
| Total Pages | : 134 |
| Release | : 2008-02-15 |
| Genre | : Political Science |
| ISBN | : 0821373838 |
Achieving Better Service Delivery Through Decentralization in Ethiopia examines the role decentralization has played in the improvement of human development indicators in Ethiopia. Ethiopia has made major strides in improving its human development indicators in the past 15 years, achieving significant increases in the coverage of basic education and health services in a short period of time. Improvements took place during a period of massive decentralization of fiscal resources, to the regions in 1994 and to woredas in 2002-03. The devolution of power and resources from the federal and regional governments to woredas appears to have improved the delivery of basic services. Surveys of beneficiaries reveal that they perceive that service coverage and quality have improved. Beneficiary satisfaction has increased markedly in education, and less conspicuously in water and health services. In the south, the decentralization to woredas in 2002-03 tended to narrow differences in per capita expenditures on education and health across woredas. Decentralization disproportionately favored woredas that are remote (more than 50 kilometers from a zonal capital), food-insecure, and pastoral, suggesting that decentralization has been pro-poor. Decentralization also narrowed the gap in educational outcomes between disadvantage and better-off woredas, especially in the south. Pastoral, food-insecure, and remote woredas gained in terms of the educational outcomes examined (gross enrollment rates, grade 8 examination pass rates, repetition rates, pupil-teacher ratios, and teacher-section ratios).
| Author | : David H. Peters |
| Publisher | : World Bank Publications |
| Total Pages | : 366 |
| Release | : 2009 |
| Genre | : Medical |
| ISBN | : 0821379437 |
Reliable information on how health service strategies affect the poor is in short supply. In an attempt to redress the imbalance, 'Improving Health Service Delivery in Developing Countries' presents evidence on strategies for strengthening health service delivery, based on systematic reviews of the literature, quantitative and qualitative analyses of existing data, and seven country case studies. The authors also explore how changes in coverage of different health services affect each other on the national level. Finally, the authors explain why setting international targets for health services has been not been successful and offer an alternative approach based on a specific country's experience.The book's findings are clear and hopeful: There are many ways to improve health services. Measuring change and using information to guide decisions and inform stakeholders are critically important for successful implementation. Asking difficult questions, using information intelligently, and involving key stakeholders and institutions are central to the "learning and doing" practices that underlie successful health service delivery.
| Author | : Sameh El-Saharty |
| Publisher | : |
| Total Pages | : |
| Release | : 2013 |
| Genre | : |
| ISBN | : |
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.
| Author | : Saltman, Richard |
| Publisher | : McGraw-Hill Education (UK) |
| Total Pages | : 327 |
| Release | : 2006-12-01 |
| Genre | : Education |
| ISBN | : 033521925X |
Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.
| Author | : World Bank |
| Publisher | : World Bank Publications |
| Total Pages | : 114 |
| Release | : 2005-01-01 |
| Genre | : Business & Economics |
| ISBN | : 0821362429 |
African countries need to improve the performance of their public sectors if they are going to achieve their goals of growth, poverty reduction, and the provision of better services for their citizens. Between 1995 and 2004, the Bank provided some $9 billion in lending and close to $900 million in grants and administrative budget to support public sector capacity building in Africa. This evaluation assesses Bank support for public sector capacity building in Africa over these past 10 years. It is based on six country studies, assessments of country strategies and operations across the Region, and review of the work of the World Bank Institute, the Institutional Development Fund, and the Bank-supported African Capacity Building Foundation.
| Author | : Madhushree Sekher |
| Publisher | : Springer |
| Total Pages | : 249 |
| Release | : 2018-01-08 |
| Genre | : Political Science |
| ISBN | : 9811059632 |
Building, largely, on insights from India, and case studies in Brazil, China, and South Africa, this book provides insights into the contested topic of ‘governance and governed’ from a state–society inter-relationship perspective. It argues that the centrality of an understanding of state-governance today is rooted in concerns regarding diversities and contingencies of concrete political reality to address inequalities, exclusion and vulnerabilities. These countries are part of the BRICSs consortium, and have been recognised for their growth potential in the world economy. But their economic progress alone may not necessarily translate into a better quality of life. The approach here is not to focus on a particular understanding of governance, but to utilise a wider lens to understand the nature and extent of incremental processes in the different case-study contexts in order to offer a broader framework for procedural and substantive understanding of governance, rather than a prescription of a government and its activity of governing. The focus is on deriving practical lessons about governance process that are of interest to the wider development community.
| Author | : R. Paul Shaw |
| Publisher | : World Bank Publications |
| Total Pages | : 188 |
| Release | : 2007-01-01 |
| Genre | : Business & Economics |
| ISBN | : 0821369504 |
Specialist groups have often advised health ministers and other decision makers in developing countries on the use of social health insurance (SHI) as a way of mobilizing revenue for health, reforming health sector performance, and providing universal coverage. This book reviews the specific design and implementation challenges facing SHI in low- and middle-income countries and presents case studies on Ghana, Kenya, Philippines, Colombia, and Thailand.
| Author | : Taye Assefa |
| Publisher | : African Books Collective |
| Total Pages | : 175 |
| Release | : 2007 |
| Genre | : Central-local government relations |
| ISBN | : 9994450115 |
The 1991 government change in Ethiopia ushered in a centralised system of governance, aimed to bring about harmony and cooperation between different groups and to promote local self-rule. It has proceeded in two phases: 1991-2001 centred on creating and powering National/Regional Governments, termed mid-level decentralisation. Further powers were devolved in 2001 through the District Level Decentralization Program and Urban Management Profram. This volume brings together studies by the Forum for Social Studies and others, with the aim of identifying knowledge gaps for further research and to generate debate on the issues in Ethiopia. The study is in two parts: a literature review seeking to document existing studies and highlight research gaps; and field work which involved a rapid assessment of eight weredas and two kifle ketemas in Addis Ababa. The other three studies are synopses of master theses submitted to the Institute of Regional and Local Development Studies of Addis Ababa University.
| Author | : Huihui Wang |
| Publisher | : World Bank Publications |
| Total Pages | : 121 |
| Release | : 2016-04-25 |
| Genre | : Medical |
| ISBN | : 1464808163 |
As a low-income country, Ethiopia has made impressive progress in improving health outcomes. This report examines how Ethiopia s Health Extension Program (HEP) has contributed to the country s move toward Univeral Health Coverage (UHC), and to shed light on how other countries may learn from Ethiopia s experiences of HEP when designing their own path to UHC. HEP is one of the government s UHC strategies introduced in a context of limited resources and low coverage of essential health services. The key aspects of the program include the capacity building and mobilization of more than 30, 000 Health Extension Workers (HEWs) targeting more than 12 million model families, and the mobilization of health development army ? to support the community-based health system. Using the HEP-UHC conceptual model and data from Demographic and Health Surveys, the study examines how the HEP has contributed to the country s move toward UHC. During the period that the HEP has been implemented, the country has experienced significant improvements in many dimensions: in terms of socioeconomic, psychological, behavioral, and biological dimensions of the beneficiaries; and in terms of the coverage of health care services. The study finds an accelerated rate of improvements among the rural, less-educated, and the poor population, which is leading to an overall reduction in equity gaps and improvements in the equity indicators including the concentration indices - that suggest a more equitable distribution of resources and health outcomes. The HEP in Ethiopia has demonstrated that an institutionalized community approach is effective in helping a country make progress toward UHC. The elements of success in the HEP include the emphasis on community mobilization which identifies community priorities, engages and empowers community members, and supports their ability to solve local problems. The other aspect of HEP is the emphasis on institutionalization of the activities, which addresses the sustainability of community programs through high level of political commitment, and effective coordination of national policies and leveraging of support from partners. These findings may offer useful lessons for other low income countries facing similar challenges in developing and implementing a sustainable UHC strategy.
