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Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia

BACKGROUND: Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approac...

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Autores principales: Tadesse, Amare Worku, Gurmu, Kassu Ketema, Kebede, Selamawit Tesfaye, Habtemariam, Mahlet Kifle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074348/
https://www.ncbi.nlm.nih.gov/pubmed/33902625
http://dx.doi.org/10.1186/s12992-021-00702-7
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author Tadesse, Amare Worku
Gurmu, Kassu Ketema
Kebede, Selamawit Tesfaye
Habtemariam, Mahlet Kifle
author_facet Tadesse, Amare Worku
Gurmu, Kassu Ketema
Kebede, Selamawit Tesfaye
Habtemariam, Mahlet Kifle
author_sort Tadesse, Amare Worku
collection PubMed
description BACKGROUND: Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. METHODS: We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. RESULTS: Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. CONCLUSIONS: Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system.
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spelling pubmed-80743482021-04-26 Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia Tadesse, Amare Worku Gurmu, Kassu Ketema Kebede, Selamawit Tesfaye Habtemariam, Mahlet Kifle Global Health Research BACKGROUND: Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. METHODS: We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. RESULTS: Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. CONCLUSIONS: Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system. BioMed Central 2021-04-26 /pmc/articles/PMC8074348/ /pubmed/33902625 http://dx.doi.org/10.1186/s12992-021-00702-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Tadesse, Amare Worku
Gurmu, Kassu Ketema
Kebede, Selamawit Tesfaye
Habtemariam, Mahlet Kifle
Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia
title Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia
title_full Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia
title_fullStr Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia
title_full_unstemmed Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia
title_short Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia
title_sort analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from ethiopia
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074348/
https://www.ncbi.nlm.nih.gov/pubmed/33902625
http://dx.doi.org/10.1186/s12992-021-00702-7
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