The major determinants of child health outcomes in Ethiopia : evidence of regional, religious and ethnic inequity as well as the result of general health inputs?
Derbew, Henoch Fente.
Thesis (M.P.P.)--Georgetown University, 2009.; Includes bibliographical references. The EPRDF ruling party in Ethiopia has come under much scrutiny for its governance through "ethnic federalism" following its coming to power in 1991. Much of the relevant political literature has critiqued Ethiopian federalism as a face-saving measure arguing that the Ethiopian government in reality continues to maintain a highly centralized system, focusing the country's resources to Tigray State - the home state of many in the ruling party. Using the Demographic and Health Surveys' 2005 survey in Ethiopia, I estimated six health productions functions (two national and four local - for SNNPR, Oromiya, Amhara and Tigray States) using common health variables as well as variables for region, religion and ethnicity. These models seek to identify the major determinants of health for Ethiopian children under six years old through their height-for-age z-scores (HAZs) as well as potential inequities in health throughout the country. The results confirmed that for the most part, child health was poor throughout the country, averaging -1.75 HAZ. Many of the expected determinants of health also generally held, especially mother's size which had the most significant impact on child health, though the significance of some of these inputs varied depending on if the model was national or local. In terms of region, religion and ethnicity, the results somewhat contradicted the literature. The children of Tigray State had relatively average health (averaging -1.73 HAZ) and the children of a number of other states had better health that were not expected to such as Oromiya State's (averaging -1.56 HAZ), while Amhara State's children had some of the worst health in Ethiopia (averaging -2.13 HAZ). The regression results identified significant impacts on health because of region, especially in Amhara State where HAZ decreased by .49 due to residency there, but religion and ethnicity usually yielded insignificant impacts. The quantitative analysis measuring the determinants and potential disparities in health offered by this thesis should be added to the existing literature as a starting point since it measures how and where inequities in health, and therefore living standards, likely exist rather than assuming what the sources and effects of predicted inequities are.
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Brigadier-General, Hilary F. Jaeger, MD, CHE, Chair of CCHSE's Ethics Committee, Answers the Question: How Can a Health Service Leader, Such as a Regional Health Authority Chief Executive Officer, Ensure That He or She Remains Compliant With The College's Code of Ethics When Faced With Political or Fiscal Pressure Leading to Management Decisions Which, in the Opinion of the Leader, Are Likely to Adversely Affect Real Health Outcomes? Jaeger, Hilary F. (2008-09)