Abstract

Addressing health inequalities is a pressing global challenge especially in low- and middle-income countries like Ethiopia, where research on ethno-regional health inequalities is notably limited. This thesis investigates the role of the broader politicaleconomic environment and public policy practices in perpetuating regional inequalities in child health in Ethiopia from 2000 to 2016.
The study adopts a political economy lens to explore spatial child health inequalities, utilizing a retrospective policy analysis and a case study approach that includes interviews with policy actors and an examination of policy documents. The study identifies several interrelated factors contributing to persistent regional child health inequalities. Firstly, the historical context of governance and public policies has led to systemic disadvantages for certain regions and population groups. Secondly, shortcomings in institutional frameworks, notably governance at federal and regional level state institutions, have intensified these health inequalities. Thirdly, the influence of political ideologies and informal power dynamics has skewed resource allocation and decision-making processes, often disadvantaging marginalized groups.
The thesis also critiques Ethiopian policy design and implementation, noting a failure to integrate a strong equity focus, which has further perpetuated regional health inequalities. Additionally, it highlights the insufficient role of global governance actors in promoting equity-sensitive policies, attributing this to a lack of consistent, globally recommended pragmatic policy actions to advance an equity agenda in contexts like Ethiopia.
In conclusion, the study finds that Ethiopian public policy tends to prioritize overall health improvements (efficiency) over an equity-centred approach. It underscores the need for more rigorous attention to equity in the development and implementation of public policies, both in Ethiopia and other similar contexts. By prioritizing equity, governments, international organizations, and various stakeholders can more effectively tackle regional health inequalities and progress towards universal health equity.