Governance, Maternal Mortality and Health Systems in Ethiopia

Studies have related maternal mortality to stage of economic development and access to reproductive services. Recent research has suggested that governance in health systems is also a strong determinant of maternal health. Ethiopia has one of the highest maternal mortality rates in sub-Saharan Africa. It is also reported to have some governance indicators below the 25th percentile by global standards. Governance indicators include the following : transparency and accountability; responsiveness to client needs; safeguards against corruption and political interference; sensitivity to socio-cultural factors; political commitment and policy environment; human resources management and infrastructure; affordability and sustainability; and partnership, participation and involvement of non-health stakeholders.

This pilot study will identify the governance variables that affect access to reproductive health in Ethiopia. Researchers will interview key informants regarding community needs, expectations and availability of reproductive health care; construct a conceptual model to describe the relationship between governance of the health system and delivery of reproductive health care; engage policymakers and program managers in a problem-solving exercise; and design culturally sensitive tools and interventions for reducing maternal mortality in Ethiopia and other low- and middle-income countries.