UNDERSTANDING MULTISECTORAL COLLABORATION FOR STRENGTHENING PUBLIC HEALTH CAPACITIES IN ETHIOPIA

Abstract

Background: Multisectoral collaboration is critical to capacity strengthening efforts for improved global health security, enabling stakeholders to achieve successes they may be unable to attain alone. While there has been some study of multisectoral collaboration, little is known about how it occurs for strengthening public health capacities in low-income settings, including factors influencing collaboration strength. A multiple case study design was utilized to explore multisectoral collaboration in Ethiopia for strengthening public health capacities in two cases: public health emergency preparedness (PHEP) and zoonotic diseases (ZD). Methods: Document analysis and in-depth interviews (IDIs) identified stakeholders for each of the cases and mapped stakeholder roles and responsibilities (Paper 1). IDIs also explored how collaboration occurs for public health capacity development and perceived collaboration barriers and facilitators (Paper 2). Finally, an expert panel review and IDI data were used to adapt a collaboration strength assessment tool for Ethiopia’s context (Paper 3). Results: 42 documents were reviewed for a preliminary understanding of multisectoral collaboration for public health capacity development in Ethiopia. Across PHEP and ZD, 39 individuals from 23 stakeholder organizations were interviewed. Ethiopian government stakeholders were viewed as leading capacity development approaches. Stakeholders perceived multisectoral collaboration as critical to capacity development efforts; platforms convening sectors for planning and implementing activities, such as the National One Health Steering Committee, were important collaboration facilitators. To strengthen collaboration, improved awareness and commitment to its importance is needed among decision-makers in the public health capacity development environment. Institutionalizing multisectoral collaboration can affirm political buy-in at the highest levels of country leadership and reinforce expectations that such collaboration efforts align with Ethiopia’s priorities. Stakeholder organizations also need a common understanding of roles and responsibilities in collaboration efforts and strengthened communication for related activities and contributions. Addressing these gaps can improve accountability, sustainability, and trust for multisectoral collaboration efforts. Conclusion: Research findings can improve understanding of how multisectoral collaboration occurs in Ethiopia for public health capacity development. This research also began the adaptation process for a collaboration assessment tool for Ethiopia’s context. This tool can be further adapted to understand and improve collaboration in Ethiopia and other settings.