Assessing the policy and institutional framework for multisectoral governance and accountability in emergency preparedness and response in Ethiopia

Bibliographic Data

ID23312553
AuthorsSileshi Demelash (0000-0002-7273-8923, Ethiopian Public Health Institute, corresponding author), Melkamu Asrat Alava (Ethiopian Public Health Institute), Lensa Fekadu (Ethiopian Public Health Institute), Haymanot Firdie (Ethiopian Public Health Institute), Neima Zeynu Ali (Ethiopian Public Health Institute), Tarekegn Solomon (0000-0003-0923-2740, Ethiopian Public Health Institute), Melkamu Abte Afele (Ethiopian Public Health Institute)
EditorsVeena Sriram (0000-0002-7465-5881)
Year2026
Volume6
Issue7
Pagese0006915
Publication date2026-07-24
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0006915
PMID42497143
OpenAlexW7170527600
LanguageEN
References cited52

Public health emergencies place sustained pressure on health systems, particularly where effective coordination across sectors and levels of governance is required. Although Ethiopia has established policy frameworks and coordination mechanisms aligned with global initiatives, evidence on how these arrangements function in practice remains limited. This study assessed multisector governance for public health emergency preparedness and response, focusing on accountability, coordination, institutional roles, and implementation. A sequential mixed-methods study was conducted in Ethiopia between July and September 2025. Quantitative data were collected through a cross-sectional survey of 74 stakeholders from institutions involved in emergency preparedness and response across the health, disaster risk management, agriculture, livestock, academic, and partner sectors. Governance was assessed across seven predefined domains using 5-point Likert-scale measures, with domain scores summarized using descriptive institutional maturity categories. Qualitative data from purposively selected key informants were analyzed thematically to contextualize and explain quantitative findings. The survey achieved a response rate of 92.5%. The overall perceived governance maturity score was 3.31, corresponding to the predefined functional category. Most governance domains were rated as functional, whereas policy framework implementation remained at the emerging level. Qualitative findings indicated that national guidelines and coordination platforms were widely recognized, but their implementation varied across administrative levels. Persistent challenges included role ambiguity, inconsistent coordination and reporting practices, weak feedback mechanisms, and uneven implementation of policy and legal frameworks, particularly at subnational levels, where governance frequently relied on adaptive and informal practices. Overall, Ethiopia has established a functional institutional foundation for multisector emergency governance; however, important policy-to-practice gaps remain. Strengthening operational guidance, coordination, accountability, and implementation across administrative levels will be essential to improve emergency preparedness and response.

Accountability · Corporate governance · Emergency management · Maturity (psychological) · Preparedness · Public health · Qualitative property · Qualitative research · Survey data collection · Disaster Response and Management · Global Maternal and Child Health · Viral Infections and Outbreaks Research