Exploring the implications of transitioning NTD program interventions to the primary health care system in Ethiopia: a case study Open Access

Abstract

The World Health Organization (WHO) published the WHO 2030 NTD Roadmap for 2021-2030 in January of 2021. The roadmap calls for sweeping changes in how neglected tropical disease (NTD) interventions are planned, funded, and evaluated, emphasizing unified country-owned NTD programming. This is a change from the previous ten-year period of NTD control and elimination efforts, which saw gains in 600 million fewer people requiring intervention but was primarily implemented and planned by non-governmental organizations (NGOs) outside of the Ministries of Health (MoH). This paper reports on the findings from a qualitative case study of Ethiopian NTD experts in order to identify the barriers and implications of the shift to country ownership. The findings mapped contextual factors affecting Ethiopia’s transition to country ownership as competing political priorities in light of the conflict in the country, a lack of political will to expand NTD programming, and a culture of dependence in the country on NGO support. We also found three main barriers to this transition are NTD funding, workforce capacity, and NTD data management capacity. Using qualitative in-depth interviewing offered a holistic and rich contextual analysis of the county’s anticipated barriers from experts within the country. We discuss tools and approaches to addressing these barriers as well, including framework tools like the research fairness initiative evaluation tool which may be applicable to other countries that are transitioning to NTD program ownership.

Table of Contents

Purpose Statement 1

Background 1

The state of NTDS today 1

The shift to country ownership 2

NTD Programming in Ethiopia 3

Significance 5

Methods 6

Sampling Strategy 6

In-Depth key informant interviews 7

Analysis 7

Ethics statement 8

Findings 8

Contextual Factors Influencing NTD Program Management in Ethiopia 8

Barriers to the Shift to Country Ownership of NTD Programs 11

Funding 12

Human Resource Capacity 14

Data Management Capacity and Ownership 18

Discussion 21

Funding 22

Human Resource Capacity 23

Data Management Capacity and Ownership 25

Limitations 26

Conclusion 26

References 29

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	NTD 2030 Roadmap Global Health Country ownership Neglected Tropical Diseases Fair Partnerships
Committee Chair / Thesis Advisor	Lavery, James, Emory University

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