In 2004, the Ethiopian government launched what has been called an innovative and groundbreaking solution to the country's public health challenges; the Health Extension Programme (HEP). The positive public health outcomes that have been reported following the implementation of the HEP have led researchers and global health actors to propose it as a model for other countries to emulate. In this systematic review, we point to a potential weakness and methodological bias in the existing research. Despite being implemented within a context of an increasingly authoritarian regime, research conducted following the implementation of HEP reflects a limited discussion of the political context. Following a discussion of why political context is marginalized we provide arguments for why a focus on political context is important: first, political context has an impact on health systems and actualizes questions related to good governance and ethics. While some of the studies we reviewed acknowledge the importance of political factors we contend that the one-sided focus on the positive relationship between political will, political commitment and political leadership on the one hand, and key public health outcomes on the other, reflects a narrow engagement with health system governance frameworks. This leads to a silencing of issues actualized by the authoritarian nature of the Ethiopian regime. Secondly, the political context has methodological implications. More specifically, we contend that the current political situation increases the probability of social desirability bias. In order to balance the overarching positive literature on Ethiopia's health system, research that takes the political context into account is much needed.
How are global policies on women's rights and gender equality translated into local contexts and who are the translators in this process? This article describes and analyses contradictory and competing translations of gender equality in two districts in Ethiopia. Two main strands of translations are identified: 'gender experts' in the government's gender machinery emphasize the importance of changing the gendered division of labour while the 'grassroots' underscore the importance of collaborative work and mutual agreement through conjugal dialogue. Although these translations are similar in terms of their focus on labour, they represent fundamentally different visions of gender equality, the first reflecting a vision of equality as sameness, the latter ideals of gender complementarity. Rather than presenting one or both translations as examples of resistance against or misinterpretation of gender equality, I argue that contemporary theories of translation and discursively informed theories on global norm diffusion offer perspectives that allow us to recognize the potential of contestations in meaning creation. This opens up the translational space as the 'grassroots' are recognized as translators.
In Ethiopia, both Christians and Muslims interpreted the Covid-19 pandemic as God's punishment for sin. Prayer, fasting, and congregating in houses of worship therefore became important as means to plead God to act; practices that deviated from the biomedically informed efforts promoted by the Ethiopian government. This article explores these religious perceptions and practices and how they were negotiated in relation to official public health policies. At first glance, this case could serve as a typical example of how a government's secular policies are pitted against a 'religiously-inclined' population. However, the religious interpretations did not prevent people from recognizing the value of public-health informed mitigating efforts, and neither these efforts immune from ideas about divine agency. Therefore, the Ethiopian case serves to illustrate how seemingly demarcated epistemes, or imagined separate domains, are more open to exchange and interaction than commonly assumed.
With a focus on responses to coronavirus disease 2019 (COVID-19) in Ethiopia and on political developments that have occurred in the country during the pandemic, this article contributes to the existing scholarship that explores the relationship between health and politics. Drawing on qualitative data from the project ‘COVID-19 Impact Tracing in Ethiopia: Social, Economic, Political, and Security Ramifications’, carried out in the Tigray, Amhara and Oromia Regional States (RS) from June to September 2020, we offer new empirical and theoretical perspectives that shed light on the political status of health and health policies in Ethiopia and beyond. In all the three regions, COVID-19 and the government’s pandemic response was subject to politicization and securitization. The degree of securitization and politicization differed between the regions and fluctuated over time; in areas with strong opposition to political authorities, the COVID-19 mitigating efforts were—during the first phase of the pandemic—more politicized and securitized than in areas with less opposition. Yet, as the political opposition and instability increased, threatening national security and Prime Minister Abiy Ahmed’s political project, the authorities and the public paid increasingly less attention to the pandemic and the mitigating policies. In our analysis of these dynamics, we draw on a classic distinction that scholars of global public health have borrowed from political science: that of ‘low’ and ‘high’ politics. We argue that a contextually situated use of the high/low distinction allows us to recognize the fleeting and context-dependent nature of health’s political status, providing valuable insights that help us understand the ways that health emerges and disappears as high politics. The temporal and inter-regional shifts that appeared in, and as a response to, Ethiopia’s pandemic policies illustrate the importance of a continuous analysis of the relationships between health and politics at national as well as at sub-national levels.
Norway is often seen as a “world champion” in gender equality. Norwegian aid policies on gender often emphasize how lessons can be learned from “the Norwegian model” and experiences. This article explores the extent to which Norway’s domestic gender policies have influenced the country’s aid policies. The analysis, which is based on literature review of Norwegian gender equality history and discursive analysis of the current gender and aid policy documents, reveals that the essence of Norwegian domestic gender equality politics—social policies that address the relationship between care and breadwinning—is largely missing in Norway’s aid policies. While we doubt whether a specific model can be exported, we suggest that Norwegian experiences may provide valuable inputs for development aid policies. Since Norwegian aid policies tend to reflect the dominating international aid discourse, our analysis has relevance beyond the particular Norwegian case. We argue that policies of care, motherhood and fatherhood, should be at the heart of the Norwegian and international aid policies.
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