Essays in Child Health and Health Systems in Eastern Africa: Evidence from South Sudan and Ethiopia

Type Thesis or Dissertation - PhD thesis
Title Essays in Child Health and Health Systems in Eastern Africa: Evidence from South Sudan and Ethiopia
Publication (Day/Month/Year) 2015
Prevailing research pegs health status to a multitude of explanations, with many countries sharing almost similar experiences, depending on their development trajectory. There is consensus that fragility begets substandard health outcomes. This suggests that settings that are embroiled in fragility often experience increased morbid health and deaths (Guha-Sapir et al 2005). Alleviating these adverse health conditions requires addressing the underlying ills of state fragility. Yet, other researchers show that, net of other circumstances, the nature in which the health services are administered to the population substantially influences health (Bossert et al 2003; Bossert and Beauvais 2002). This strand of research emphasizes that good governance in healthcare fundamentally promotes goodhealth. This dissertation augments these research efforts by spatially and periodically mapping child health conditions and linking differentiated health outcomes to health systems in Eastern Africa, focusing primarily on South Sudan and Ethiopia. Looking specifically at infants and children under the age of five, the central objective of this research is to generate empirical evidence that resonates with proximate child health policy interests in the region. This dissertation finds that certain events, such as war, development, spatial heterogeneity, and governance substantially impact health. Finally, the current research could benefit from possible improvements in a number of areas. Primarily, there is need to address one major caveat—lack of information at micro levels in both countries, i.e., local settings. Specifically, future research efforts should pay attention to generating necessary data at these levels for more distilled mortality analyses. In South Sudan, such levels would be counties, payams, and bomas and in Ethiopia, they would include woredas and kebeles. New insights would be useful in two ways. First, they could help map child health conditions at these subnational levels. Secondly, those results could be used to improve health policies at those levels. In addition, evaluating in detail environmental health conditions in South Sudan may help us shed light on urban-rural early age mortality differentials. As well, an analysis on whether peace crowds out humanitarian and international development investments is desired.

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