The Magnitude of Governance in Addressing HIV/AIDS Problems in Ethiopia

Daniel Messele Balcha, MAMay 27, 2009

Prague

CHARLES UNIVERSITY IN PRAGUEFaculty of Social Sciences

Department of Public and Social Policy

Supervisor: Prof. PhDr. Martin Potůček, CSc., MSc.

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Structure of the Presentation• General Information

– Ethiopia– HIV/AIDS

• Research Problem

• Objectives

• Theoretical Consideration

• Methodology

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Location & Neighboring Countries of Ethiopia, Major Cities

Location

•Eastern Africa

Neighboring Countries

•Eritrea

•Djibouti

•Somalia

•Kenya

•Sudan

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General Facts about Ethiopia

• Population: about 80 million• >80 ethnic groups • >50 languages• Official language: Amharic• Religions: Orthodox, Muslim, Catholic and

Protestant• GDP: 25,658,000,000, per capita 897 /2008,IMF/• Bicameral parliamentary system

– the House of Peoples’ Representatives and – the House of the Federation

• HIV Prevalence: 2.3%

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Country Subject Descriptor Scale 2006 2007 2008 2009

EthiopiaGross domestic product, current prices Billions 15.168 19.431 25.658 34.762

Ethiopia

Gross domestic product based on purchasing-power-parity (PPP) per capita GDP Units 724.443 806.702 896.635 939.589

Ethiopia Population Millions 75.071 77.173 79.179 81.238

International Monetary Fund, World Economic Outlook Database, April 2009

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HIV PrevalenceAdult Prevalence (%) 2004 2005 2006 2007 2008 2009 2010

Total Rural 1.0 1.0 1.0 0.9 0.9 0.9 0.9

Urban 7.9 7.8 7.8 7.7 7.7 7.7 7.7

R+U 2.2 2.1 2.1 2.1 2.2 2.3 2.4

Male Rural 0.8 0.8 0.8 0.7 0.7 0.7 0.7

Urban 6.4 6.3 6.2 6.2 6.2 6.2 6.2

R+U 1.7 1.7 1.7 1.7 1.8 1.8 1.9

Female Rural 1.2 1.2 1.1 1.1 1.1 1.1 1.1

Urban 9.5 9.4 9.3 9.3 9.2 9.2 9.2

R+U 2.6 2.5 2.5 2.6 2.6 2.8 2.9

Source: Single Point HIV Prevalence Estimate June 2007

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Impacts of HIV/AIDS at Different Levels

Macro-economy

Firms and businesses

Families

Individuals

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Research Question• Data shows that prevalence rate is still

increasing and will also increase in the years to come. – H. I. competition among specially NGOs on

beneficiaries and financial resources have resulted in partnership failure

– H. II. New policy on NGOs• unintended consequences

– H. III. uneven and insufficient share of the government, civic and business sector in addressing the problem.

• Formulation + Implementation

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Objectives• Identification of barriers concerning public

policy formation and implementation /PPFI/ on HIV/AIDS

– Develop an ideal model of public policy directed towards HIV/AIDS/ more applicable model in designing PPFI with special focus on:

• Ideal interrelationship/ partnership among the three• main actors on policy arena who define policy agenda

– Identify the major barriers in implementing the model

• Legislative• Administrative and financial • Cultural

– Explore the partnership patterns among NGOs, GOs and the private sector

• challenges vs. consequences.

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Theoretical Considerations

• Multi – Dimensional Concept of Governance (Potůček)– Dimension 1: Vertical layers of Governance

• local administration

– Dimension 2: Regulators – market, state, and civic sector

– Dimension 3: Actor’s networks and networking• Horizontal layer of cooperative ties between

regulators emerged as a response to definite issue

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Theoretical Considerations• Governance

– Rhodes • self-regulation, • cooperation and • political decision making

– Papadopoulos• enhancing state’s resources in terms of

– knowledge, – organization and – authority

• New modes of governance

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Normative Models of Public Policy

• Rawl’s principle of justice • Each person is to have an equal right • social and economic qualities are to be arranged

• reducing inequality • supplementing the market with a redistribution of

resources

• criterion of human dignity model • cultural and economic realities of a given country

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Social capital• Putnam (1993)

– bonding social capital and – bridging social capital.

• Baker (1990) defines social capital as, – “a resource that actors derive from specific social structures and

then use to pursue their interests; it is created by changes in the

relationship among actors”

• Actors Network > Network Governance > Social Capital

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Table 1. Four Views of Social Capital

Perspective Actors Policy prescriptions

Communitarian view Local associations

Community groups Voluntary organizations

Small is beautiful Recognize social assets of the poor

Networks viewBonding and bridgingcommunity ties

EntrepreneursBusiness groupsInformation

brokers

DecentralizeCreate enterprise zones Bridge social divides

Institutional view Political and legal

institutions

Private and public sectors

Grant civil and political libertiesInstitute transparency,

accountability

Synergy viewCommunity networks

and state-society relations

Community groups, civil society, firms, states

Coproduction, complementarity Participation, linkages

Enhance capacity and scale oflocal organizations

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Formation and Implementation of Public Policy

• partnership networks increase policy-making efficiency (Kjaer (2004))

• needs, capacities and commitment of local actors

• The most accepted model of the policy process is a four-stage model, Potůček, et al. (2003) – Agenda setting, – formulation, – implementation and – evaluation

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Implementation Models• Potůček, et al. (2003)

– The authoritative model• directive instructions, planning, control, hierarchy and accountability.

– The participative model, • setting goals, spontaneity, training, adaptation, negotiation,

cooperation and trust as suitable methods and conditions of implementation.

– The coalition of actors model, • plurality of actors, communicate between one another, negotiate,

reach compromises, but who at the same time share a definite common set of values and who are striving to achieve the same objectives.

– And the endless learning model, • an effort to achieve an optimal solution gradually (often by making

use of the method of trial and error or by sheer imitation), optimize the structure of their objectives and the techniques used to achieve them.

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Actors• Fritz W. Scharpf 

– capacity like amount of power and other resources like money, knowledge, and personnel.

– The influence of the various actors in policy making and implementation

– actor-centered theory defends that policy results from actors who have

• capacity (power for) to act independently; • able to impose their preferences on other actors (power over)

• State• Private sector

– Profit sector– Non for profit sector

• Papadopoulos– represent different territorial levels, – experts and – interest representatives

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Legal Framework • Potůček, et al. (2003) mention are the

problems caused by a policy’s undesired consequences

• Frič (2008:241) – adequate legal framework for the operation of

various different types of NGOs Vs. tendencies to keep the NGOs in state of financial precariousness and at a comfortable distance from decision-making processes

• New NGO law was adopted by the Ethiopian Parliament in January 2009

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PLURALISM

• Arthur Bentley/ James Madison– The interest groups play the most important

role in the processes of public policy. – That is pluralistic systems of policy making– Joint implementation

• Schmitter (1974) states that societal corporatism = pluralism = means for interaction between state and societal organizations

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Cultural Traditions

Governance

HIV/AIDS POLICY FORMATION AND IMPLEMENTATION

Attitudes and behaviourof the population

Financial Resources

Legislative Factors

Administrative Barriers

Private Sector

Government

Social Capital +Partnerships

HIV/AIDS Policy Formation and Implementation Model

http://www.martinpotucek.cz/index.php?option=com_rubberdoc&view=doc&id=180&format=raw&lang=en

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Methodology– Descriptive case study – policy formation and implementation

• governance, partnership and the social capital– describing the existing processes

– interpreting them

– evaluate the practice

– Study Area, Population and Sampling• purposive sampling technique

– organizations working in more than 1/3 of the states

– umbrella organizations

– Tools of Data Collection• interview with key informants and • document analysis • Secondary data and other research works

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Developments • 1985 - National Task Force on HIV/AIDS • 1987 - Ministry of Health (MOH) began HIV prevention

and control efforts• 1988 - National HIV/AIDS Policy was issued by the

government• 2000 - National AIDS Council Secretariat, which has since

become HIV/AIDS Prevention and Control Office (HAPCO)

• June 2006 at the UN General Assembly to issue the Political Declaration on HIV/AIDS

• 2008 - strategy for the implementation of the policy – Mainstream HIV/AIDS knowledge, skills, and attitudes into the

schools curriculum, educational materials, and activities– Effect behavioral change that prevents HIV/AIDS amongst

learners, etc..• Key HIV/AIDS intervention programs • Key challenges

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