Understanding how "urban health" got onto the agenda of Ethiopia: Retrospective Analysis using Hall's theoretical model

Context and purpose: Ethiopia, one of the fast urbanizing countries in the world, has embraced the concept of 'urban health' though it is at its infancy. The purpose of this article is to analyze, describe and present how... [ view full abstract ]

Context and purpose: Ethiopia, one of the fast urbanizing countries in the world, has embraced the concept of 'urban health' though it is at its infancy. The purpose of this article is to analyze, describe and present how 'urban health' has got onto formal health policy agenda of Ethiopia.
Methods: Hall's theoretical model which proposes that only when an issue and likely responses are high in terms of legitimacy, feasibility and support do they get onto government agenda.

Results: The provision of community-based 'urban health' service has a legitimacy because the rural Health Extension Program was considered effective and the government has the obligation to expand the interventions to urban areas. It was feasible because it was perceived by the policy makers that extending Health Extension Program to urban centers can be done by employing the technical knowledge and experiences from the rural health extension program. Support was expected since the rural health extension program was presented as a strong case in improving maternal and child health indicators of Ethiopia. As expected, policy entrepreneurs outside the government took advantage of agenda setting opportunities to move urban health concept onto the government's formal health policy agenda.

Conclusion: Advocates of urban health may apply Hall's model to prospectively analyze the odds of successfully putting 'urban health' on government's formal policy agenda. The following key policy research questions should be pursued and appropriately described. Does the government feel obligated for 'urban health' interventions ? How does policy entrepreneurs inside and outside the government perceive about the feasibility of implementing urban health in terms of technical knowledge and resources? Who are the supporters and opponents of introducing 'urban health' and why?