The purpose of this study was to investigate the health service delivery by private health sector and develop guidelines to enhance provision of health service so as to increase their contribution in the country’s health system. Interviews with 1112 participants were conducted in phase I. Descriptive statistics, chi square tests and logistic regression analysis were used for analysis. Private health facilities (30.5%) were providing healthcare services in their own buildings that were constructed for that purpose while others work in a rented houses built for residence or others. Some facilities (11.7%) received loan services from financial institutions in the region. A significant association was found between obtaining loan and owning building for healthcare services delivery (x2=13.99, p<0.001). Private health facilities were mainly engaged in profit driven and curative services while their participation in the promotive and preventive services like FP, ANC HIV test, TB and malaria prevention and control was not minimal. Majority, 247 (96.5%) provide services for extended hours out of normal working time such as evening, weekends and holidays. Physicians, more than other professionals were found practicing part time work (dual practice). Service consumers of the private health sector were urban dwellers 417 (71.6%) and 165 (28.4%) rural residents. Nearly three-fourth (73.0%) of study participants had a history of multiple visits to both public and private health facilities for current medical condition. Median payment of patients in a single visit including diagnosis and medicine was 860 birr ($30.85) (IQR = 993 ($35.62). Only 2.1% have paid through insurance services while others through out of pocket payments. Price of services delivered in private health facilities were set mainly by owners’ will (91.4%) while others with established team. Satisfaction on the fairness of prices to services obtained from each facility were reported by 63.1% service consumers. Those patients without any companion (AOR=1.83, 95% CI=1.16-2.91) and no history of visit to other facilities (AOR=1.97, 95% CI=1.24-3.12) were more likely to be satisfied than those coming with companions and those with history of visit. In addition, as age of consumers increase, satisfaction to services prices tend to decline (AOR=0.97, 95% CI=0.96-0.99). Uncomplimentary regulatory system to private health facilities, lack of training and continuing education for health professionals, unavailability of enough health workforce in the market and shortage of supplies to private facilities were among main gaps disclosed. Based on findings, five guidelines were developed to enhance health services delivery in the private health sector, namely, increase facilitation for financial access to actors in the sector, increase facilitation to access regular updating trainings and continuing education for healthcare workers, enhance and scale up the capability of existing association in the private health sector, strengthen and support working for extended hours to promote user friendly services and accessibility of healthcare services for the poor through community based health insurance and exemption. Therefore, these recommendations to help enhance the private health sector for better performance and contribution. / Health Studies / D.Lit.Phil (Health Studies

In these days environmental issues are critical. Environmental concerns mainly rise from energy productions. Fortunately Ethiopia is trying to use renewable energy sources as a means for electrical power production and it is a great start for a long, tiresome green energy journey. The basic job to be done in green energy sectors is to maximize the capacity of renewable technologies to fulfil the best efficiency.  Intermittent nature of the energy production and their inefficiency to meet peak load demands are the basic problems in renewable energy sectors.   Ethiopia’s electrical power production is mainly dependent on hydropower; according to latest data from EEPCO hydro covers 88% of the total production. There are two major nature of this power plant; since the working medium is water it is mainly dependent on the nature of the seasons and secondly it rarely meets peak load demands. After the erection of the power plant the energy production is not time dependent; it can produce power continuously; but the consumption is time dependent which is defined as peak hours and off-peak hours. There is excess load in time of off-peak hours and scarcity in peak hours. So this work can help to maximize the capacity of the water for production by using technological advancements to produce lot of energy in almost full capacity throughout the year to full fill the need of our country. Tana Beles hydropower plant is the largest hydropower plant which starts to work in May, 2010 with an investment cost of $500 million and capacity of 460 MW. The project is planted in Amhara region using the water source of Lake Tana. To make this large and very necessary renewable energy resource sustainable using energy storage system will be vital. This study will figure out a pumped storage system for the hydropower plant for additional power production and for the sustainability of the water resource.    Pumped storage system is the only viable, large-scale resource that is being broadly utilized today for storing energy, and it offers the best option available for harnessing off-peak generation from renewable sources. The contributions of pumped storage hydro to our nation’s transmission grid by providing stability services, storage capacity needs, and expanding the green job market are considerable today.   The high energy demand of the pump will be considered to be covered using the excess electrical power production during night or weekends and if the resource is available using wind solar PV hybrid systems.   The author will try to assess the technology not only for other mini hydro power plants but also for irrigation and other purposes merely in Amhara region, Ethiopia. The feasibility of the system will be considered technically and economically for the hydropower plant.

Philosophiae Doctor - PhD / The prime aim of this thesis is to examine the link between fiscal decentralization and local financial governance in fiscally empowered woreda administrations (districts) of the Amhara region in Ethiopia. Local financial governance has been one of the reasons and arguably the crucial one that drives many countries to subscribe to fiscal decentralization. The presumption is that public finance mobilization and spending can be implemented in a more efficient, responsive, transparent and accountable manner at the local government level than at the centre. Nonetheless, empirical studies show that the linkage between fiscal decentralization and these local financial governance benefits is not automatic. Several developing countries that have tried to implement fiscal decentralization have failed to realise the promised financial governance gains largely due to design and implementation flaws. A review of the various theoretical perspectives suggest that local financial governance is not a factor of just devolution of fiscal power but also other intervening forces such as financial management system, citizen voicing mechanisms and the social and political context. It is within the framework of this theoretical argument that this study sought to investigate how the mixed and incomplete efforts of the district level fiscal decentralization program in the Amhara region has impacted on financial governance of woreda administrations. The study assesses the efficacy and role of various initiatives of the district level decentralization program of the Amhara region, such as the fiscal empowerment of woredas; financial management system reforms; citizen voicing mechanisms and political party structures and system in influencing woreda financial governance. To this end, the investigation process largely took the form of an interpretative approach employing a combination of various methods of gathering the required qualitative and quantitative data from respondents and documents in the selected four case woredas or districts. Findings on the assessment of the intergovernmental relations to measure the adequacy of devolution of fiscal power indicate that, despite the constitutional provision that affords the woredas the power to mobilize and spend public finance for the provision of various local public services, several design and implementation shortcomings have constrained woreda administrations from exercising such power effectively. As a result, the district level fiscal decentralization framework of the Amhara region appears to have features of decentralization by de-concentration rather than by devolution. Despite the extensive financial management reforms that have been undertaken, the research findings indicate that the financial management system in woreda administrations faces a range of challenges triggered largely by important design and implementation shortcomings. It is observed that the ‘getting the basics right first’ reforms in various financial management processes of woreda administrations are not only incomplete but also found to be inconsistent with each other and therefore could not serve their purpose. Furthermore, there has not been any other change in the last two decades since the initial implementation of these reforms despite such serious shortcomings. Most importantly, woreda administrations could not properly implement the techniques, methods, procedures and rules that constituted the reform process due to serious implementation problems such as the lack of manpower competency and problems associated with the lack of administrative accountability. The results of the study’s assessment regarding the practice of social accountability show that currently there is no arrangement for citizens to participate in public financial decisions and controls. In general, people have little interest in participating in the meetings organised by woreda government. Formal and informal community based organizations suffer from important capcity constraints, and the lack of strong civil society organizations to support these community based organizations makes such problems more difficult to resolve. However, local communities did indicate that they would be interested in participating in financial and budgeting processes if a number of conditions were satisfied. These included the availability of adequate and relevant information; the introduction of genuine forms of participation in which citizens were empowered; and evidence that popular participation was making a visible impact on financial decisions related to service delivery in their surroundings. The assessment of the ruling party structure and system suggests that the centralized system of the regional ruling party has created a dominant relationship between party organs at various levels so much sothat it has undermined the fiscal discretionary power of woreda administrations; blurred relationship between party and woreda financial management systems; and undermined direct voicing. Consequently, the genuine devolution of fiscal power, the effective implementation of the decentralised financial management systems, and direct participation of citizens are unlikely to be realised within the current ruling party system and structure. Moreover, the study shows that the intergovernmental relations, the implementation of financial management reforms and direct involvement of people influence each other. The evidence suggests that the effective implementation of the financial management reforms is not possible without genuine devolution of fiscal power and arrangements for the activeinvolvement of citizens. Despite these limitations and shortcomings, the research nevertheless reveals that the decentralization process has achieved some positive results, such as the expansion of access to basic services; the economic use of resources for such expansion; the mobilization of resources from local communities; and the streamlining of a number of bureaucratic processes. However, the prevalence of various financial governance challenges such as excessive budget transfers; low budget execution; uneconomical procurement; illicit spending; budget pressure; inadequate revenue collection; poor financial transparency; and compromised accountability in fiscally decentralized woreda administrations means the promised local financial governance benefits of fiscal decentralization are remain largely unrealized. The evidences in the study strongly suggest that the shortcomings in the design and implementation of intergovernmental relations, financial management system reforms, and direct voicing mechanisms areresponsible in combination with each other for these local financial governance challenges. Thus, the study concludes that local financial governance is a result of a complex network of interactions of intergovernmental relations, public financial management arrangements and social accountability mechanisms. The success of initiatives to improve local financial governance is dependent on contextual factors such as the capacity of civil society organizations and the ruling party system and structure. Therefore, while recommending further efforts of genuine devolution of power, in particular through the continuation of the financial management reform processes towards full-fledged reforms, the study contends that opening enough space for the proliferation of civil society organizations and alternative political parties will be the main priority.

Resettlement as a development discourse has become a worldwide phenomenon. This phenomenon is mainly caused by population pressure, war or prolonged hostilities between countries or groups within the country, irreversible environmental degradation and development projects. While there are diverse causes of resettlement situations, this study focused on state sponsored resettlement programmes caused by socio-economic, political and environmental problems in Amhara and the southern regions of Ethiopia. The main objective of this empirical study was to analyse the effects of planned government intra-regional resettlement programme on the sustainable livelihoods of resettled households in Ethiopia. The central research question was: Does a planned intra-regional resettlement programme provide sustainable livelihoods for settler households in the two selected regions of Ethiopia? If it does, what chain of factors explains the livelihood security and sustainability? If it does not, what are the interacting variables and how have they generated a process of livelihood insecurity? To this end, the combination of Sustainable Livelihood Framework (SLF) and Impoverishment Risks and Reconstruction (IRR) models were used as the pillars of the theoretical and conceptual framework of the study. Mixed method design that combines both quantitative and qualitative data from primary and secondary sources were used in this study. Primary data were collected through a household survey, key informants interview, focus group discussion and field observation. A total of 250 households were surveyed and a total of 28 interviewees were contacted from the two regions. A total of 6 focus group discussions were also conducted with purposively selected participants. This study concludes that the effects of planned resettlement on the sustainable livelihoods of resettlers were mixed and challenged the generic representation of the scheme as a success or a failure. The adverse effects were mainly due to policy gaps, the mismatch between policy and practice, poor inter-sectoral and inter-regional integration and inadequate capacity building efforts. Recommendations were provided in line with these gaps. In addition, the knowledge documented through the application of SLF and IRR in mixed method design contributed to the methodological and theoretical advancement of resettlement and livelihood studies. / Development Studies / D. Litt. et Phil. (Development Studies)

Resettlement as a development discourse has become a worldwide phenomenon. This phenomenon is mainly caused by population pressure, war or prolonged hostilities between countries or groups within the country, irreversible environmental degradation and development projects. While there are diverse causes of resettlement situations, this study focused on state sponsored resettlement programmes caused by socio-economic, political and environmental problems in Amhara and the southern regions of Ethiopia. The main objective of this empirical study was to analyse the effects of planned government intra-regional resettlement programme on the sustainable livelihoods of resettled households in Ethiopia. The central research question was: Does a planned intra-regional resettlement programme provide sustainable livelihoods for settler households in the two selected regions of Ethiopia? If it does, what chain of factors explains the livelihood security and sustainability? If it does not, what are the interacting variables and how have they generated a process of livelihood insecurity? To this end, the combination of Sustainable Livelihood Framework (SLF) and Impoverishment Risks and Reconstruction (IRR) models were used as the pillars of the theoretical and conceptual framework of the study. Mixed method design that combines both quantitative and qualitative data from primary and secondary sources were used in this study. Primary data were collected through a household survey, key informants interview, focus group discussion and field observation. A total of 250 households were surveyed and a total of 28 interviewees were contacted from the two regions. A total of 6 focus group discussions were also conducted with purposively selected participants. This study concludes that the effects of planned resettlement on the sustainable livelihoods of resettlers were mixed and challenged the generic representation of the scheme as a success or a failure. The adverse effects were mainly due to policy gaps, the mismatch between policy and practice, poor inter-sectoral and inter-regional integration and inadequate capacity building efforts. Recommendations were provided in line with these gaps. In addition, the knowledge documented through the application of SLF and IRR in mixed method design contributed to the methodological and theoretical advancement of resettlement and livelihood studies. / Development Studies / D. Litt. et Phil. (Development Studies)

No description available.

This study examines rural household food security and its determinants in drought-prone Amhara Region of Ethiopia by focusing on Lay Gaint district as a case study site. A range of factors from physical environmental circumstances to policy and institutions-related issues determine households‟ vulnerability to food insecurity and livelihood outcomes. The survey results showed that the majority (74%) of the sampled households experienced food insecurity. The situation was worse among female-headed households such that 86% of them were food insecure. The study revealed that, despite the low level of productivity related to local environmental constraints, rural livelihoods remain undiversified with small scale rain-fed agriculture to provide the primary source of livelihood for the large majority of households (~93% of respondents). Only about 25% of the respondents participated in some form of non-farm or off-farm activities, but with only little contribution to their total annual incomes. Food insecurity is a chronic problem in that, on average, households in the study area consume from own production for only about six months. The study found out that the majority of households (about 80%) perceived annual rainfall to be inadequate to support the growing of crops and grazing of animals. The main adaptive strategies employed by the majority of households included diversifying livestock kept, planting trees and diversifying crops. The study revealed that incidence, depth and severity of food insecurity of the food insecure households showed that Woina-Dega and Kolla agro-ecologies are prone to vulnerability to food insecurity. This suggests that development interventions that are geographically differentiated; and build household assets will improve household food security in the study area, and in other similar environments in the country. / Geography / D.Phil.

This study analyses the impact of land registration and certification scheme on sustainable use of farmlands in Debre Mawi and Densa Bahta rural kebeles of Amhara region in northwestern Ethiopia, with a view to contributing to the theoretical debate on tenure security and more realistic policy advocacy on the sustainable use of farmlands. Within the framework of qualitative research methodology, the case study approach helps to observe and understand the relationship between land titling and sustainable use of farmlands in Densa Bahta and Debre Mawi kebeles of the Amhara region in Ethiopia. Specific methods employed were focus group discussions, in-depth interviews and observation, complemented by context analyses of relevant documents. It was found that land titling has contributed to a high perception of security of land tenure among study respondents. However, results show that land titling has both positive and negative impacts on sustainable use of farmlands. The positive impact of land titling is ascribed to its assurance effect and legal obligation imposed on farmers to adopt proper land management practices. The negative impact of land titling arises from its failure to address the existing inequality in possession of farmlands among the village communities. Failure of farmers’ high perceptions of their security of land tenure to translate into sustainable land use practices has implications for the relative importance of productive asset endowments, self-efficacy and risk perception on the sustainable use of farmlands in the Amhara region. Interviewees that follow unsustainable farming practices were endowed with relatively lower pieces of farmland and disadvantaged in possession of other productive assets. They also demonstrated a low level of self-efficacy and a risk-averse attitude to adopting conservation technologies, as they possessed smaller sizes of farmland compared with the village and regional average. The study urges a holistic approach and comprehensive analytical framework to understand the synergy of several factors that affect the sustainable use of farmlands. / Environmental Sciences / D. Litt. et Phil. (Development Studies)

This study analyses the impact of land registration and certification scheme on sustainable use of farmlands in Debre Mawi and Densa Bahta rural kebeles of Amhara region in northwestern Ethiopia, with a view to contributing to the theoretical debate on tenure security and more realistic policy advocacy on the sustainable use of farmlands. Within the framework of qualitative research methodology, the case study approach helps to observe and understand the relationship between land titling and sustainable use of farmlands in Densa Bahta and Debre Mawi kebeles of the Amhara region in Ethiopia. Specific methods employed were focus group discussions, in-depth interviews and observation, complemented by context analyses of relevant documents. It was found that land titling has contributed to a high perception of security of land tenure among study respondents. However, results show that land titling has both positive and negative impacts on sustainable use of farmlands. The positive impact of land titling is ascribed to its assurance effect and legal obligation imposed on farmers to adopt proper land management practices. The negative impact of land titling arises from its failure to address the existing inequality in possession of farmlands among the village communities. Failure of farmers’ high perceptions of their security of land tenure to translate into sustainable land use practices has implications for the relative importance of productive asset endowments, self-efficacy and risk perception on the sustainable use of farmlands in the Amhara region. Interviewees that follow unsustainable farming practices were endowed with relatively lower pieces of farmland and disadvantaged in possession of other productive assets. They also demonstrated a low level of self-efficacy and a risk-averse attitude to adopting conservation technologies, as they possessed smaller sizes of farmland compared with the village and regional average. The study urges a holistic approach and comprehensive analytical framework to understand the synergy of several factors that affect the sustainable use of farmlands. / Environmental Sciences / D. Litt. et Phil. (Development Studies)

This thesis examines the historical introduction and spatial expansion of modern water supply infrastructure in Amhara region across the three successive regimes: imperial, military, and EPRDF. It attempts to explore the institutional setup of the three governments together with their policies and strategies. The study also aims at giving an idea about the socio-economic changes registered because of improved access to safe water. Furthermore, it assesses the water consumption and conservation pattern of the society and the environmental impact of the water infrastructure development. Modern infrastructure development in Ethiopia traced its beginning back to the late 19th century. Safe drinking water supply had been one of those modern infrastructures introduced in Addis Ababa. Not long afterwards, it proliferated to the provinces. In Amhara region, drinking water supply infrastructure construction began in the early 20th century. However, this thesis inquired whether there was a programmed water supply infrastructure development before the mid-1950s or not. The water supply work started gaining momentum and became a state program in the late imperial period. However, it was affected by financial, technological and trained human resource constraints, lack of appropriate institution, defective management systems, and improper implementation methods. The military government had strengthened water supply institutions and improved workers' expertise. These developments helped the water supply infrastructure work to be executed in a programmed manner. Yet, financial restraints, the incessant political chaos of the time and the accompanied disruptive working environment had greatly impacted the temporal and spatial coverage of the water supply infrastructure development. The promising start of the Derg period did not continue with similar pace during the early years of the EPRDF rule. Despite the efforts made to set up water institutions at Regional, Zonal and Woreda (district) levels, no significant achievement was recorded in the field. The aftermath of the civil war together with internal and external challenges epitomized the transition period had impinged on the water supply work. This thesis testifies to the emergence of some socio-economic changes in the region. Yet, the slow progress of the water supply infrastructure work had stalled the socio-economic change that should have been registered through improved access to safe water supply. Despite the observable environmental degradation, the thesis argues that the retarded water supply work had nothing to do with the dearth of fresh water. While the trend shows steady growth of water consumption level across the three regimes, the conservation habit of the population remained low. / D.Litt. et Phil. (History)