Assessing the Policy and Institutional Framework for Multisectoral Governance and Accountability in Emergency Preparedness and Response in Ethiopia

Public health emergencies such as pandemics, natural disasters, and conflicts place sustained pressure on health systems, particularly where effective coordination across sectors is required. Ethiopia has established policy frameworks aligned with global initiatives (e.g., IHR, Sendai Framework), yet empirical evidence on how these arrangements function in practice remains limited. This study assessed the multisector emergency governance in Ethiopia, focusing on accountability, coordination, role clarity, and implementation. Using a sequential mixed-methods design conducted between July and September 2025, quantitative data were collected from 74 respondents (92.5% response rate) across health, disaster risk management, agriculture, and academic sectors. Qualitative data were generated via semi-structured key informant interviews. Governance performance was measured across seven domains using a 5-point maturity scale (Nascent to Optimized). Results indicate an overall mean institutional governance maturity score of 3.31 (Functional). While domains such as coordination mechanisms and institutional roles scored as functional, challenges related to policy frameworks remained at an emerging level (3.0). Qualitative findings revealed significant policy-to-practice gaps: although national guidelines exist, their application varies drastically across administrative levels. Subnational actors face role overlap, resource constraints, inconsistent reporting, and reliance on informal communication (e.g., WhatsApp) over formal procedures. Conclusions: Multisector emergency governance in Ethiopia is underpinned by formal frameworks, but operationalization is uneven. The study demonstrates that governance performance is shaped less by the presence of policies than by how they are enacted in practice. Strengthening routine training, clarifying intersectional roles outside of crisis periods, and institutionalizing after-action reviews are critical priorities.