Stakeholder analysis to strengthen Public Health Emergency Management: A Delphi study from Ethiopia

To systematically identify and prioritize key stakeholders within Ethiopia's Public Health Emergency Management (PHEM) system using a modified Delphi approach to strengthen emergency preparedness and intersectoral coordination.

A modified Delphi study.

Stakeholders were initially mapped through document review and consultative workshops. A modified three-round Delphi process was conducted with 35 public health experts via anonymous online surveys. Panelists rated stakeholders across five predefined criteria importance, influence, involvement, engagement quality, and resource contribution and could propose additional stakeholders during early rounds. Quantitative analyses included descriptive statistics, inter-rater reliability testing (Kendall's W), and influence-interest mapping. A post-Delphi survey assessed participants' learning, satisfaction, and experience.

A total of 72 stakeholders were prioritized, with 12 achieving over 75 % expert consensus. Stakeholders were categorized into four groups high interest/high influence, high interest/low influence, low interest/high influence, and low interest/low influence based on influence-interest mapping. Inter-rater reliability was high (Kendall's W = 0.751). The analysis identified the central roles of government agencies in policy formulation and implementation, supported by non-governmental and international partners.

This study demonstrates the value of structured stakeholder analysis in enhancing PHEM systems. By identifying and prioritizing actors across governance levels, it reinforces the need for coordinated engagement to improve resource mobilization, policy formulation, and community outreach. These findings contribute to the design of more resilient and inclusive emergency response systems in Ethiopia and similar settings.