Generation of political priority for global health initiatives: a framework and case study of maternal mortality

Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To analyse this question we propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ide...

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Published in	The Lancet (British edition) Vol. 370; no. 9595; pp. 1370 - 1379
Main Authors	Shiffman, Jeremy, Smith, Stephanie
Format	Journal Article
Language	English
Published	London Elsevier Ltd 13.10.2007 Lancet Elsevier Limited
Subjects	Biological and medical sciences Case studies Civil rights Climate change Community Developing countries Epidemiology Family planning Female General aspects Global Health Health Priorities Health promotion HIV Human immunodeficiency virus Humans Initiatives Internal Medicine LDCs Leadership Maternal mortality Maternal Mortality - trends Maternal Welfare Medical sciences Mortality Organizational Case Studies - organization & administration Organizational Case Studies - statistics & numerical data Political systems Politics Public health. Hygiene Public health. Hygiene-occupational medicine Qualitative research Social activism World Case study Pregnancy Medicine Mother Health Political aspect Mortality Priority Epidemiology
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Abstract	Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To analyse this question we propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself. We apply this framework to the case of a global initiative to reduce maternal mortality, which was launched in 1987. We undertook archival research and interviewed people connected with the initiative, using a process-tracing method that is commonly employed in qualitative research. We report that despite two decades of effort the initiative remains in an early phase of development, hampered by difficulties in all these categories. However, the initiative's 20th year, 2007, presents opportunities to build political momentum. To generate political priority, advocates will need to address several challenges, including the creation of effective institutions to guide the initiative and the development of a public positioning of the issue to convince political leaders to act. We use the framework and case study to suggest areas for future research on the determinants of political priority for global health initiatives, which is a subject that has attracted much speculation but little scholarship.
AbstractList	Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To analyse this question we propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself. We apply this framework to the case of a global initiative to reduce maternal mortality, which was launched in 1987. We undertook archival research and interviewed people connected with the initiative, using a process-tracing method that is commonly employed in qualitative research. We report that despite two decades of effort the initiative remains in an early phase of development, hampered by difficulties in all these categories. However, the initiative's 20th year, 2007, presents opportunities to build political momentum. To generate political priority, advocates will need to address several challenges, including the creation of effective institutions to guide the initiative and the development of a public positioning of the issue to convince political leaders to act. We use the framework and case study to suggest areas for future research on the determinants of political priority for global health initiatives, which is a subject that has attracted much speculation but little scholarship.Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To analyse this question we propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself. We apply this framework to the case of a global initiative to reduce maternal mortality, which was launched in 1987. We undertook archival research and interviewed people connected with the initiative, using a process-tracing method that is commonly employed in qualitative research. We report that despite two decades of effort the initiative remains in an early phase of development, hampered by difficulties in all these categories. However, the initiative's 20th year, 2007, presents opportunities to build political momentum. To generate political priority, advocates will need to address several challenges, including the creation of effective institutions to guide the initiative and the development of a public positioning of the issue to convince political leaders to act. We use the framework and case study to suggest areas for future research on the determinants of political priority for global health initiatives, which is a subject that has attracted much speculation but little scholarship. Summary Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To analyse this question we propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself. We apply this framework to the case of a global initiative to reduce maternal mortality, which was launched in 1987. We undertook archival research and interviewed people connected with the initiative, using a process-tracing method that is commonly employed in qualitative research. We report that despite two decades of effort the initiative remains in an early phase of development, hampered by difficulties in all these categories. However, the initiative's 20th year, 2007, presents opportunities to build political momentum. To generate political priority, advocates will need to address several challenges, including the creation of effective institutions to guide the initiative and the development of a public positioning of the issue to convince political leaders to act. We use the framework and case study to suggest areas for future research on the determinants of political priority for global health initiatives, which is a subject that has attracted much speculation but little scholarship. Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To analyse this question we propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself. We apply this framework to the case of a global initiative to reduce maternal mortality, which was launched in 1987. We undertook archival research and interviewed people connected with the initiative, using a process-tracing method that is commonly employed in qualitative research. We report that despite two decades of effort the initiative remains in an early phase of development, hampered by difficulties in all these categories. However, the initiative's 20th year, 2007, presents opportunities to build political momentum. To generate political priority, advocates will need to address several challenges, including the creation of effective institutions to guide the initiative and the development of a public positioning of the issue to convince political leaders to act. We use the framework and case study to suggest areas for future research on the determinants of political priority for global health initiatives, which is a subject that has attracted much speculation but little scholarship. Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To analyse this question we propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself. We apply this framework to the case of a global initiative to reduce maternal mortality, which was launched in 1987. We undertook archival research and interviewed people connected with the initiative, using a process-tracing method that is commonly employed in qualitative research. We report that despite two decades of effort the initiative remains in an early phase of development, hampered by difficulties in all these categories. However, the initiative's 20th year, 2007, presents opportunities to build political momentum. To generate political priority, advocates will need to address several challenges, including the creation of effective institutions to guide the initiative and the development of a public positioning of the issue to convince political leaders to act. We use the framework and case study to suggest areas for future research on the determinants of political priority for global health initiatives, which is a subject that has attracted much speculation but little scholarship. [PUBLICATION ABSTRACT]
Author	Shiffman, Jeremy Smith, Stephanie
Author_xml	– sequence: 1 givenname: Jeremy surname: Shiffman fullname: Shiffman, Jeremy email: jrshiffm@maxwell.syr.edu organization: Department of Public Administration, Maxwell School of Syracuse University, Syracuse, NY, USA – sequence: 2 givenname: Stephanie surname: Smith fullname: Smith, Stephanie organization: Department of Public Administration, Maxwell School of Syracuse University, Syracuse, NY, USA
BackLink	http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19128037$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/17933652$$D View this record in MEDLINE/PubMed
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Snippet	Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To analyse... Summary Why do some global health initiatives receive priority from international and national political leaders whereas others receive little attention? To...
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SubjectTerms	Biological and medical sciences Case studies Civil rights Climate change Community Developing countries Epidemiology Family planning Female General aspects Global Health Health Priorities Health promotion HIV Human immunodeficiency virus Humans Initiatives Internal Medicine LDCs Leadership Maternal mortality Maternal Mortality - trends Maternal Welfare Medical sciences Mortality Organizational Case Studies - organization & administration Organizational Case Studies - statistics & numerical data Political systems Politics Public health. Hygiene Public health. Hygiene-occupational medicine Qualitative research Social activism
Title	Generation of political priority for global health initiatives: a framework and case study of maternal mortality
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