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Setting the global health agenda: The influence of advocates and ideas on political priority for maternal and newborn survival

Thursday, 15th of September 2016

Soc Sci Med. 2016 Oct;166:86-93. doi: 10.1016/j.socscimed.2016.08.013. Epub 2016 Aug 9.

Setting the global health agenda: The influence of advocates and ideas on political priority for maternal and newborn survival

Smith SL¹, Shiffman J².

Author information

• ¹School of Public Administration, The University of New Mexico, Social Sciences Bldg. 3008, MSC05 3100, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA. Electronic address: slsmith@unm.edu.
• ²Department of Public Administration and Policy, School of Public Affairs, American University, 4400 Massachusetts Ave., NW, Washington, DC, 20016-8070, USA. Electronic address: jshiffma@american.edu.

Abstract below; full text is athttp://www.sciencedirect.com/science/article/pii/S027795361630435X

 

This study investigates a puzzle concerning global health priorities-why do comparable issues receive differential levels of attention and resources? It considers maternal and neonatal mortality, two high-burden issues that pertain to groups at risk at birth and whose lives could be saved with effective intrapartum care. Why did maternal survival gain status as a global health priority earlier and to a greater degree than newborn survival? Higher mortality and morbidity burdens among newborns and the cost-effectiveness of interventions would seem to predict that issue´s earlier and higher prioritization. Yet maternal survival emerged as a priority two decades earlier and had attracted considerably more attention and resources by the close of the Millennium Development Goals era. This study uses replicative process-tracing case studies to examine the emergence and growth of political priority for these two issues, probing reasons for unexpected variance. The study finds that maternal survival´s grounding as a social justice issue spurred growth of a strong and diverse advocacy network and aligned the issue with powerful international norms (e.g. expectations to advance women´s rights and the Millennium Development Goals), drawing attention and resources to the issue over three decades. Newborn survival´s disadvantage stems from its long status as an issue falling under the umbrellas of maternal and child survival but not fully adopted by these networks, and with limited appeal as a public health issue advanced by a small and technically focused network; network expansion and alignment with child survival norms have improved the issue´s status in the past few years.

Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

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