National responses to global health targets: exploring policy transfer in the context of the UNAIDS '90-90-90' treatment targets in Ghana and Uganda.
Identifieur interne : 000841 ( PubMed/Curation ); précédent : 000840; suivant : 000842National responses to global health targets: exploring policy transfer in the context of the UNAIDS '90-90-90' treatment targets in Ghana and Uganda.
Auteurs : Ellen Mcrobie [Royaume-Uni] ; Fred Matovu [Ouganda] ; Aisha Nanyiti [Ouganda] ; Justice Nonvignon [Ghana] ; Daniel Nana Yaw Abankwah [Ghana] ; Kelsey K. Case [Royaume-Uni] ; Timothy B. Hallett [Royaume-Uni] ; Johanna Hanefeld [Royaume-Uni] ; Lesong Conteh [Royaume-Uni]Source :
- Health policy and planning [ 1460-2237 ] ; 2017.
Abstract
Global health organizations frequently set disease-specific targets with the goal of eliciting adoption at the national-level; consideration of the influence of target setting on national policies, programme and health budgets is of benefit to those setting targets and those intended to respond. In 2014, the Joint United Nations Programme on HIV/AIDS set 'ambitious' treatment targets for country adoption: 90% of HIV-positive persons should know their status; 90% of those on treatment; 90% of those achieving viral suppression. Using case studies from Ghana and Uganda, we explore how the target and its associated policy content have been adopted at the national level. That is whether adoption is in rhetoric only or supported by programme, policy or budgetary changes. We review 23 (14 from Ghana, 9 from Uganda) national policy, operational and strategic documents for the HIV response and assess commitments to '90-90-90'. In-person semi-structured interviews were conducted with purposively sampled key informants (17 in Ghana, 20 in Uganda) involved in programme-planning and resource allocation within HIV to gain insight into factors facilitating adoption of 90-90-90. Interviews were transcribed and analysed thematically, inductively and deductively, guided by pre-existing policy theories, including Dolowitz and Marsh's policy transfer framework to describe features of the transfer and the Global Health Advocacy and Policy Project framework to explain observations. Regardless of notable resource constraints, transfer of the 90-90-90 targets was evident beyond rhetoric with substantial shifts in policy and programme activities. In both countries, there was evidence of attempts to minimize resource constraints by seeking programme efficiencies, prioritization of programme activities and devising domestic financing mechanisms; however, significant resource gaps persist. An effective health network, comprised of global and local actors, mediated the adoption and adaptation, facilitating a shift in the HIV programme from 'business as usual' to approaches targeting geographies and populations.
DOI: 10.1093/heapol/czx132
PubMed: 29040476
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Case</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Hallett, Timothy B" sort="Hallett, Timothy B" uniqKey="Hallett T" first="Timothy B" last="Hallett">Timothy B. 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In 2014, the Joint United Nations Programme on HIV/AIDS set 'ambitious' treatment targets for country adoption: 90% of HIV-positive persons should know their status; 90% of those on treatment; 90% of those achieving viral suppression. Using case studies from Ghana and Uganda, we explore how the target and its associated policy content have been adopted at the national level. That is whether adoption is in rhetoric only or supported by programme, policy or budgetary changes. We review 23 (14 from Ghana, 9 from Uganda) national policy, operational and strategic documents for the HIV response and assess commitments to '90-90-90'. In-person semi-structured interviews were conducted with purposively sampled key informants (17 in Ghana, 20 in Uganda) involved in programme-planning and resource allocation within HIV to gain insight into factors facilitating adoption of 90-90-90. Interviews were transcribed and analysed thematically, inductively and deductively, guided by pre-existing policy theories, including Dolowitz and Marsh's policy transfer framework to describe features of the transfer and the Global Health Advocacy and Policy Project framework to explain observations. Regardless of notable resource constraints, transfer of the 90-90-90 targets was evident beyond rhetoric with substantial shifts in policy and programme activities. In both countries, there was evidence of attempts to minimize resource constraints by seeking programme efficiencies, prioritization of programme activities and devising domestic financing mechanisms; however, significant resource gaps persist. An effective health network, comprised of global and local actors, mediated the adoption and adaptation, facilitating a shift in the HIV programme from 'business as usual' to approaches targeting geographies and populations.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">29040476</PMID><DateCreated><Year>2017</Year><Month>10</Month><Day>17</Day></DateCreated><DateRevised><Year>2017</Year><Month>10</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1460-2237</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2017</Year><Month>Oct</Month><Day>11</Day></PubDate></JournalIssue><Title>Health policy and planning</Title><ISOAbbreviation>Health Policy Plan</ISOAbbreviation></Journal><ArticleTitle>National responses to global health targets: exploring policy transfer in the context of the UNAIDS '90-90-90' treatment targets in Ghana and Uganda.</ArticleTitle><ELocationID EIdType="doi" ValidYN="Y">10.1093/heapol/czx132</ELocationID><Abstract><AbstractText>Global health organizations frequently set disease-specific targets with the goal of eliciting adoption at the national-level; consideration of the influence of target setting on national policies, programme and health budgets is of benefit to those setting targets and those intended to respond. In 2014, the Joint United Nations Programme on HIV/AIDS set 'ambitious' treatment targets for country adoption: 90% of HIV-positive persons should know their status; 90% of those on treatment; 90% of those achieving viral suppression. Using case studies from Ghana and Uganda, we explore how the target and its associated policy content have been adopted at the national level. That is whether adoption is in rhetoric only or supported by programme, policy or budgetary changes. We review 23 (14 from Ghana, 9 from Uganda) national policy, operational and strategic documents for the HIV response and assess commitments to '90-90-90'. In-person semi-structured interviews were conducted with purposively sampled key informants (17 in Ghana, 20 in Uganda) involved in programme-planning and resource allocation within HIV to gain insight into factors facilitating adoption of 90-90-90. Interviews were transcribed and analysed thematically, inductively and deductively, guided by pre-existing policy theories, including Dolowitz and Marsh's policy transfer framework to describe features of the transfer and the Global Health Advocacy and Policy Project framework to explain observations. Regardless of notable resource constraints, transfer of the 90-90-90 targets was evident beyond rhetoric with substantial shifts in policy and programme activities. In both countries, there was evidence of attempts to minimize resource constraints by seeking programme efficiencies, prioritization of programme activities and devising domestic financing mechanisms; however, significant resource gaps persist. An effective health network, comprised of global and local actors, mediated the adoption and adaptation, facilitating a shift in the HIV programme from 'business as usual' to approaches targeting geographies and populations.</AbstractText><CopyrightInformation>© The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>McRobie</LastName><ForeName>Ellen</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Matovu</LastName><ForeName>Fred</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>School of Economics, Makerere University, Kampala, Uganda.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Policy Analysis & Development Research Institute, Kampala, Uganda.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nanyiti</LastName><ForeName>Aisha</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>School of Economics, Makerere University, Kampala, Uganda.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nonvignon</LastName><ForeName>Justice</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Health Policy, Planning & Management, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Abankwah</LastName><ForeName>Daniel Nana Yaw</ForeName><Initials>DNY</Initials><AffiliationInfo><Affiliation>Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Case</LastName><ForeName>Kelsey K</ForeName><Initials>KK</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hallett</LastName><ForeName>Timothy B</ForeName><Initials>TB</Initials><AffiliationInfo><Affiliation>Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hanefeld</LastName><ForeName>Johanna</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Anthropology, Politics and Policy Group, Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Conteh</LastName><ForeName>Lesong</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Health Economics Group, School of Public Health, Imperial College London, London, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>10</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Health Policy Plan</MedlineTA><NlmUniqueID>8610614</NlmUniqueID><ISSNLinking>0268-1080</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">HIV</Keyword><Keyword MajorTopicYN="N">Policy analysis</Keyword><Keyword MajorTopicYN="N">UNAIDS</Keyword><Keyword MajorTopicYN="N">networks</Keyword><Keyword MajorTopicYN="N">targets</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>09</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>10</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>10</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>10</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29040476</ArticleId><ArticleId IdType="pii">4430985</ArticleId><ArticleId IdType="doi">10.1093/heapol/czx132</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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