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Collapsing the vertical-horizontal divide: An ethnographic study of evidence-based policymaking in maternal health

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  • Béhague, D.P.
  • Storeng, K.T.

Abstract

Using the international maternal health field as a case study, we draw on ethnographic research to investigate how public health researchers and policy experts are responding to tensions between vertical and horizontal approaches to health improvement. Despite nominal support for an integrative health system approach, we found that competition for funds and international recognition pushes professionals toward vertical initiatives. We also highlight how research practices contribute to the dominance of vertical strategies and limit the success of evidence-based policymaking for strengthening health systems. Rather than support disease- and subfield-specific advocacy, the public health community urgently needs to engage in open dialogue regarding the international, academic, and donor-driven forces that drive professionals toward an exclusive interest in vertical programs.

Suggested Citation

  • Béhague, D.P. & Storeng, K.T., 2008. "Collapsing the vertical-horizontal divide: An ethnographic study of evidence-based policymaking in maternal health," American Journal of Public Health, American Public Health Association, vol. 98(4), pages 644-649.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2007.123117_1
    DOI: 10.2105/AJPH.2007.123117
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    Cited by:

    1. Atina Krajewska, 2015. "Bioethics and Human Rights in the Constitutional Formation of Global Health," Laws, MDPI, vol. 4(4), pages 1-32, December.
    2. Closser, Svea & Mendenhall, Emily & Brown, Peter & Neill, Rachel & Justice, Judith, 2022. "The anthropology of health systems: A history and review," Social Science & Medicine, Elsevier, vol. 300(C).
    3. Sarkar, Nandini D.P. & Baingana, Florence & Criel, Bart, 2022. "Integration of perinatal mental health care into district health services in Uganda: Why is it not happening? The Four Domain Integrated Health (4DIH) explanatory framework," Social Science & Medicine, Elsevier, vol. 296(C).
    4. Lois Orton & Ffion Lloyd-Williams & David Taylor-Robinson & Martin O'Flaherty & Simon Capewell, 2011. "The Use of Research Evidence in Public Health Decision Making Processes: Systematic Review," PLOS ONE, Public Library of Science, vol. 6(7), pages 1-10, July.
    5. Behague, Dominique & Tawiah, Charlotte & Rosato, Mikey & Some, Télésphore & Morrison, Joanna, 2009. "Evidence-based policy-making: The implications of globally-applicable research for context-specific problem-solving in developing countries," Social Science & Medicine, Elsevier, vol. 69(10), pages 1539-1546, November.
    6. Tayebeh Abbasi & Akbar Hassanpoor, 2022. "Exploring the Factors Influencing the Success of Public Policies: Evidence from Iran’s Higher Education," Public Organization Review, Springer, vol. 22(2), pages 421-435, June.
    7. Smith, K.E. & Stewart, E.A., 2017. "Academic advocacy in public health: Disciplinary ‘duty’ or political ‘propaganda’?," Social Science & Medicine, Elsevier, vol. 189(C), pages 35-43.
    8. Suh, Siri, 2015. "“Right tool,” wrong “job”: Manual vacuum aspiration, post-abortion care and transnational population politics in Senegal," Social Science & Medicine, Elsevier, vol. 135(C), pages 56-66.

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