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Agenda setting for maternal survival in Ghana and Tanzania against the backdrop of the MDGs

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  • Smith, Stephanie L.
  • Hunsmann, Moritz

Abstract

High-level political support for the United Nations Millennium Development Goals (MDGs) drew international attention to included causes at the turn of the century. Influences of this normative framework on national-level health agenda setting remain little investigated. This study investigates the agenda status of maternal survival against the backdrop of the MDGs in two countries in sub-Saharan Africa. Informed by replicative case studies conducted in Ghana and Tanzania, the study finds the MDGs played a significant role in the issue's increasing status in both countries by helping to align several factors that facilitate the agenda setting process, including: ideas concerning the severity of the problem and expectations for its redress; institutions that shape policies, programs and monitoring; and economic and political interests. The agenda setting process was similar in the countries but for two dynamics. HIV/AIDS dominated Tanzania's health policy agenda in the early 2000s, crowding out attention to maternal and other health issues. A network of concerned actors that expanded to form a broad political coalition later facilitated agenda setting in Tanzania, including securing some budgetary commitments. By contrast, Ghana's core maternal health network remained technically oriented and closed to broader political and civil society engagement, limiting its capacity to expand issue attention and budgetary commitments beyond the health sector.

Suggested Citation

  • Smith, Stephanie L. & Hunsmann, Moritz, 2019. "Agenda setting for maternal survival in Ghana and Tanzania against the backdrop of the MDGs," Social Science & Medicine, Elsevier, vol. 226(C), pages 135-142.
    • Handle: RePEc:eee:socmed:v:226:y:2019:i:c:p:135-142
    DOI: 10.1016/j.socscimed.2019.02.049
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    References listed on IDEAS

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    1. Hunsmann, Moritz, 2012. "Limits to evidence-based health policymaking: Policy hurdles to structural HIV prevention in Tanzania," Social Science & Medicine, Elsevier, vol. 74(10), pages 1477-1485.
    2. Ziblim Abukari & Ahmed Bawa Kuyini & Abdulai Kuyini Mohammed, 2015. "Education and Health Care Policies in Ghana," SAGE Open, , vol. 5(4), pages 21582440156, October.
    3. Finnemore, Martha & Sikkink, Kathryn, 1998. "International Norm Dynamics and Political Change," International Organization, Cambridge University Press, vol. 52(4), pages 887-917, October.
    4. Price, Richard, 1998. "Reversing the Gun Sights: Transnational Civil Society Targets Land Mines," International Organization, Cambridge University Press, vol. 52(3), pages 613-644, July.
    5. Reich, Michael R., 1995. "The politics of health sector reform in developing countries: three cases of pharmaceutical policy," Health Policy, Elsevier, vol. 32(1-3), pages 47-77.
    6. Smith, Stephanie L., 2014. "Political contexts and maternal health policy: Insights from a comparison of south Indian states," Social Science & Medicine, Elsevier, vol. 100(C), pages 46-53.
    7. Jeremy Shiffman & Stephanie Smith, 2007. "Generation of Political Priority for Global Health Initiatives: A Framework and Case Study of Maternal Mortality," Working Papers 129, Center for Global Development.
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    1. Bukenya, Badru & Golooba-Mutebi, Frederick, 2020. "What explains sub-national variation in maternal mortality rates within developing countries? A political economy explanation," Social Science & Medicine, Elsevier, vol. 256(C).
    2. Chinwah, Viviane & Nyame-Asiamah, Frank & Ekanem, Ignatius, 2020. "Risk factors affecting maternal health outcomes in Rivers State of Nigeria: Towards the PRISMA model," Social Science & Medicine, Elsevier, vol. 265(C).

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