Health Systems Program

Baltimore, MD, United States

Health Systems Program

Baltimore, MD, United States
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PubMed | Health Systems Program, African Population and Health Research Center and Health Systems Program.
Type: | Journal: Health policy and planning | Year: 2015

Policy transfer theories explain how policy ideas move across time and geography and offer an approach to understanding waves of policy change, a common phenomenon in global health. Four primary mechanisms for the transfer of policies from global to national levels are posited: learning, coercion, socialization and competition.We used six concurrent country case studies of policy change for child survival followed by a global study to analyse (1) mechanisms for policy transfer and (2) the roles of international organizations in promoting policy transfer. Our six country cases drew upon early adopters of integrated Community Case Management of Childhood Illness policy (Malawi, Niger), as well as countries that were slower to adopt due either to practical implementation challenges (Mozambique, Mali) and/or policy resistance (Burkina Faso, Kenya). In total, 145 semi-structured interviews and 283 document reviews were conducted across the six country cases, and 25 semi-structured interviews and 72 document reviews for the global study.Three of the four diffusion mechanisms (learning, coercion and socialization) were important in these cases, but not competition. Multiple strategies were employed by multilateral organizations to support policy transfer, such as regional meetings or academic publications, frequently serving multiple diffusion mechanisms simultaneously (e.g. both learning and socialization). In just one country case, funding conditionalities were used to press for policy change. The emphasis of policy transfer mechanisms varied between early and later adopters. Early adopters, for example, were more likely to engage in learning. International multilateral organizations were active policy transfer agents, and national policy-makers perception of them as trusted partners made them well suited for this role. However, on occasion their role became more that of advocates than neutral facilitators.International actors use multiple synergistic channels to promote uptake of global health policies in low- and middle-income countries, and tailor strategies employed to country contexts.


Trujillo A.J.,Health Systems Program | Trujillo A.J.,International Injury Research Unit | Puvanachandra P.,Health Systems Program | Puvanachandra P.,International Injury Research Unit | And 2 more authors.
Geriatrics and Gerontology International | Year: 2011

Aim: The burden of falls amongst the elderly raises important public health concerns. Empirical evidence suggests that macroeconomic growth may not be sufficient to reduce mortality and morbidity from injuries among the elderly. This paper consolidates macro- and microeconomic evidence of the effect of income on elderly falls in Latin America. Method: Using household databases, we estimate an empirical model to assess the relationship between income and falls. Results: The estimations indicate that an increase in personal income reduces the probability of falling; yet, the size of the effect is negligible. A 10% increase in income reduces the probability of falling between 0.001 and 0.002% while a 20% increase reduced the probability by up to 1%. Conclusion: These findings are consistent with macroeconomic data where morbidity and mortality among seniors are inelastic to economic growth. Policy implications of cash transfer programs targeting the elderly are discussed. © 2010 Japan Geriatrics Society.

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