Gómez Eduardo J, Ruger Jennifer Prah
King's College London.
University of Pennsylvania.
J Health Polit Policy Law. 2015 Feb;40(1):3-11. doi: 10.1215/03616878-2854256. Epub 2014 Dec 5.
In recent years, several emerging nations with burgeoning economies and in transition to democracy have pursued health policy innovations. As these nations have integrated into the world economy through bilateral trade and diplomacy, they have also become increasingly exposed to international pressures and norms and focused on more effective, equitable health care systems. There are several lessons learned from the case studies of Brazil, Ghana, India, China, Vietnam, and Thailand in this special issue on the global and domestic politics of health policy in emerging nations. For the countries examined, although sensitive to international preferences, domestic governments preferred to implement policy on their own and at their own pace. During the policy-making and implementation process, international and domestic actors played different roles in health policy making vis-à-vis other reform actors -- at times the state played an intermediary role. In several countries, civil society also played a central role in designing and implementing policy at all levels of government. International institutions also have a number of mechanisms and strategies in their tool box to influence a country's domestic health governance, and they use them, particularly in the context of an uncertain state or internal discordance within the state.
近年来，一些经济蓬勃发展且正转向民主的新兴国家推行了卫生政策创新。随着这些国家通过双边贸易和外交融入世界经济，它们也越来越多地受到国际压力和规范的影响，并致力于建立更有效、公平的医疗体系。在本期关于新兴国家卫生政策的全球与国内政治的特刊中，从巴西、加纳、印度、中国、越南和泰国的案例研究中可以吸取若干经验教训。对于所研究的国家而言，尽管对国际偏好敏感，但国内政府更倾向于自行并按自己的节奏实施政策。在政策制定和实施过程中，国际和国内行为体在卫生政策制定方面相对于其他改革行为体发挥了不同作用——有时国家发挥了中介作用。在一些国家，公民社会在各级政府的政策设计和实施中也发挥了核心作用。国际机构在其工具库中也有一些机制和策略来影响一个国家的国内卫生治理，并且它们会加以运用，尤其是在国家状况不确定或国内存在不和谐的情况下。
