Shiffman Jeremy, Quissell Kathryn, Schmitz Hans Peter, Pelletier David L, Smith Stephanie L, Berlan David, Gneiting Uwe, Van Slyke David, Mergel Ines, Rodriguez Mariela, Walt Gill
American University, Washington, DC 20016, USA,
American University, Washington, DC 20016, USA.
Health Policy Plan. 2016 Apr;31 Suppl 1(Suppl 1):i3-16. doi: 10.1093/heapol/czu046. Epub 2015 Aug 29.
Since 1990 mortality and morbidity decline has been more extensive for some conditions prevalent in low- and middle-income countries than for others. One reason may be differences in the effectiveness of global health networks, which have proliferated in recent years. Some may be more capable than others in attracting attention to a condition, in generating funding, in developing interventions and in convincing national governments to adopt policies. This article introduces a supplement on the emergence and effectiveness of global health networks. The supplement examines networks concerned with six global health problems: tuberculosis (TB), pneumonia, tobacco use, alcohol harm, maternal mortality and newborn deaths. This article presents a conceptual framework delineating factors that may shape why networks crystallize more easily surrounding some issues than others, and once formed, why some are better able than others to shape policy and public health outcomes. All supplement papers draw on this framework. The framework consists of 10 factors in three categories: (1) features of the networks and actors that comprise them, including leadership, governance arrangements, network composition and framing strategies; (2) conditions in the global policy environment, including potential allies and opponents, funding availability and global expectations concerning which issues should be prioritized; (3) and characteristics of the issue, including severity, tractability and affected groups. The article also explains the design of the project, which is grounded in comparison of networks surrounding three matched issues: TB and pneumonia, tobacco use and alcohol harm, and maternal and newborn survival. Despite similar burden and issue characteristics, there has been considerably greater policy traction for the first in each pair. The supplement articles aim to explain the role of networks in shaping these differences, and collectively represent the first comparative effort to understand the emergence and effectiveness of global health networks.
自1990年以来，低收入和中等收入国家中某些常见疾病的死亡率和发病率下降幅度比其他疾病更大。一个原因可能是近年来激增的全球卫生网络在有效性上存在差异。在引起对某种疾病的关注、筹集资金、制定干预措施以及说服各国政府采取政策方面，一些网络可能比其他网络更有能力。本文介绍了一期关于全球卫生网络的兴起与有效性的增刊。该增刊考察了与六个全球卫生问题相关的网络：结核病、肺炎、烟草使用、酒精危害、孕产妇死亡率和新生儿死亡。本文提出了一个概念框架，勾勒出可能影响网络为何围绕某些问题比其他问题更容易形成，以及一旦形成，为何有些网络比其他网络更有能力塑造政策和公共卫生成果的因素。所有增刊文章都借鉴了这个框架。该框架由三类10个因素组成：（1）构成网络的网络和行为体的特征，包括领导力、治理安排、网络构成和框架策略；（2）全球政策环境中的条件，包括潜在盟友和对手、资金可得性以及关于哪些问题应优先处理的全球期望；（3）问题的特征，包括严重性、可处理性和受影响群体。本文还解释了该项目的设计，其基于对围绕三个匹配问题的网络的比较：结核病和肺炎、烟草使用和酒精危害，以及孕产妇和新生儿生存。尽管负担和问题特征相似，但每一对中的第一个问题在政策上获得了更大的推动。增刊文章旨在解释网络在塑造这些差异方面的作用，并共同代表了理解全球卫生网络的兴起与有效性的首次比较性努力。
