Brolan Claire E, Hill Peter S
School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia
School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia.
Health Policy Plan. 2016 May;31(4):514-26. doi: 10.1093/heapol/czv101. Epub 2015 Oct 22.
In 2001, technocrats from four multilateral organizations selected the Millennium Development Goals mainly from the previous decade of United Nations (UN) summits and conferences. Few accounts are available of that significant yet cloistered synthesis process: none contemporaneous. In contrast, this study examines health's evolving location in the first-phase of the next iteration of global development goal negotiation for the post-2015 era, through the synchronous perspectives of representatives of key multilateral and related organizations. As part of the Go4Health Project, in-depth interviews were conducted in mid-2013 with 57 professionals working on health and the post-2015 agenda within multilaterals and related agencies. Using discourse analysis, this article reports the results and analysis of a Universal Health Coverage (UHC) theme: contextualizing UHC's positioning within the post-2015 agenda-setting process immediately after the Global Thematic Consultation on Health and High-Level Panel of Eminent Persons on the Post-2015 Development Agenda (High-Level Panel) released their post-2015 health and development goal aspirations in April and May 2013, respectively. After the findings from the interview data analysis are presented, the Results will be discussed drawing on Shiffman and Smith (Generation of political priority for global health initiatives: a framework and case study of maternal mortality.The Lancet2007; 370: : 1370-79) agenda-setting analytical framework (examining ideas, issues, actors and political context), modified by Benzianet al.(2011). Although more participants support the High-Level Panel's May 2013 report's proposal-'Ensure Healthy Lives'-as the next umbrella health goal, they nevertheless still emphasize the need for UHC to achieve this and thus be incorporated as part of its trajectory. Despite UHC's conceptual ambiguity and cursory mention in the High-Level Panel report, its proponents suggest its re-emergence will occur in forthcoming State led post-2015 negotiations. However, the final post-2015 SDG framework for UN General Assembly endorsement in September 2015 confirms UHC's continued distillation in negotiations, as UHC ultimately became one of a litany of targets within the proposed global health goal.
2001年,来自四个多边组织的技术官僚主要从联合国(UN)此前十年的峰会和会议中挑选出了千年发展目标。关于这一意义重大却隐秘的综合过程的记述寥寥无几:没有同时期的记录。相比之下,本研究通过关键多边组织和相关组织代表的同步视角,审视了健康议题在2015年后时代全球发展目标谈判下一阶段第一期的演变情况。作为“促进健康项目”的一部分,2013年年中对多边组织及相关机构中57位从事健康议题及2015年后议程工作的专业人员进行了深入访谈。本文运用话语分析方法,报告了全民健康覆盖(UHC)主题的结果及分析:在健康问题全球专题协商会和2015年后发展议程知名人士高级别小组(高级别小组)分别于2013年4月和5月公布其2015年后健康与发展目标愿景之后,将全民健康覆盖在2015年后议程设定过程中的定位置于具体情境中进行分析。在呈现访谈数据分析结果之后,将借鉴希夫曼和史密斯(《全球健康倡议的政治优先事项的产生:一个框架及孕产妇死亡率案例研究》。《柳叶刀》2007年;370:1370 - 79)经本齐亚内等人(2011年)修改的议程设定分析框架(审视理念、问题、行为体和政治背景)来讨论研究结果。尽管更多参与者支持高级别小组2013年5月报告中的提议——“确保健康生活 ”——作为下一个总体健康目标,但他们仍强调全民健康覆盖对于实现这一目标的必要性,因此全民健康覆盖应作为该目标轨迹的一部分被纳入其中。尽管全民健康覆盖在概念上存在模糊性,且在高级别小组报告中只是被粗略提及,但其支持者认为全民健康覆盖将在即将到来的由各国主导的2015年后谈判中再度出现。然而,2015年9月供联合国大会认可的最终2015年后可持续发展目标框架证实了全民健康覆盖在谈判中仍在不断提炼,因为全民健康覆盖最终成为了拟议的全球健康目标中一长串具体目标之一。