Jones Catherine M, Clavier Carole, Potvin Louise
Chaire Approches communautaires et inégalités de santé, Montréal, Québec, Canada.
Institut de recherche en santé publique de l'Université de Montréal, Montréal, Québec, Canada.
BMJ Glob Health. 2017 Apr 4;2(2):e000120. doi: 10.1136/bmjgh-2016-000120. eCollection 2017.
Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it.
Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian and the using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design.
Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway.
Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making.
自2007年《奥斯陆部长级宣言》签署以来,外交政策制定应纳入卫生考量这一理念在联合国议程上得到越来越多的支持,关于全球卫生与外交政策的年度联大决议便是明证。通过国家全球卫生政策(NPGH)是一些成员国将卫生与外交政策制定相结合的一种方式。本文探讨了这些政策的意图以及各国计划如何实施。
采用最相似系统设计,我们对2012年正式通过的两份政策文件进行了比较研究。我们运用施耐德和英格拉姆的政策设计框架,对挪威和[此处原文缺失国名]的政策文件进行了定向定性内容分析。在对每份文件重复分析方法后,我们将它们并列分析,以探究国家全球卫生政策设计要素的异同。
分析表明,国家全球卫生政策期望影响境外的变革。以国际层面为目标,它们旨在影响政策场所、多边伙伴关系和国际机构。支持预期变革的手段主要是卫生外交,瑞士在国内、挪威在国外将其作为在多个部门之间就全球卫生利益和目标进行谈判的工具。
研究结果表明,国家全球卫生政策设计通过将全球卫生治理体系确定为政策目标,为构建该体系做出了贡献,而且除非实施规则明确纳入,否则政策手段可能会避开卫生部门行为体。研究应探讨未来国家全球卫生政策设计如何构建不同类型的目标,作为各国政府试图对其施加影响以进行全球卫生决策的政治化行为体群体。