Department of Public Administration and Policy, School of Public Affairs, American University, Washington, DC, USA.
Int J Health Policy Manag. 2017 Apr 1;6(4):183-189. doi: 10.15171/ijhpm.2017.14.
Global health networks, webs of individuals and organizations with a shared concern for a particular condition, have proliferated over the past quarter century. They differ in their effectiveness, a factor that may help explain why resource allocations vary across health conditions and do not correspond closely with disease burden. Drawing on findings from recently concluded studies of eight global health networks-addressing alcohol harm, early childhood development (ECD), maternal mortality, neonatal mortality, pneumonia, surgically-treatable conditions, tobacco use, and tuberculosis-I identify four challenges that networks face in generating attention and resources for the conditions that concern them. The first is problem definition: generating consensus on what the problem is and how it should be addressed. The second is positioning: portraying the issue in ways that inspire external audiences to act. The third is coalition-building: forging alliances with these external actors, particularly ones outside the health sector. The fourth is governance: establishing institutions to facilitate collective action. Research indicates that global health networks that effectively tackle these challenges are more likely to garner support to address the conditions that concern them. In addition to the effectiveness of networks, I also consider their legitimacy, identifying reasons both to affirm and to question their right to exert power.
在过去的四分之一个世纪里,关注特定疾病的个人和组织的全球健康网络如雨后春笋般涌现。它们在效果上存在差异,这一因素可能有助于解释为什么资源分配在不同的健康状况下存在差异,并且与疾病负担并不完全一致。本文利用最近对八个全球健康网络的研究结果——这些网络分别针对酒精危害、儿童早期发展(ECD)、产妇死亡率、新生儿死亡率、肺炎、可手术治疗的疾病、烟草使用和结核病——确定了网络在为其关注的疾病争取关注和资源时所面临的四个挑战。第一个挑战是问题定义:就问题是什么以及应该如何解决达成共识。第二个挑战是定位:以激励外部受众采取行动的方式描绘问题。第三个挑战是建立联盟:与这些外部行为者建立联盟,特别是卫生部门以外的行为者。第四个挑战是治理:建立机构以促进集体行动。研究表明,有效应对这些挑战的全球健康网络更有可能获得支持,以解决其关注的疾病。除了网络的有效性外,我还考虑了它们的合法性,确定了肯定和质疑它们行使权力的权利的原因。