College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
BMJ Glob Health. 2020 Sep;5(9). doi: 10.1136/bmjgh-2020-002457.
Understanding the international and domestic political factors influencing the evolution of type 2 diabetes policies and primary care institutions is a new area of scholarly research. This article contributes to this area of inquiry by illustrating how a government's shifting foreign policy aspirations, that is, to establish the government's reputation as an internationally recognised leader in type 2 diabetes policy and presidential electoral incentives provide alternative insights into the evolution of type 2 diabetes treatment policies and primary care institutional reforms.
I conduct a single-case study analysis with the usage of qualitative data; quantitative statistical data on epidemiological trends and government policy spending is also provided as supportive evidence.
The case of Brazil illustrates how a reduction in foreign policy commitment to international reputation building in health as well as presidential electoral incentives to use diabetes policy as an electoral strategy account for a decline in sustaining policy and primary care institutional innovations in response to type 2 diabetes.
Future scholars interested in understanding the lack of sustainability and effectiveness in type 2 diabetes programmes should consider investigating the complex international and domestic political factors influencing political interests, incentives and commitment to reform.
了解影响 2 型糖尿病政策和基层医疗体系演变的国际和国内政治因素是学术研究的一个新领域。本文通过阐述政府不断变化的外交政策愿望(即树立政府在 2 型糖尿病政策方面国际公认的领导者的声誉)和总统选举激励如何为 2 型糖尿病治疗政策和基层医疗体系改革的演变提供替代视角,为这一研究领域做出了贡献。
我采用单一案例研究分析,并使用定性数据;还提供了关于流行病学趋势和政府政策支出的定量统计数据作为支持证据。
巴西的案例说明了减少在卫生领域的外交政策承诺以建立国际声誉,以及将糖尿病政策作为选举策略的总统选举激励,如何导致政策和基层医疗体系创新难以持续,以应对 2 型糖尿病。
未来有兴趣了解 2 型糖尿病计划缺乏可持续性和有效性的学者,应该考虑调查影响政治利益、激励和改革承诺的复杂国际和国内政治因素。