在全球运动的推动下:探索影响乌干达国家一级预防死产工作重点的因素。
Building on momentum from the global campaigns: an exploration of factors that influenced prioritization of stillbirth prevention at the national level in Uganda.
机构信息
Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
School of Public Health, University of the Western Cape, Cape Town, South Africa.
出版信息
Global Health. 2021 Jun 26;17(1):66. doi: 10.1186/s12992-021-00724-1.
BACKGROUND
Of the close to 2.6 million stillbirths that happen annually, most are from low-income countries where until recently policies rarely paid special attention to addressing them. The global campaigns that followed called on countries to implement strategies addressing stillbirths and the adoption of recommendations varied according to contexts. This study explored factors that influenced the prioritization of stillbirth reduction in Uganda.
METHODS
The study employed an exploratory qualitative design adopting Shiffman's framework for political prioritization. Data collection methods included a document review and key informants' interviews with a purposively selected sample of 20 participants from the policy community. Atlas. Ti software was used for data management while thematic analysis was conducted to analyze the findings.
FINDINGS
Political prioritization of stillbirth interventions gained momentum following norm promotion from the global campaigns which peaked during the 2011 Lancet stillbirth series. This was followed by funding and technical support of various projects in Uganda. A combination of domestic advocacy factors such as a cohesive policy community converging around the Maternal and Child Health cluster accelerated the process by vetting the evidence and refining recommendations to support the adoption of the policy. The government's health systems strengthening aspirations and integration of interventions to address stillbirths within the overall Maternal and Child Health programming resonated well.
CONCLUSIONS
The transnational influence played a key role during the initial stages of raising attention to the problem and provision of technical and financial support. The success and subsequent processes, however, relied heavily on domestic advocacy and the national political environment, and the cohesive policy community.
背景
每年近 260 万例死产中,大多数发生在低收入国家,这些国家直到最近才很少有专门针对死产问题的政策。随后的全球运动呼吁各国实施解决死产问题的战略,并根据具体情况采用不同的建议。本研究探讨了影响乌干达优先考虑减少死产的因素。
方法
本研究采用 Shiffman 的政治优先排序框架,采用探索性定性设计。数据收集方法包括文献回顾和关键知情人访谈,从政策界中选择了 20 名有目的的参与者。使用 Atlas. Ti 软件进行数据管理,同时对发现进行主题分析。
结果
全球运动倡导规范后,死产干预措施的政治优先排序获得了动力,这一动力在 2011 年《柳叶刀》死产系列中达到顶峰。随后,乌干达的各种项目得到了资金和技术支持。国内倡导因素的结合,如围绕母婴健康集群聚集的凝聚力政策社区,通过审查证据和完善建议来支持政策的采用,加速了这一进程。政府对卫生系统加强的愿望以及将解决死产问题的干预措施纳入整体母婴健康规划的做法得到了很好的回应。
结论
跨国影响在引起对该问题的关注以及提供技术和财政支持的初期阶段发挥了关键作用。然而,成功和随后的进程在很大程度上依赖于国内倡导和国家政治环境,以及凝聚力强的政策社区。
相似文献
Glob Health Action. 2015-3-31
Cochrane Database Syst Rev. 2022-2-1
引用本文的文献
Health Policy Plan. 2025-8-18
本文引用的文献
Women Birth. 2020-11
BMC Health Serv Res. 2019-9-10
Glob Health Sci Pract. 2019-3-13
BMC Pregnancy Childbirth. 2017-11-8