Health Policy and Systems, Sambodhi Research and communications, Noida, India.
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Int J Health Policy Manag. 2023;12:7916. doi: 10.34172/ijhpm.2023.7916. Epub 2023 Apr 15.
To understand the role of power in health policy processes in low- and middle-income country (LMIC) contexts, it is necessary to engage with global and local power structures and their historical contexts. In this commentary, we outline three dimensions that shape a dominant power in health policy processes-the biomedical power. We propose that understanding the linkages between medical power and colonialism; the close connection of public health, medicine and elite networks; and the intersectionalities that shape the powers of medical professionals can offer the means to examine the biomedical hegemony in health policy processes. Additionally we suggest that a more nuanced understanding of the interaction of local powers with global funding can offer some entry points to achieving more equitable and interdisciplinary health policy processes in LMICs.
为了理解权力在中低收入国家(LMIC)卫生政策制定过程中的作用,有必要参与到全球和地方权力结构及其历史背景中。在本评论中,我们概述了塑造卫生政策制定过程中主导权力的三个维度——生物医学权力。我们认为,理解医学权力与殖民主义之间的联系;公共卫生、医学和精英网络之间的密切联系;以及塑造医学专业人员权力的交叉性,可以提供一种手段来检验卫生政策制定过程中的生物医学霸权。此外,我们还认为,更细致地理解地方权力与全球资金的相互作用,可以为实现 LMIC 中更公平和跨学科的卫生政策制定过程提供一些切入点。