Okeke Chinyere, Uzochukwu Benjamin, Shung-King Maylene, Gilson Lucy
Department of Community Medicine, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria.
Health Policy Research Group, University of Nigeria Enugu-Campus, Enugu Nigeria.
Health Promot Perspect. 2023 Jul 10;13(2):147-156. doi: 10.34172/hpp.2023.18. eCollection 2023.
Maternal and child health is a priority for most governments, especially those in low and middle-income countries (LMICs), due to high mortality rates. The combination of individual and social actions designed to gain political commitment, policy support and social acceptance for health goals are influenced by the interplay between the advocates and the strategies they deploy in planning and advocating for maternal and child health issue. This study aims to deepen our understanding of how advocacy has influenced maternal and child health priority setting in Nigeria.
This is a mixed method study that involved 24 key informant interviews, document review, policy tracking and mapping of advocacy events that contributed to the repositioning of maternal and child health on the political agenda was done. Respondents were deliberately selected according to their roles and positions. Analysis was based on Shiffman and Smith's policy analysis framework of agenda setting.
Our findings suggest that use of various strategies for advocacy such as influencers, media, generated different outcomes and the use of a combination of strategies was found to be more effective. The role of advocacy in issue emergence was prominent and the presence of powerful actors, favorable policy window helped achieve desired outcomes. The power of the advocates and the strength of the individuals involved played a key role.
This study finds it possible to understand the role of advocacy in policy agenda setting through the application of agenda setting framework. To achieve the health SDG goals, advocacy barriers need to be addressed at multiple levels.
由于死亡率高，孕产妇和儿童健康是大多数政府的优先事项，特别是中低收入国家（LMICs）的政府。旨在为卫生目标争取政治承诺、政策支持和社会认可的个人行动与社会行动相结合，受到倡导者及其在规划和倡导孕产妇和儿童健康问题时所采用策略之间相互作用的影响。本研究旨在加深我们对倡导如何影响尼日利亚孕产妇和儿童健康优先事项设定的理解。
这是一项混合方法研究，涉及24次关键信息访谈、文件审查、政策跟踪以及对有助于将孕产妇和儿童健康重新定位到政治议程上的倡导活动进行映射。根据受访者的角色和职位进行了有针对性的选择。分析基于希夫曼和史密斯的议程设置政策分析框架。
我们的研究结果表明，使用各种倡导策略，如有影响力的人、媒体，会产生不同的结果，并且发现综合使用多种策略更有效。倡导在问题出现方面的作用显著，强大行为体的存在、有利的政策窗口有助于实现预期结果。倡导者的权力和所涉个人的力量起到了关键作用。
本研究发现，通过应用议程设置框架可以理解倡导在政策议程设定中的作用。为实现卫生可持续发展目标，需要在多个层面解决倡导障碍。
