Mapping HIV Policies to Explore Health Policy in the Global South

• In Event: New Theoretical Lessons for Health Politics from the Global South

Abstract

Health policy has often lacked measures with which to conduct robust quantitative cross-national analysis in low- and middle-income countries (LMICs)—apart from spending data, which is a notoriously poor predictor of wellbeing or health policy in LMICs. In the last decade, increased attention has been paid to such analysis of welfare states—with evidence used to both classify welfare state systems and explore diffusion. But literature on LMICs has far less information about the determinants of both health policy choice and change (e.g. diffusion, learning, coercion) and notably lacks evidence about the ways in which policy environments play a causal role in the production of population health. In the global North, however, large scale efforts to track policy change and agenda setting have been undertaken by multiple researchers. Meanwhile U.S. scholars have applied techniques labeled “policy surveillance” to track health-related laws and regulations across U.S. states—generating high quality comparative evidence about the impact of health policies. This paper is part of a multi-year effort to bridge this divide—adapting tools of the north including policy-surveillance methods to track policies in the global South. In particular we focus on HIV policies—for which significant international attention and support makes it possible to track, code, and benchmark numerous policy areas. LMICs, however, pose a particular set of challenges in crafting valid measures of policy (e.g. low resource settings often lack written documentation of policies; policymaking authority is less easy to trace) and in building models for comparative analysis (e.g. vastly different economic and cultural contexts). To address these issues we propose mobilizing key tools from the political economy of development—but show that this requires adaptation for use in a health context. This paper explores methodology and initial empirical findings from this early-stage work that suggest this work has high potential for fruitful empirical research among both those who focus on political determinants and those concerned about health outcomes in global public health.

Author

• Matthew Kavanagh, Georgetown University