Conceptual Clarity and Empirical Measurement of the ‘Global Health Agenda'

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

Abstract

Many global health policy and advocacy communities claim that their issue of concern is 'neglected.' In other words, they argue that their issue does not receive the attention and resources it deserves: it is not on the 'global health agenda.' However, these communities and many scholars neglect to define what it means to be on the ‘global health agenda,’ resulting in a lack of clarity concerning whether and the extent to which issues are or are not on the agenda. This analysis offers definitional clarity and a means to measure global health agenda status – an important undertaking for overcoming challenges with conducting prospective studies in this area and more broadly, advancing the study of agenda-setting in global health.

We examine the use of the term ‘agenda’ and how agenda status is measured in practice – among health practitioners and policymakers, as well as in theory across the political science and policy scholarship and the health policy analysis field. We triangulate across various data sources, including media reports, World Health Organization resolutions, published scholarly articles, national health plans and reports on global health funding from various donors. We also draw on existing agenda setting theories and frameworks. We employ qualitative synthesis, a methodology often used to review health policy analysis research in low- and middle-income countries (Gilson and Raphaely 2008; Gilson 2014; Berlan et al. 2014; Erasmus 2014; Erasmus et al. 2014; Gilson et al. 2014; Walt and Gilson 2014) and global health diplomacy (Ruckert et al. 2016). We extract and pool the findings of systematically selected qualitative, quantitative, and mixed methods studies in order to produce definitions of ‘global health agenda’ and identify measures used for determining agenda status. We first inductively code the findings of relevant research for how agenda status is defined and second, generate and organize descriptive themes concerning criteria for how global health agenda status is measured. Finally, we use the findings of the thematic analysis for assessment of agenda status across various health issues.

Our preliminary analysis delineates several, and often overlapping, arenas in which issues compete for attention in global health: social arenas, political systems, among donors, and within international institutions and governing bodies. Global health agenda status may be measured by observing the extent to which an issue receives attention from media, researchers and authoritative actors, as well as the extent to which policy is formulated and funds are allocated across different arenas and over time. We consider the social construction of these arenas and measurement categories, as well as the contestation and pathologies of measurement – across and within these arenas.

Our paper ends with a discussion of further areas of inquiry and the implications for developing quantitative indicators to delineate the agenda status of global health issues. By providing conceptual clarity and guidance on empirical measurement, scholars, policy-makers and practitioners are better equipped to understand the relative agenda status of global health issues.

Authors

• Yusra Ribhi Shawar, Johns Hopkins University

• Stephanie L. Smith, Virginia Tech