Agenda setting for maternal survival in Ghana and Tanzania against the backdrop of the MDGs. (April 2019)

• Record Type: Journal Article
• Authors: Smith, Stephanie L.; Hunsmann, Moritz
• Is Part Of: Social science & medicine. Volume 226(2019)
• Page Start: 135
• Page End: 142
• Publication Date: 2019-04
• Subjects: Ghana -- Tanzania -- Health policy -- Agenda setting -- Millennium development goal -- MDG -- Maternal health; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2019.02.049
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: High-level political support for the United Nations Millennium Development Goals (MDGs) drew international attention to included causes at the turn of the century. Influences of this normative framework on national-level health agenda setting remain little investigated. This study investigates the agenda status of maternal survival against the backdrop of the MDGs in two countries in sub-Saharan Africa. Informed by replicative case studies conducted in Ghana and Tanzania, the study finds the MDGs played a significant role in the issue's increasing status in both countries by helping to align several factors that facilitate the agenda setting process, including: ideas concerning the severity of the problem and expectations for its redress; institutions that shape policies, programs and monitoring; and economic and political interests. The agenda setting process was similar in the countries but for two dynamics. HIV/AIDS dominated Tanzania's health policy agenda in the early 2000s, crowding out attention to maternal and other health issues. A network of concerned actors that expanded to form a broad political coalition later facilitated agenda setting in Tanzania, including securing some budgetary commitments. By contrast, Ghana's core maternal health network remained technically oriented and closed to broader political and civil society engagement, limiting its capacity to expand issue attention and budgetary commitments beyond the health sector. Highlights: MDG 5 helped draw government attention and resources to maternal health. Maternal survival faced strong competition for attention from HIV/AIDS in Tanzania. Lagging progress toward MDG 5 was an influential frame in both countries. A health network that expanded to form a broad political coalition held an advantage.