Cervical cancer and the global health agenda: Insights from multiple policy-analysis frameworks

Abstract

Cervical cancer is the second leading cause of cancer deaths for women globally, with an estimated 88% of deaths occurring in the developing world. Available technologies have dramatically reduced mortality in high-income settings, yet cervical cancer receives considerably little attention on the global health policy landscape. The authors applied four policy-analysis frameworks to literature on global cervical cancer to explore the question of why cervical cancer may not be receiving the international attention it may otherwise warrant. Each framework explores the process of agenda setting and discerns factors that either facilitate or hinder policy change in cases where there is both a clear problem and a potential effective solution. In combination, these frameworks highlight a number of crucial elements that may be needed to raise the profile of cervical cancer on global health agendas, including improving local (national or sub-national) information on the condition; increasing mobilisation of affected civil society groups; framing cervical cancer debates in ways that build upon its classification as a non-communicable disease (NCD) and an issue of women's rights; linking cervical cancer screening to well-funded services such as those for HIV treatment in some countries; and identifying key global policy windows of opportunity to promote the cervical cancer agenda, including emerging NCD global health discussions and post-2015 reviews of the Millennium Development Goals.

The Politics of Universal Health Coverage in Low and Middle-Income Countries: A Framework for Evaluation and Action

“…Though the cycle heuristic has been criticized as overly linear, rational, and apolitical (e.g., Downs 1972;Weissert and Weissert 2002), we believe, with others, that it is a useful way to organize different political theories about policy reform (Walt et al 2008). While other articles have reviewed existing policy-analysis frameworks (e.g., Parkhurst and Vulimiri 2013), most of these efforts focus on the agendasetting stage of the policy cycle to answer the question of why certain health priorities receive disproportionate attention over others. Here we propose a framework that synthesizes considerations across the policy cycle.…”

Can the Success of HIV Scale-Up Advance the Global Chronic NCD Agenda?

“…The framework developed by Shiffman provides useful insights into why some important health issues fail to garner appropriate resources and attention. It has been used to analyze the responses to maternal mortality [18], maternal and child health [19, 20], cervical cancer [21], oral health [22], mental health [23], and NCDs [24]. In this paper, we use Shiffman’s framework to contrast characteristics of HIV and NCDs that may explain the different global responses to the two entities and suggest potential avenues for the path forward (Table 1).…”

Challenging Gendered Inequalities in Global Health: Dilemmas for NGOs

“…The political nature of priority setting in formulating global health policy has been widely acknowledged and concern has been expressed that donor prioritization of HIV/AIDS treatment and prevention in developing countries has displaced aid for other health issues (Parkhurst and Vulimiri, 2013). Indeed, this is particularly apparent in sub-Saharan Africa where development in health has become nearly synonymous with HIV/AIDS and there has been a profound reconfiguration in development efforts prioritizing AIDS over other concerns (Morfitt, 2011).…”