Policy adoption in dynamic international environments: Evidence from national AIDS programs

Abstract

The policy adoption is often seen as a function of internal determinants, external determinants, or a combination of the two. In the years since the start of the HIV/AIDS epidemic nearly every country in the world has adopted of some nature a program to combat the epidemic. This article demonstrates the mixed mechanisms influencing the adoption of AIDS programs, in a quantitative study of 90 countries. Prior studies have claimed that multilateral organizations were vital to global action against the HIV/AIDS epidemic. This study provides empirical evidence showing the actions taken by the multilateral organizations have both helped and hindered efforts to combat the HIV/AIDS epidemic. Copyright © 2009 John Wiley & Sons, Ltd.

What, why and how do health systems learn from one another? Insights from eight low- and middle-income country case studies

“…Many of the case study findings are consistent with the broader literature on health policy transfer in low- and middle-income countries [36, 37]. Both case studies and the literature illustrate that evidence is used in conceptualisation through the identification of a problem or policy need, facilitated by relationships that exist through policy networks, and sometimes through advocacy of international agencies, and is facilitated by the alignment of goals between relevant stakeholders [9–11, 38]. However, the case studies illuminate many aspects of health policy transfer that are either differently or under-represented in current literature.…”

“…This is a theme which emerges throughout the literature as agencies either impose or neutrally act as the medium through which policy is transferred. While most criticism of international agencies in the literature centres around the issue of coercion and how agencies and their financing have been used as a means for wealthy countries to shape policy formation for their own agendas [38, 43], the case studies present a more nuanced understanding of the role of international agencies as being influencers rather than controllers of policy conceptualisation, uptake and development. The case studies acknowledge that international agencies have their own mandates and agendas that, in some cases, differ from the governments they work with; however, the impact of agencies is met with the motivations of key in-country decision-makers.…”

“…The existence of policy networks is another mechanism that is widely identified as important in conceptualisation by both published studies and the case studies. Policy networks consisting of formal or informal relationships between governments and other policy stakeholders [49] are understood to be useful for promoting dialogue and learning between stakeholders [11, 50, 51], and are enhanced by political and social connections between decision-makers and other actors [38, 39]. As would be expected, the case studies demonstrate that, while the influence of external information is typically stronger at earlier stages of the policy cycle, i.e.…”

The diffusion of the United Nations Convention on the Rights of the Child (UNCRC) more than the African Charter on the Rights and Welfare of the Child (ACRWC) in Africa: The influence of coercion and emulation

“…Organizations such as the International Monetary Fund (IMF) and World Bank can impose conditionalities on their lending. As most developing countries are recipients of official development assistance (ODA) of various kinds, coercion mechanisms become important in explaining policy diffusion in these countries more than in the advanced economies (Clark, 2009;Simmons et al, 2006). For instance, the United States has been averse to international treaties, including the UNCRC and various other international treaties.…”

“…For instance, the United States has been averse to international treaties, including the UNCRC and various other international treaties. But because of its global economic hegemony, it has been known to decline to adapt many binding treaties at the international level and at times resisted treaties that it imposed on other nations (Clark, 2009;Strang and Chang, 1993). The work by Appuhami et al (2011) details how Sri Lanka, a developing nation, was coerced to adopt the policy of public-private partnership by international aid-granting organizations through conditionalities attached to financial assistance.…”