Policy response to COVID-19 in Senegal: power, politics, and the choice of policy instruments

Ridde, Valéry; Faye, Adama

doi:10.1080/25741292.2022.2068400

Cited by 9 publications

(11 citation statements)

References 58 publications

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“…We found a persistent poor government commitment in most public health policy initiations, formulations and implementations [ 24 , 26 , 29 , 31 – 38 ]. Again, most public policies were formulated and implemented based on the motivation of policy-makers’ financial incentives as well as government and foreign policy conditionalities [ 27 , 30 , 36 , 37 , 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…Fortunately, evidence suggests a consensus among actors in the policy process which promotes collective ownership, high political commitment, pressure from civil society and other relevant stakeholders as well as policy alignment with political priorities that led to some successes in public health policy formulation [ 29 , 31 – 34 , 46 , 51 , 60 ].…”

Section: Resultsmentioning

confidence: 99%

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Politics–evidence conflict in national health policy making in Africa: a scoping review

Ansah,

Maneen,

Ephraim

et al. 2024

Health Res Policy Sys

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Background Generally, public health policy-making is hardly a linear process and is characterized by interactions among politicians, institutions, researchers, technocrats and practitioners from diverse fields, as well as brokers, interest groups, financiers and a gamut of other actors. Meanwhile, most public health policies and systems in Africa appear to be built loosely on technical and scientific evidence, but with high political systems and ideologies. While studies on national health policies in Africa are growing, there seems to be inadequate evidence mapping on common themes and concepts across existing literature. Purpose The study seeks to explore the extent and type of evidence that exist on the conflict between politics and scientific evidence in the national health policy-making processes in Africa. Methods A thorough literature search was done in PubMed, Cochrane Library, ScienceDirect, Dimensions, Taylor and Francis, Chicago Journals, Emerald Insight, JSTOR and Google Scholar. In total, 43 peer-reviewed articles were eligible and used for this review. Result We found that the conflicts to evidence usage in policy-making include competing interests and lack of commitment; global policy goals, interest/influence, power imbalance and funding, morals; and evidence-based approaches, self-sufficiency, collaboration among actors, policy priorities and existing structures. Barriers to the health policy process include fragmentation among actors, poor advocacy, lack of clarity on the agenda, inadequate evidence, inadequate consultation and corruption. The impact of the politics–evidence conflict includes policy agenda abrogation, suboptimal policy development success and policy implementation inadequacies. Conclusions We report that political interests in most cases influence policy-makers and other stakeholders to prioritize financial gains over the use of research evidence to policy goals and targets. This situation has the tendency for inadequate health policies with poor implementation gaps. Addressing these issues requires incorporating relevant evidence into health policies, making strong leadership, effective governance and a commitment to public health.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Politics–evidence conflict in national health policy making in Africa: a scoping review

Ansah,

Maneen,

Ephraim

et al. 2024

Health Res Policy Sys

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“…One study showed how Senegalese immigrants in Europe were sometimes used as scapegoats in the early stages of the COVID-19 epidemic (Onoma, 2021 ). Once again, the power issues surrounding the biomedical approach (Frielet al, 2021 ) contribute to the explanation of these authoritarian public health approaches in which civil society and community organizations, in Senegal (Ridde & Faye, 2022 ) and elsewhere in the world (Cambon et al, 2021 ), have often been excluded from implementation. Indeed, “despite the successful response to the epidemic, the absence of a community dimension in health operations has been very detrimental to the population” (Carillon et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Before the arrival of COVID-19, Senegal had structures for responding to health disasters such as the National Epidemic Management Committee (CNGE) and its regional and local committees, and the Health Emergency Operations Centre (COUS), which coordinates the response to any health event of national or international concern. These structures were created at the time of the response to the Ebola epidemic (Ridde & Faye, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Challenges in Implementing the National Health Response to COVID-19 in Senegal

Ridde

Faye

2022

Glob Implement Res Appl

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Since the beginning of the COVID-19 pandemic in Africa, many epidemiological or anthropological studies have been published. However, few studies have yet been conducted to understand the implementation of State interventions to fight the COVID-19 pandemic. In Senegal, the national response plan was planned before the country experienced its first official case of COVID-19 on 2 March 2020. This qualitative study, conducted in March and April 2021, based on 189 interviews, aims to understand how the national response has been implemented in several regions of Senegal. Implementation of the response to the pandemic was favoured by good preparation, capacity to adapt, responsiveness of health actors, and commitment for both the political and religious authorities. The implementation response was confronted by several constraining factors such as the coercive approach, the challenges of coordinating actors, and the lack of intersectoral response. The central level has sometimes used reflexivity processes to adapt its response, but it has remained highly politicized, centralized, directive, and with little involvement of civil society. In Senegal, the response to the pandemic has been implemented in a relatively political and directive, even coercive manner, without necessarily considering prior knowledge and the need to adapt it to local contexts and to involve civil society and community actors in the process. Supplementary Information The online version contains supplementary material available at 10.1007/s43477-022-00053-4.

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“…Donors in development assistance for health (DAH) play a significant role in shaping health policies in many low- and middle-income countries [ 1 – 9 ]. They exert their influence through financial resources, knowledge transfer, technical expertise, inter-sectoral leverage, and indirect financial and political incentives [ 5 , 6 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Development assistance, donor–recipient dynamic, and domestic policy: a case study of two health interventions supported by World Bank–UK and Global Fund in China

Huang,

Zhao,

Cao

et al. 2024

glob health res policy

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Background This study views sustainability after the exit of development assistance for health (DAH) as a shared responsibility between donors and recipients and sees transitioning DAH-supported interventions into domestic health policy as a pathway to this sustainability. It aims to uncover and understand the reemergent aspects of the donor–recipient dynamic in DAH and how they contribute to formulating domestic health policy and post-DAH sustainability. Methods We conducted a case study on two DAH-supported interventions: medical financial assistance in the Basic Health Services Project supported by the World Bank and UK (1998–2007) and civil society engagement in the HIV/AIDS Rolling Continuation Channel supported by the Global Fund (2010–2013) in China. From December 2021 to December 2022, we analyzed 129 documents and interviewed 46 key informants. Our data collection and coding were guided by a conceptual framework based on Walt and Gilson’s health policy analysis model and the World Health Organization’s health system building blocks. We used process tracing for analysis. Results According to the collected data, our case study identified three reemergent, interrelated aspects of donor–recipient dynamics: different preferences and compromise, partnership dialogues, and responsiveness to the changing context. In the case of medical financial assistance, the dynamic was characterized by long-term commitment to addressing local needs, on-site mutual learning and understanding, and local expertise cultivation and knowledge generation, enabling proactive responses to the changing context. In contrast, the dynamic in the case of HIV/AIDS civil society engagement marginalized genuine civil society engagement, lacked sufficient dialogue, and exhibited a passive response to the context. These differences led to varying outcomes in transnational policy diffusion and sustainability of DAH-supported interventions between the cases. Conclusions Given the similarities in potential alternative factors observed in the two cases, we emphasize the significance of the donor–recipient dynamic in transnational policy diffusion through DAH. The study implies that achieving post-DAH sustainability requires a balance between donor priorities and recipient ownership to address local needs, partnership dialogues for mutual understanding and learning, and collaborative international–domestic expert partnerships to identify and respond to contextual enablers and barriers.

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Policy response to COVID-19 in Senegal: power, politics, and the choice of policy instruments

Cited by 9 publications

References 58 publications

Politics–evidence conflict in national health policy making in Africa: a scoping review

Politics–evidence conflict in national health policy making in Africa: a scoping review

Challenges in Implementing the National Health Response to COVID-19 in Senegal

Development assistance, donor–recipient dynamic, and domestic policy: a case study of two health interventions supported by World Bank–UK and Global Fund in China

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