Polycentrism in Global Health Governance Scholarship Comment on "Four Challenges That Global Health Networks Face"

Tosun, Jale

doi:10.15171/ijhpm.2017.64

Cited by 17 publications

(10 citation statements)

References 18 publications

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“…Rather than speak of prerequisites or of overlooking the state, there are more promising ways to frame this research agenda. One is to take up a valuable suggestion offered by Tosun 5 to apply to global health the perspective of polycentric governance, associated with the work of Elinor Ostrom, 42 often used in climate change research. Ostrom argued that (p. 552):…”

Section: Interests and Ideasmentioning

confidence: 99%

Agency, Structure and the Power of Global Health Networks

Shiffman

2018

Int J Health Policy Manag

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Global health networks—webs of individuals and organizations linked by a shared concern for a particular condition—have proliferated over the past quarter century. In a recent editorial in this journal, I presented evidence that their effectiveness in addressing four challenges—problem definition, positioning, coalitionbuilding and governance—shapes their ability to influence policy. The editorial prompted five thoughtful commentaries that reflected on these and other challenges. In this follow-up editorial, I build on the commentaries to suggest ways of advancing research on global health networks. I argue that investigators would do well to consider three social theory-influenced global governance debates pertaining to agency—the capacity of individuals and organizations to act autonomously amidst structural constraints. The three debates concern the relationship between agency and structure, the power of ideas vis-à-vis interests and material capabilities, and the level of influence of non-state actors in a global governance system that most scholars identify as state-dominated. Drawing on these debates, I argue that rather than presume global health network influence, we need to find more robust ways to investigate their effects. I argue also that rather than juxtapose agency and structure, ideas and interests and non-state and state power, it would be more productive to consider the ways in which these elements are intertwined.

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Section: Interests and Ideasmentioning

confidence: 99%

Agency, Structure and the Power of Global Health Networks

Shiffman

2018

Int J Health Policy Manag

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“…The problem is that these relationships may be invisible to global health policy practitioners, in particular when these relationships are built through the involvement of actors from policy sectors other than their own. This relational problem is central to polycentric governance of global health (or other policy regimes of global scope like climate change) because policy development and action at one level may not be independent of a combination of influences (cooperation or competition) from others (Tosun 2017;Gautier et al 2018). Knowledge about potential interdependencies between global/foreign and national/ domestic public policy processes pertaining to GHG may benefit policy scholars and practitioners to learn how national policy-makers from different sectors engage in GHG and where are the interfaces between GHG and national-level decision-making on state action in global health.…”

Section: Introductionmentioning

confidence: 99%

Policy processes sans frontières: interactions in transnational governance of global health

2020

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National policy on global health (NPGH) arenas are multisectoral governing arrangements for cooperation between health, development, and foreign affairs sectors in government policy for global health governance. To explore the relationship between national and global processes for governing global health, this paper asks: in what forms of interaction between NPGH arenas and global health governance are learning and networking processes present? In a multiple case study of Norwegian and Swiss NPGH arenas, we collected data on intersectoral policy processes from semi-structured interviews with 33 informants in 2014-2015. Adapting Real-Dato's framework, we analyzed each case separately, producing monographs for comparing NPGH arenas. Analyzing both NPGH arenas for relational structures linking external resources to internal policy arena processes, we found five zones of interactions -including institutions, transgovernmental clubs, and connective forms. These interactions circulate ideas and soften arenas' boundaries. We argue that NPGH is characteristic of transnational governance of global health.

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“…13 In particular, the complexity of transnational networks' influence in diffusion processes has received little attention from global health scholars. 14 Building on 2 main strands of public policy literature, policy diffusion 12 and sociologie de l' action publique, 15 the framework developed by Gautier et al helps to unravel the multiple features of those influential actors who strive to foster policy diffusion in LMICs, aka "diffusion entrepreneurs" (DEs). 16 This theoreticallydriven framework features the diverse and interrelated dimensions of the political economy of performance-based financing (PBF) diffusion in SSA.…”

Section: Introductionmentioning

confidence: 99%

Transnational Networks’ Contribution to Health Policy Diffusion: A Mixed Method Study of the PerformanceBased Financing Community of Practice in Africa

Gautier

Allegri

Ridde

2020

Int J Health Policy Manag

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Background: Transnational networks such as Communities of Practice (CoPs) are flourishing, yet their role in diffusing health systems reforms has been seldom investigated. Over the past decade, performance-based financing (PBF) has rapidly spread in Africa. This study explores how, through the PBF Community of Practice’s attributes, structure, and strategies, PBF diffusion was fostered in sub-Saharan Africa (SSA). Methods: Informed by the diffusion entrepreneurs’ (DEs) framework dimensions, we used a mixed methods convergent design to investigate how the attributes, structure, and strategies of this community fostered the diffusion of PBF. The quantitative strand of work included firstly a semantic discourse analysis of textual data extracted from CoP’s online discussion forum (n=1346 posts). Secondly, the relational data extracted from these 1346 forum posts was examined using social network analysis (SNA). We confronted these quantitative results with a thematic analysis of qualitative interviews (n=40) and data extracted from the CoP’s key documentation (n=17). Results: CoP members’ attributes included: representation systems anchored in clinical and economic sciences, strong expectations that the CoP would boost professional visibility and career, and significant health systems knowledge and social resources. The CoP’s core group, dominated by high-income country (HIC) members, critically matched PBF principles to major health systems issues in Africa. The broad consensus in online PBF thematic discussions created a strong sense of community, a breeding ground for emulation among CoP members. The CoP also sought to produce and promote experiential knowledge exchanges about PBF amongst African practitioners. Findings from network analyses showed that the promoted Africa-driven community was led by HIC members, although their prominence tended to decrease with time. Conclusion: This empirical research highlighted some of the constituting features, structure, and strategies of policy networks in influencing health policy diffusion. Despite good intentions to disrupt the established governance landscape, influential actors coming from HICs continued to drive the framing, and shaped health systems policy experimentation, emulation, and learning in African countries. Beyond mere knowledge exchange platforms, CoP can act as meaningful transnational policy networks pursuing the diffusion of health systems reforms, such as PBF.

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Polycentrism in Global Health Governance Scholarship Comment on "Four Challenges That Global Health Networks Face"

Cited by 17 publications

References 18 publications

Agency, Structure and the Power of Global Health Networks

Agency, Structure and the Power of Global Health Networks

Policy processes sans frontières: interactions in transnational governance of global health

Transnational Networks’ Contribution to Health Policy Diffusion: A Mixed Method Study of the PerformanceBased Financing Community of Practice in Africa

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