Generation of Political Priority for Global Health Initiatives: A Framework and Case Study of Maternal Mortality - Working Paper 129

October 15, 2007

Global health initiatives vary in the level of political priority they receive from international and national leaders. Some serious health issues—such as HIV/AIDS—get considerable attention while others—such as malaria and collapsing health systems—very little. But because of the lack of systematic research on the subject, little is known about the sources of variance in priority levels afforded to global health initiatives.

In this working paper Jeremy Shiffman and co-author Stephanie Smith draw on scholarship on collective action to propose a framework for analyzing the determinants of political priority—defined as the degree to which international and national political leaders actively pay attention to an issue, and back up that attention with the provision of financial, technical and human resources commensurate with the problem's severity—for global health initiatives. The framework consists of four categories of factors: the power of involved actors; the ideas they use to position the issue; the nature of the political contexts in which they operate; and characteristics of the issue itself. The authors apply this framework to the global safe motherhood initiative, launched in 1987 to reduce maternal mortality levels. Despite determined efforts by advocates, it has yet to attract the level of political attention its founders hoped it would receive.

The authors find that political priority is present when: (1) international and national political leaders publicly and privately express sustained concern for the issue; (2) the organizations and political systems they lead enact policies to address the problem; and (3) these organizations and political systems devote levels of resources to the problem commensurate with its gravity.

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