2023-09-28 14:46:10 +00:00
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abstract: 'Global trends influence strategies for health-care delivery in low- and
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middle-income countries. A drive towards uniformity in the design and
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delivery of healthcare interventions, rather than solid local
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adaptations, has come to dominate global health policies. This study is
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a participatory longitudinal study of how one country in West Africa,
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The Gambia, has responded to global health policy trends in maternal and
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reproductive health, based on the authors'' experience working as a
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public health researcher within The Gambia over two decades. The paper
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demonstrates that though the health system is built largely upon the
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principles of a decentralised and governed primary care system, as
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delineated in the Alma-Ata Declaration, the more recent policies of The
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Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria and the GAVI
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Alliance have had a major influence on local policies. Vertically
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designed health programmes have not been easily integrated with the
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existing system, and priorities have been shifted according to shifting
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donor streams. Local absorptive capacity has been undermined and
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inequalities exacerbated within the system. This paper problematises
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national actors'' lack of ability to manoeuvre within this policy
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context. The authors'' observations of the consequences in the field over
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time evoke many questions that warrant discussion, especially regarding
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the tension between local state autonomy and the donor-driven trend
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towards uniformity and top-down priority setting.'
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affiliation: 'Sundby, J (Corresponding Author), Univ Oslo, Inst Hlth \& Soc, Oslo,
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Norway.
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Univ Oslo, Inst Hlth \& Soc, Oslo, Norway.'
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author: Sundby, Johanne
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author-email: johanne.sundby@medisin.uio.no
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author_list:
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- family: Sundby
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given: Johanne
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da: '2023-09-28'
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doi: 10.1080/17441692.2014.940991
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eissn: 1744-1706
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files: []
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issn: 1744-1692
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journal: GLOBAL PUBLIC HEALTH
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keywords: 'global health policy; local health systems; donor driven; public;
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private'
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keywords-plus: CARE; ORGANIZATION; INFERTILITY; COMMUNITY
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language: English
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number: 8, SI
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number-of-cited-references: '26'
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pages: 894-909
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papis_id: 6a8d10abb3ed1fe994ba9e57e95ec118
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ref: Sundby2014rollercoasterpolicy
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times-cited: '11'
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title: 'A rollercoaster of policy shifts: Global trends and reproductive health policy
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in The Gambia'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000342138000004
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usage-count-last-180-days: '0'
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usage-count-since-2013: '7'
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volume: '9'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2014'
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