International Journal of Health Policy and Management

International Journal of Health Policy and Management

On the Path to UHC – Global Evidence Must Go Local to Be Useful; Comment on “Disease Control Priorities Third Edition Is Published: A Theory of Change Is Needed for Translating Evidence to Health Policy”

Document Type : Commentary

Authors
Austen Davis 1
Damian G. Walker 2
1 Norwegian Agency for Development Cooperation (Norad), Oslo, Norway
2 Bill & Melinda Gates Foundation, Seattle, WA, USA
10.15171/ijhpm.2018.118
Abstract
The Disease Control Priorities (DCP) publications have pioneered new ways of thinking about investing in health. We agree with Norheim, that a useful first step to advance efforts to translate DCP’s global evidence into local health priorities, is to develop a clear Theory of Change (ToC). However, a ToC that aims to define how global evidence (DCP and others) can be used to inform national policy is too narrow an undertaking. We propose efforts should be directed towards developing a ToC to define how to support progressive institutional development to deliver on universal health coverage (UHC), putting the client at the center. Enhancing efforts to meet the new global health imperatives requires a shift in focus of attention to move radically from global to local. In order to achieve this we need to reorganize the nature of technical assistance (TA) along three major lines (1) examine and act to clarify the mandates and roles to be played by multilateral normative and convening agencies, (2) ensure detailed understanding of local institutions, their needs and their demands, and (3) provide TA over time and in trust with local counterparts. This last requirement implies the need for long-term local presence as well as an international network of expertise centers, to share scarce technical capabilities as well as to learn together across country engagements. Financing will need to be reorganized to incentivize and support demand-led capacity strengthening.
Keywords
Health Sector Reform
Technical Assistance
Institutional Capacity Building
Health Financing
Universal Health Coverage
Subjects
  1. Jamison DT, Mosley WH, Measham AR, Bobadilla JL. Disease Control Priorities in Developing Countries. Washington DC: The World Bank by Oxford University Press; 1993.
  2. Jamison DT, Breman J, Measham AR, et al. Disease Control Priorities in Developing Countries. 2nd ed. Washington DC: The World Bank by Oxford University Press; 2006
  3. Disease Control Priorities 3. 9 volume publication published between 2015-2017. http://www.dcp-3.org/.   Accessed October 13, 2018.
  4. http://dcp-3.org/resources/evaluation-dcp-series.  Accessed October 13, 2018.
  5. Kumaranayake L, Walker D. Cost-effectiveness and priority setting: global approach without local meaning. In: Lee K, Buse K, Fustkian S, eds. Crossing Boundaries: Health Policy in a Globalising World. Cambridge: Cambridge University Press; 2002:140-156.
  6. Norheim OF. Disease Control Priorities Third Edition is published: a theory of change is needed for translating evidence to health policy. Int J Health Policy Manag. 2018;7(9):771–777. doi:10.15171/ijhpm.2018.60
  7. Soucat A, Dale E, Mathauer I, Kutzin J. Pay-for-performance debate: not seeing the forest for the trees. Health Systems and Reform. 2017;3(2):74-79. doi:10.1080/23288604.2017.1302902
  8. WHO 13th general Programme for Work. http://www.who.int/about/what-we-do/gpw-thirteen-consultation/en/.  Accessed October 13, 2018.
  9. Chou VB, Bubb-Humfryes O, Sanders R, et al. Pushing the envelope through the Global Financing Facility: potential impact of mobilizing additional support to scale-up life-saving interventions for women, children and adolescents in 50 high-burden countries. BMJ Global Health. 2018;3:e001126. doi:10.1136/bmjgh-2018-001126
  10. New $200 Million Global Initiative to Improve Health Systems Strengthening. https://www.r4d.org/news/hssaccelerator/.  Accessed October 13, 2018.
  11. Priority Setting. http://www.pmaconference.mahidol.ac.th/index.php?option=com_content&view=article&id=743&Itemid=222.  Accessed October 13, 2018.
International Journal of Health Policy and Management
Volume 8, Issue 3
March 2019
Pages 181-183

  • Received Date 15 October 2018
  • Revised Date 24 November 2018
  • Accepted Date 24 November 2018
  • First Published Date 01 March 2019
  • Published Date 01 March 2019