Variation in issue prominence on the global health agenda
: a comparative case study

  • Hannah Parry

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Why do some health issues gain prominence but others do not? Diarrhoeal diseases cause hundreds of thousands of child deaths annually, but have struggled in recent decades to attain prominence on the global health agenda. Polio, today has very low morbidity and mortality rates but still cultivates a comparatively high profile in the global health arena. This thesis looks to identify causative dynamics for agenda ‘status’ for these two health issues drawing on Kingdon’s multiple streams approach to do so. It is not looking to suggest where attention/resources should be targeted, rather it adds to literature which is illuminating important drivers of global health agenda setting and contributing to building a better scaffold for global health decision making. By developing greater awareness of the multi-layered influences involved in agenda formation, improvements can be made for issues falling through the net, learning from those which have shown resilience in a fickle and multifaceted arena. The thesis finds the key tenets of multiple streams are a largely useful means of understanding the relative agenda ‘position’ of each case. The alignment of three influential streams (problem, policy and political), strong advocacy, and policy windows helped both issues to attain prominence historically. However, in recent decades, these elements have failed to coalesce effectively for diarrhoeal diseases. Specifically, the absence of a succinct, well articulated solution to diarrhoeal diseases as a whole issue, weakened advocacy, and failure to resonate with the wider political climate in global health, hampers its capacity to cultivate a higher profile on the global health agenda. In contrast, polio’s sustained prominence on the agenda can be explained through the continued orientation of the streams, in conjunction with the support of strong policy entrepreneurs.
Date of Award2023
Original languageEnglish
Awarding Institution
  • Aberystwyth University
SupervisorColin McInnes (Supervisor) & Kamila Stullerova (Supervisor)

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