Our case study of power in policymaking in Niger reveals iCCM to be founded on political conditions favouring positive outcomes for the poor, well-timed injections of external funds (the HIPC monies and Catalytic Initiative implementation financing), a (sometimes unstated) pro-poor agenda at external agencies, and the ability of Ministry officials to complement ‘scientific’ evidence with operational and health systems expertise. Among others, the UK Department for International Development and the Swedish development agency (Sida) have used power analyses to inform policy initiatives; however many development programs fail to consider such issues and, we argue, risk squandering their resources.Health policies in particular tend to be more context-specific than other policies, as they involve political, social, economic
and cultural considerations (Walt and Gilson 1994)—but while accounting for political and contextual dynamics ‘might seem obvious . . . it is rarely the norm’ (Wild et al. 2015). Researchers and proponents of pro-poor health policies in LMICs should consider placing more attention on understanding individual country contexts, particularly as policies are unlikely to be successfully transferred when they conflict with national power structures
Our case study of power in policymaking in Niger reveals iCCM to be founded on political conditions favouring positive outcomes for the poor, well-timed injections of external funds (the HIPC monies and Catalytic Initiative implementation financing), a (sometimes unstated) pro-poor agenda at external agencies, and the ability of Ministry officials to complement ‘scientific’ evidence with operational and health systems expertise. Among others, the UK Department for International Development and the Swedish development agency (Sida) have used power analyses to inform policy initiatives; however many development programs fail to consider such issues and, we argue, risk squandering their resources.Health policies in particular tend to be more context-specific than other policies, as they involve political, social, economicand cultural considerations (Walt and Gilson 1994)—but while accounting for political and contextual dynamics ‘might seem obvious . . . it is rarely the norm’ (Wild et al. 2015). Researchers and proponents of pro-poor health policies in LMICs should consider placing more attention on understanding individual country contexts, particularly as policies are unlikely to be successfully transferred when they conflict with national power structures
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