In recent years, scholars of health policy in LMICs have observed
that power dynamics can be decisive in policy outcomes, for example
via the exercise of political power in priority-setting processes and policy
reform (Reich 1995; Shiffman and Garce´s del Valle 2006; Shiffman
and Smith 2007) and the ability of front-line health workers to limit or
shape the implementation of decisions made at higher levels (Lipsky
1980; Erasmus and Gilson 2008; Lehmann and Gilson 2012)