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首页> 外文期刊>Social science and medicine >'The one with the purse makes policy': Power, problem definition, framing and maternal health policies and programmes evolution in national level institutionalised policy making processes in Ghana
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'The one with the purse makes policy': Power, problem definition, framing and maternal health policies and programmes evolution in national level institutionalised policy making processes in Ghana

机译：“用钱包的一个政策”：权力，问题定义，框架和母体健康政策和计划在加纳国家一级制度化政策制定进程中的进化

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摘要

This paper seeks to advance our understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. We theorized that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to evidence in the form of health sector performance reviews and demographic health surveys; and knowledge of national plans such as Ghana Poverty Reduction Strategy. Understanding of power sources and their use as negotiation tools in policy development should not be ignored in the pursuit of transformative change and sustained improvement in health systems in low- and middle income countries (LMIC). (C) 2016 Elsevier Ltd. All rights reserved.
机译：本文旨在通过探索2002年至2012年期间的工作议程卫生部门和发展妇女卫生政策和计划，探讨妇女卫生政策和计划的卫生政策议程设定和制定过程的理解。我们理论制定了在工作方案中议程和其命运的政策或计划的外观主要受国家决策者如何利用其权力来源来定义孕产妇健康问题和框架政策叙述的影响。国家一级决策者使用其电力来源作为谈判工具，以在国家卫生部门工作方案的框架内进行孕产妇卫生问题和设计产妇卫生政策和方案。所确定的权力来源包括法律和结构权;通过政治影响力地访问权威;控制和获取资源（主要是财务）;以卫生部门绩效审查和人口健康调查的形式获取证据;和加纳减贫战略等国家计划的知识。在追求政策开发中的谈判工具时，对电力资源及其用途的理解不应忽视低收入和中等收入国家（LMIC）的卫生系统持续改进。 （c）2016 Elsevier有限公司保留所有权利。

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