Limits...
Introduction of male circumcision for HIV prevention in Uganda: analysis of the policy process.

Odoch WD, Kabali K, Ankunda R, Zulu JM, Tetui M - Health Res Policy Syst (2015)

Bottom Line: Researchers' initial disregard of the Ministry of Health in the research process of MC and the missing civil society advocacy arm contributed to delays in the policy development process.This study underscores the importance of securing top political leadership as well as key implementing partners' support in policy development processes.Equally important is the appreciation of the various forms of actors' power and how such power shapes the policy agenda, development process, and content.

View Article: PubMed Central - PubMed

Affiliation: East, Central and Southern Africa-Health Community (ECSA), P.O. Box 1009, Arusha, Tanzania. walodoch@yahoo.com.

ABSTRACT

Background: Health policy analysis is important for all health policies especially in fields with ever changing evidence-based interventions such as HIV prevention. However, there are few published reports of health policy analysis in sub-Saharan Africa in this field. This study explored the policy process of the introduction of male circumcision (MC) for HIV prevention in Uganda in order to inform the development processes of similar health policies.

Methodology: Desk review of relevant documents was conducted between March and May 2012. Thematic analysis was used to analyse the data. Conceptual frameworks that demonstrate the interrelationship within the policy development processes and influence of actors in the policy development processes guided the analysis.

Results: Following the introduction of MC on the national policy agenda in 2007, negotiation and policy formulation preceded its communication and implementation. Policy proponents included academic researchers in the early 2000s and development partners around 2007. Favourable contextual factors that supported the development of the policy included the rising HIV prevalence, adoption of MC for HIV prevention in other sub-Saharan African countries, and expertise on MC. Additionally, the networking capability of proponents facilitated the change in position of non-supportive or neutral actors. Non-supportive and neutral actors in the initial stages of the policy development process included the Ministry of Health, traditional and Muslim leaders, and the Republican President. Using political authority, legitimacy, and charisma, actors who opposed the policy tried to block the policy development process. Researchers' initial disregard of the Ministry of Health in the research process of MC and the missing civil society advocacy arm contributed to delays in the policy development process.

Conclusions: This study underscores the importance of securing top political leadership as well as key implementing partners' support in policy development processes. Equally important is the appreciation of the various forms of actors' power and how such power shapes the policy agenda, development process, and content.

No MeSH data available.


Related in: MedlinePlus

Estimated prevalence of HIV infection in selected sub-Saharan countries
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4487978&req=5

Fig3: Estimated prevalence of HIV infection in selected sub-Saharan countries

Mentions: The epidemiological context of HIV in Uganda also affected the speed of the MC policy process at the negotiation stage. The HIV prevalence in Uganda declined rapidly from over 25 % in the late 1980s until about 2005, when it stagnated at about 7 % [45]. The other countries that quickly considered MC still had an HIV prevalence in excess of 10 % (Fig. 3). This perhaps made it easy for proponents of MC for HIV prevention in those countries as any opponent to the development of the MC policy for HIV prevention would be viewed as being insensitive.Fig. 3


Introduction of male circumcision for HIV prevention in Uganda: analysis of the policy process.

Odoch WD, Kabali K, Ankunda R, Zulu JM, Tetui M - Health Res Policy Syst (2015)

Estimated prevalence of HIV infection in selected sub-Saharan countries
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4487978&req=5

Fig3: Estimated prevalence of HIV infection in selected sub-Saharan countries
Mentions: The epidemiological context of HIV in Uganda also affected the speed of the MC policy process at the negotiation stage. The HIV prevalence in Uganda declined rapidly from over 25 % in the late 1980s until about 2005, when it stagnated at about 7 % [45]. The other countries that quickly considered MC still had an HIV prevalence in excess of 10 % (Fig. 3). This perhaps made it easy for proponents of MC for HIV prevention in those countries as any opponent to the development of the MC policy for HIV prevention would be viewed as being insensitive.Fig. 3

Bottom Line: Researchers' initial disregard of the Ministry of Health in the research process of MC and the missing civil society advocacy arm contributed to delays in the policy development process.This study underscores the importance of securing top political leadership as well as key implementing partners' support in policy development processes.Equally important is the appreciation of the various forms of actors' power and how such power shapes the policy agenda, development process, and content.

View Article: PubMed Central - PubMed

Affiliation: East, Central and Southern Africa-Health Community (ECSA), P.O. Box 1009, Arusha, Tanzania. walodoch@yahoo.com.

ABSTRACT

Background: Health policy analysis is important for all health policies especially in fields with ever changing evidence-based interventions such as HIV prevention. However, there are few published reports of health policy analysis in sub-Saharan Africa in this field. This study explored the policy process of the introduction of male circumcision (MC) for HIV prevention in Uganda in order to inform the development processes of similar health policies.

Methodology: Desk review of relevant documents was conducted between March and May 2012. Thematic analysis was used to analyse the data. Conceptual frameworks that demonstrate the interrelationship within the policy development processes and influence of actors in the policy development processes guided the analysis.

Results: Following the introduction of MC on the national policy agenda in 2007, negotiation and policy formulation preceded its communication and implementation. Policy proponents included academic researchers in the early 2000s and development partners around 2007. Favourable contextual factors that supported the development of the policy included the rising HIV prevalence, adoption of MC for HIV prevention in other sub-Saharan African countries, and expertise on MC. Additionally, the networking capability of proponents facilitated the change in position of non-supportive or neutral actors. Non-supportive and neutral actors in the initial stages of the policy development process included the Ministry of Health, traditional and Muslim leaders, and the Republican President. Using political authority, legitimacy, and charisma, actors who opposed the policy tried to block the policy development process. Researchers' initial disregard of the Ministry of Health in the research process of MC and the missing civil society advocacy arm contributed to delays in the policy development process.

Conclusions: This study underscores the importance of securing top political leadership as well as key implementing partners' support in policy development processes. Equally important is the appreciation of the various forms of actors' power and how such power shapes the policy agenda, development process, and content.

No MeSH data available.


Related in: MedlinePlus