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2023: Two-year Impact Factor: 2.4
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CiteScore (2023):7.1
 
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Health Promot Perspect. 2023;13(2): 147-156.
doi: 10.34172/hpp.2023.18
PMID: 37600547
PMCID: PMC10439451
Scopus ID: 85166915381
  Abstract View: 645
  PDF Download: 424
  Full Text View: 161

Original Article

The invisible hands in policy making: A qualitative study of the role of advocacy in priority setting for maternal and child health in Nigeria

Chinyere Okeke 1,2* ORCID logo, Benjamin Uzochukwu 1,2, Maylene Shung-king 3, Lucy Gilson 3

1 Department of Community Medicine, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria
2 Health Policy Research Group, University of Nigeria Enugu-Campus, Enugu Nigeria
3 Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
*Corresponding Author: Chinyere Okeke, Emails: cecilia.okeke@unn. edu.ng; , Email: chinyereokeke83@yahoo.com

Abstract

Background: Maternal and child health is a priority for most governments, especially those in low and middle-income countries (LMICs), due to high mortality rates. The combination of individual and social actions designed to gain political commitment, policy support and social acceptance for health goals are influenced by the interplay between the advocates and the strategies they deploy in planning and advocating for maternal and child health issue. This study aims to deepen our understanding of how advocacy has influenced maternal and child health priority setting in Nigeria.

Methods: This is a mixed method study that involved 24 key informant interviews, document review, policy tracking and mapping of advocacy events that contributed to the repositioning of maternal and child health on the political agenda was done. Respondents were deliberately selected according to their roles and positions. Analysis was based on Shiffman and Smith’s policy analysis framework of agenda setting.

Results: Our findings suggest that use of various strategies for advocacy such as influencers, media, generated different outcomes and the use of a combination of strategies was found to be more effective. The role of advocacy in issue emergence was prominent and the presence of powerful actors, favorable policy window helped achieve desired outcomes. The power of the advocates and the strength of the individuals involved played a key role.

Conclusion: This study finds it possible to understand the role of advocacy in policy agenda setting through the application of agenda setting framework. To achieve the health SDG goals, advocacy barriers need to be addressed at multiple levels.

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Submitted: 27 Feb 2023
Revision: 20 Apr 2023
Accepted: 12 May 2023
ePublished: 10 Jul 2023
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