Setting priorities helps leaders in the field of international health to make decision about programs to support, which will impact population health. It becomes important in the global health agenda because of the imperative of allocating resources within the constraint of limited funding. The participation of several actors and organizations in the global health movement also has a role in shaping the context for priority setting by fashioning the ways in which leaders perceive issues and initiatives related to health at a global level. Aware of this situation, researchers and authors have examined the way in which disease priority setting has been implemented in the global health community. Jeremy Shiffman, for example, has proposed a social explanation to elucidate the reasons some global health issues get more attention and priority whereas other fall. Advancing a social constructionism perspective, Shiffman emphasizes the strength of ideas; he also proposes that tractability, severity, neglect, and benefit pertain to issues that attract national and international leaders. Furthermore, he recognizes that strong institutions are essential in portraying issues that can attract political leaders in the international health community. Those institutions can “strongly create and negotiate issues and can portray issues such as infants and child health better than others”.
However, the social constructionism does not suffice to guarantee the priority of an issue among diverse actors at international community. A political approach of priority setting in the global health community stands as other ways to link leader`s attention to issues that cause challenges in the field of international health. It aims to harness ideas brought by individuals and organization with the strength of institution and actors, political contexts, and characteristic of the issue. Under this approach, political context is substantially emphasized; and political activities that carry out solutions to issues are paramount in the political approach unlike in the human-based and developmental approaches.
During the past decades, maternal mortality has been portrayed as a developmental, human tragedy, as well as a human-right based approach; however, the issue has never received enough deserving attention from national and international political leaders. The result is obvious, insufficient funds are allocating to the issue in developing world. Generating a political approach of maternal mortality will link more political leaders at a national level and international level to the issue. They will take important part in implementing solutions to the issue; ultimately, accountability will follow. At the national level, when accountability is taken into consideration, the credibility of the leader will improve. The interests of grass root organizations, community leaders and political leaders will be unified, which will benefit developing countries enormously in term of reduction of maternal mortality.
1Craig Mitton and Cam Donaldson Health care priority setting: principles, practice and challenges Cost Effectiveness and Resource Allocation 2004, 2:3 doi:10.1186/1478-7547-2-3
2 Jeremy Shiffman A Social Explanation for the Rise and Fall of the Global Health Issues Bull World Health Organization 2009; 87: 608-613
Jeremy Shiffman and Stephanie Smith Generation of political priority for global health initiatives: a framework and case study of maternal mortality Lancet 2007; 370: 1370–79