ArticleInternational journal of health policy and management2022
Exploring Politics and Contestation in the Policy Process: The Case of Zambia's Contested Community Health Strategy.
Article in International journal of health policy and management, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Comparative analysis of the use of Community Health Workers while deploying the Attractive Targeted Sugar Bait (ATSB) for malaria control in Western Province, Zambia.Malaria journal · 2025Article
- Strengthening the role of community health assistants in delivering primary health care: the case of maternal health services in Zambia.BMC primary care · 2025Article
- We move together: a realist evaluation of the Safe Motherhood Action Groups in Eastern Province, Zambia.BMJ global health · 2025Article
- Analysis of a nursing workforce policy on the career ladder and pay structure of public sector nurses in the Maldives: a qualitative study.BMC nursing · 2025Article
- Collaborative dynamics and shared motivation: exploring tobacco control policy development in Zambia.Health policy and planning · 2024Article
- Implementation strategies for decentralized management of multidrug-resistant tuberculosis: insights from community health systems in Zambia.Archives of public health = Archives belges de sante publique · 2024Article
- Halting and re-issuing of the Zambia community health strategy (2017-2021): a retrospective analysis of the policy process and implications for community health systems.BMC health services research · 2024Article
- Collaboration for implementation of decentralisation policy of multi drug-resistant tuberculosis services in Zambia.Health research policy and systems · 2024Article
- Exploring the barriers, facilitators, and opportunities to enhance uptake of sexual and reproductive health, HIV and GBV services among adolescent girls and young women in Zambia: a qualitative study.BMC public health · 2024Article
- Politics-evidence conflict in national health policy making in Africa: a scoping review.Health research policy and systems · 2024Article
- Unlocking policy synergies, challenges and contradictions influencing implementation of the Comprehensive Sexuality Education Framework in Zambia: a policy analysis.Health research policy and systems · 2023Article
- Experiences of teachers and community-based health workers in addressing adolescents' sexual reproductive health and rights problems in rural health systems: a case of the RISE project in Zambia.BMC public health · 2023Article
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Authors and funding
9 authors.
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Abstract
There have been increased calls for low- and middle-income countries to develop community health systems (CHS) policies or strategies. However, emerging global guidance brackets the inherent complexity and contestation of policy development at the country level. This is explored through the case of Zambia's 5-year Community Health Strategy (CH Strategy), formulated in 2017 and then summarily withdrawn and reissued two years later, with largely similar content. This paper examines the events, actors, and contexts behind this abrupt change in the Strategy, through an analysis of documentary sources and interviews with 21 stakeholders involved in the policy process. We describe an environment of contestation, characterised by numerous international partners weighing in on the CH Strategy, interfacing with shifting loci of responsibility for the CHS in the Ministry of Health (MoH). Despite the rhetoric of participation, providers and communities played no part in the policy process. These dynamics created the conditions for the abrupt change in strategy, illustrating the inherently fraught and political nature of policy development on the CHS in many countries. Going forward, we conclude that paying attention to processes of CHS policy development, and in particular the interaction between events, actors, and contexts, is as important as ensuring meaningful policy content.
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