Exploring politics and contestation in the policy process: The case of Zambia’s contested community health strategy

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dc.contributor.authorZulu, Joseph M.
dc.contributor.authorChavula, Maligzani P.
dc.contributor.authorSchneider, Helen
dc.date.accessioned2022-02-15T08:52:29Z
dc.date.available2022-02-15T08:52:29Z
dc.date.issued2021
dc.description.abstractThere 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through the case of Zambia’s 5-year Community Health Strategy (CH Strategy), formulated in 2017 and then summarily withdrawn and reissued two years later, with largely similar content.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.en_US
dc.identifier.citationZulu, J. M. et al. (2021). Exploring politics and contestation in the policy process: The case of Zambia’s contested community health strategy. International Journal of Health Policy and Management, 11(1), 24–30. 10.34172/ijhpm.2021.145en_US
dc.identifier.issn2322-5939
dc.identifier.uri10.34172/ijhpm.2021.145
dc.identifier.urihttp://hdl.handle.net/10566/7253
dc.language.isoenen_US
dc.publisherKerman University of Medical Sciencesen_US
dc.subjectCommunity health strategyen_US
dc.subjectCommunity health systemen_US
dc.subjectPoliticsen_US
dc.subjectPolicy developmenten_US
dc.subjectZambiaen_US
dc.titleExploring politics and contestation in the policy process: The case of Zambia’s contested community health strategyen_US
dc.typeArticleen_US

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