National Poverty Reduction Strategies and HIV/AIDS Governance in Malawi: A Preliminary Study of Shared Health Governance
Social Science & Medicine, Vol. 72, pp. 1956-1964, 2011
10 Pages Posted: 9 Nov 2009 Last revised: 14 Oct 2014
Date Written: October 29, 2009
Abstract
The public health and development communities understand clearly the need to integrate anti-poverty efforts with HIV/AIDS programs. This article reports findings about the impact of the Poverty Reduction Strategy Paper (PRSP) process on Malawi’s National HIV/AIDS Strategic Framework (NSF). In this paper we ask, how does the PRSP process support NSF accountability, participation, access to information, funding, resource planning and allocation, monitoring, and evaluation?
In 2007, we developed and conducted a survey of Malawian government ministries, United Nations agencies, members of the Country Coordination Mechanism, the Malawi National AIDS Commission (NAC), and NAC grantees (N = 125, 90% response rate), seeking survey respondents’ retrospective perceptions of NSF resource levels, participation, inclusion, and governance before, during, and after Malawi’s PRSP process (2000-2004). We also assessed principle health sector and economic indicators and budget allocations for HIV/AIDS.
These indicators are part of a new conceptual framework called shared health governance (SHG), which seeks congruence among the values and goals of different groups and actors to reflect a common purpose. Under this framework, global health policy should encompass (i) consensus among global, national, and sub-national actors on goals and measurable outcomes; (ii) mutual collective accountability; and (iii) enhancement of individual and group health agency. Indicators to assess these elements included: (i) goal alignment; (ii) adequate resource levels; (iii) agreement on key outcomes and indicators for evaluating those outcomes; (iv) meaningful inclusion and participation of groups and institutions; (v) special efforts to ensure participation of vulnerable groups; and (vi) effectiveness and efficiency measures.
Results suggest that the PRSP process supported accountability for NSF resources. However, the process may have marginalized key stakeholders, potentially undercutting the implementation of HIV/AIDS Action Plans. Accountability for achieving results also fell short.
Keywords: HIV/AIDS, Poverty Reduction Strategy Paper, Malawi, National HIV/AIDS Strategic Framework
JEL Classification: H75, I18, I30, H51
Suggested Citation: Suggested Citation
Do you have negative results from your research you’d like to share?
Recommended Papers
-
Ethics in American Health 2: An Ethical Framework for Health System Reform
-
Ruger Responds - 'Health Capability: Conceptualization and Operationalization'
-
Control of Extensively Drug-Resistant Tuberculosis (XDR-TB): A Root Cause Analysis