Use this URL to cite or link to this record in EThOS: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.746880
Title: Controlling mother-to-child transmission of syphilis and HIV in China : a comparative policy analysis to inform promotion of political prioritization for elimination of mother-to-child transmission of syphilis
Author: Wu, Dadong
ISNI:       0000 0004 7226 8786
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2017
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Abstract:
Despite a large and growing burden of mother-to-child transmission (MTCT) of syphilis in China, the problem languished on the national policy agenda prior to 2010 when the Ministry of Health first committed to eliminating the infection (by 2020). In contrast, MTCT of HIV became one of the country’s foremost public health priorities in the early 2000s despite its relatively lower burden and less cost-effective interventions. Based on review of literature and policy-relevant documents, a puzzle was raised of why China responded contrastingly to MTCT of syphilis and MTCT of HIV, both of which shared a number of issue characteristics and can be eliminated by integrated interventions. To resolve the puzzle, this PhD study was conducted to identify those factors driving or hampering political prioritisation within the Chinese health policy arena, through investigating the two policy cases. Policy-relevant data were collected through stakeholder interviews, documentation review as well as observation of relevant activities, and analysed by using a nine-factor framework. A set of highly interrelated factors were identified as accounting for the significant slowness in China’s policy response to MTCT of syphilis. These factors include (1) relative neglect of the issue at global level; (2) dearth of international financial and technical assistances; (3) a poorly unified national policy community, (4) absence of capability political entrepreneurs to lead the initiative; (5) policymakers’ insufficient understanding of the problem; (6) unclear policy alternatives; as well as (7) a prevailing negative framing of syphilis that resulted in serious stigmatisation. However, not all these factors functioned at subnational level of China, but whether or not and how MTCT of syphilis was prioritised at provincial and municipal levels was mainly influenced by performance of the local policy communities. Drawing upon the findings, this study concluded with a set of recommendations for promoting political prioritisation for control of MTCT of syphilis and other neglected health issues in China. Special attention was given to how to maintain consistent political priority at multiple administrative levels in order for the country to eliminate MTCT of syphilis in the near future. In addition, the analytical framework was modified to advance its applicability in studying the Chinese health policy process.
Supervisor: Hawkes, S. ; Weale, A. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.746880  DOI: Not available
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