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Salm M, Ali M, Minihane M, Conrad P. Defining global health: findings from a systematic review and thematic analysis of the literature. BMJ Glob Health 2021; 6:bmjgh-2021-005292. [PMID: 34083243 PMCID: PMC8183196 DOI: 10.1136/bmjgh-2021-005292] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/04/2021] [Accepted: 05/04/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Debate around a common definition of global health has seen extensive scholarly interest within the last two decades; however, consensus around a precise definition remains elusive. The objective of this study was to systematically review definitions of global health in the literature and offer grounded theoretical insights into what might be seen as relevant for establishing a common definition of global health. METHOD A systematic review was conducted with qualitative synthesis of findings using peer-reviewed literature from key databases. Publications were identified by the keywords of 'global health' and 'define' or 'definition' or 'defining'. Coding methods were used for qualitative analysis to identify recurring themes in definitions of global health published between 2009 and 2019. RESULTS The search resulted in 1363 publications, of which 78 were included. Qualitative analysis of the data generated four theoretical categories and associated subthemes delineating key aspects of global health. These included: (1) global health is a multiplex approach to worldwide health improvement taught and pursued at research institutions; (2) global health is an ethically oriented initiative that is guided by justice principles; (3) global health is a mode of governance that yields influence through problem identification, political decision-making, as well as the allocation and exchange of resources across borders and (4) global health is a vague yet versatile concept with multiple meanings, historical antecedents and an emergent future. CONCLUSION Extant definitions of global health can be categorised thematically to designate areas of importance for stakeholders and to organise future debates on its definition. Future contributions to this debate may consider shifting from questioning the abstract 'what' of global health towards more pragmatic and reflexive questions about 'who' defines global health and towards what ends.
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Affiliation(s)
- Melissa Salm
- Anthropology, University of California Davis, Davis, California, USA
| | - Mahima Ali
- University of California Davis, Davis, California, USA
| | | | - Patricia Conrad
- VM:PMI, University of California Davis, Davis, California, USA
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Daly G, Kaufman J, Lin S, Gao L, Reyes M, Matemu S, El-Sadr W. Challenges and Opportunities in China's Health Aid to Africa: Findings from Qualitative Interviews in Tanzania and Malawi. Global Health 2020; 16:71. [PMID: 32727482 PMCID: PMC7388527 DOI: 10.1186/s12992-020-00577-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China has played an increasing role in development aid across Africa. Most recently, China has increased its external investments through the Belt and Road Initiative, China's signature infrastructure and trade drive to link China to Asia and Africa. This is likely to result in continuing growth of China's investment in health in sub Saharan Africa. While conflicting opinions have been raised regarding the motivation and value of these investments, few data have been solicited from those directly involved in China-Africa health aid. We conducted a qualitative study to collect information on perceptions and opinions regarding Chinese-supported health related activities in Africa through in-depth interviews among local African and Chinese participants in Malawi and Tanzania. RESULTS Our findings reveal shared experiences and views related to challenges in communication; cultural perspectives and historical context; divergence between political and business agendas; organization of aid implementation; management and leadership; and sustainability. Participants were broadly supportive and highly valued Chinese health aid. However, they also shared common insights that relate to challenging coordination between China and recipient countries; impediments to communication between health teams; and limited understanding of priorities and expectations. Further, they share perspectives about the need for shaping the assistance based on needs assessments as well as the importance of rigorous reporting, and monitoring and evaluation systems. Our findings suggest that China faces similar challenges to those experienced by other longstanding development aid and global health donors. As it continues to expand cooperation across Africa and other regions, it will be important for China to consider the issues identified through our study to help inform collaborative and effective global health assistance programs. The insights garnered from this research are not only relevant to China's engagement in Africa but for other global health assistance donors as well.
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Affiliation(s)
- Garrison Daly
- Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - Joan Kaufman
- Schwarzman Scholars, 641 Lexington Avenue, 23rd Floor, New York, NY, 10022, USA.,Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
| | - Shuang Lin
- School of International and Public Affairs, Columbia University, 420 West 118th Street, New York, NY, 10027, USA
| | - Liangmin Gao
- School of Social Sciences, Tsinghua University, Beijing, 100084, China
| | - Melissa Reyes
- Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | | | - Wafaa El-Sadr
- Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA. .,CAP at Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
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Haffeld J. Sustainable development goals for global health: facilitating good governance in a complex environment. REPRODUCTIVE HEALTH MATTERS 2015; 21:43-9. [PMID: 24315062 DOI: 10.1016/s0968-8080(13)42734-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Increasing complexity is following in the wake of rampant globalization. Thus, the discussion about Sustainable Development Goals (SDGs) requires new thinking that departs from a critique of current policy tools in exploration of a complexity-friendly approach. This article argues that potential SDGs should: treat stakeholders, like states, business and civil society actors, as agents on different aggregate levels of networks; incorporate good governance processes that facilitate early involvement of relevant resources, as well as equitable participation, consultative processes, and regular policy and programme implementation reviews; anchor adoption and enforcement of such rules to democratic processes in accountable organizations; and include comprehensive systems evaluations, including procedural indicators. A global framework convention for health could be a suitable instrument for handling some of the challenges related to the governance of a complex environment. It could structure and legitimize government involvement, engage stakeholders, arrange deliberation and decision-making processes with due participation and regular policy review, and define minimum standards for health services. A monitoring scheme could ensure that agents in networks comply according to whole-systems targets, locally defined outcome indicators, and process indicators, thus resolving the paradox of government control vs. local policy space. A convention could thus exploit the energy created in the encounter between civil society, international organizations and national authorities.
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Affiliation(s)
- Just Haffeld
- Affiliated Scholar, O'Neill Institute of National and Global Health Law, Georgetown University Law Centre, Washington DC, USA.
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Fehr A, Razum O. The German government's global health strategy--a strategy also to support research and development for neglected diseases? Glob Health Action 2014; 7:24565. [PMID: 25079287 PMCID: PMC4116622 DOI: 10.3402/gha.v7.24565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/17/2014] [Accepted: 06/18/2014] [Indexed: 11/14/2022] Open
Abstract
Neglected tropical infectious diseases as well as rare diseases are characterized by structural research and development (R&D) deficits. The market fails for these disease groups. Consequently, to meet public health and individual patient needs, political decision makers have to develop strategies at national and international levels to make up for this R&D deficit. The German government recently published its first global health strategy. The strategy underlines the German government's commitment to strengthening global health governance. We find, however, that the strategy lacks behind the international public health endeavors for neglected diseases. It fails to make reference to the ongoing debate on a global health agreement. Neither does it outline a comprehensive national strategy to promote R&D into neglected diseases, which would integrate existing R&D activities in Germany and link up to the international debate on sustainable, needs-based R&D and affordable access. This despite the fact that only recently, in a consensus-building process, a National Plan of Action for rare diseases was successfully developed in Germany which could serve as a blueprint for a similar course of action for neglected diseases. We recommend that, without delay, a structured process be initiated in Germany to explore all options to promote R&D for neglected diseases, including a global health agreement.
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Affiliation(s)
- Angela Fehr
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Oliver Razum
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany;
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Haffeld J, Heggenhougen HK, Lie SO, Røttingen JA, Schei B. The idea of a convention for global health. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2011; 131:1787-90. [PMID: 21946599 DOI: 10.4045/tidsskr.11.0609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Just Haffeld
- Faculty of Medicine, University of Oslo, Norway.
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Haffeld J, Heggenhougen H, Kiserud T, Lie S. Global helse - fra kaos til koherens. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2011; 131:1790-2. [DOI: 10.4045/tidsskr.11.0610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Haffeld J. Global helsekonvensjon kan hjelpe verdens fattige. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2011. [DOI: 10.4045/tidsskr.11.0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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