Politics and Governance will focus on understanding the national and regional context in which health policies are made, and how evidence and analysis can be better deployed to support resource allocation decisions making. The rationale for this element of the programme is that policies frequently stand or fall according to whether the appropriate, long-term, support is in place to favour and promote implementation, and so understanding how that support can be best ensured is important.
This requires an understanding of views and preferences of a range of actors, including careful interaction with policy-makers and relevant stakeholders, and will use a mixture of quantitative and qualitative research methods, including literature reviews, interviews, document analysis and meeting observations. With research undertaken within Malawi, the broader region of south eastern Africa and elsewhere on the continent, the theme will provide a key bridge to demonstrate the relevance of the programme’s research in Malawi to other low-income settings. This research theme is divided into four areas of interest:
Understanding the political background and drivers of policy making
Good policy advice can get lost without a firm understanding of politics and political systems. For this reason, we need to set out the context of health policy making and the constraints and opportunities that operate within that system. Theme 3 will focus on building that understanding, and identifying the range of actors who shape health policy at the national level.
Understanding the health budget in Malawi
Gaining a deeper understanding of Malawi’s health budget and spending processes will allow us to explore how these are working to improve – or undermine – efficient resource allocation. Building on this understanding, Theme 3 researchers aim at providing practical suggestions and policy recommendations that can help improve the efficiency of spending.
Drivers and contexts of decision making procedures in Malawi health sector
This work stream will set out the ways in which health policies in Malawi are determined and governed. It will explore the political challenges to the goal of Health of All and the delivery of the Sustainable Development Goal 3 on health and wellbeing in Malawi, identifying the actors advocating for more efficient and accountable heath spending. It will also seek to identify the priorities of those who are furthest away from meeting SDG 3.
Regional governance structures
Politics above the state can become a source of support, learning, diffusion of good practice and shared advocacy, and lesson-drawing in Southern and East Africa. Research under this work stream will examine the regionalist structures and the opportunities they present in terms of building inclusive health policies and establishing more efficient, transparent and effective processes for resource allocation and decision-making.