eprintid: 1576496
rev_number: 40
eprint_status: archive
userid: 608
dir: disk0/01/57/64/96
datestamp: 2017-11-10 14:01:51
lastmod: 2020-02-12 21:07:00
status_changed: 2017-11-10 14:01:51
type: thesis
metadata_visibility: show
creators_name: Wu, Dadong
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
ispublished: unpub
divisions: UCL
divisions: A01
divisions: B02
divisions: C09
divisions: D01
keywords: Syphilis, HIV, mother-to-child transmission, China, political prioritisation, health policy, comparative case study
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.
date: 2017-09-28
date_type: published
oa_status: green
full_text_type: other
thesis_class: doctoral_open
language: eng
thesis_view: UCL_Thesis
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1425287
lyricists_name: Hawkes, Sarah
lyricists_name: Wu, Dadong
lyricists_id: SJHAW16
lyricists_id: DWUXX34
actors_name: Wu, Dadong
actors_id: DWUXX34
actors_role: owner
full_text_status: public
pages: 320
event_title: Institute for Global Health
institution: UCL (University College London)
department: Institute for Global Health
thesis_type: Doctoral
editors_name: Hawkes, S
editors_name: Weale, A
citation:        Wu, Dadong;      (2017)    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.                   Doctoral thesis , UCL (University College London).     Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/1576496/1/Wu_1576496_20171001%20Flora%27s%20thesis%20-%20FINAL%20deposited%20version.pdf