Determinants of the effectiveness of global health policy networks

Scholarship that seeks to explain why global deaths have declined more rapidly from some conditions than others focuses primarily on the availability of medical interventions. Only rarely have studies considered the role of global health policy networks – the individuals and organizations linked by a shared concern for a condition. Such networks have proliferated in the past two decades. Some of the variance in mortality decline may be due to network effectiveness in attracting attention to the issue, in generating funding, in discovering interventions, and in convincing national governments to adopt policies and carry out programs. With a view to examining their causal role in public health outcomes, this paper compares networks concerned with six global health problems: maternal mortality, newborn deaths, tuberculosis, pneumonia, tobacco control and alcohol abuse. As part of the Global Health Advocacy and Policy Project (GHAPP), a three-year research initiative funded by the Bill and Melinda Gates Foundation, case studies were conducted on each of these six networks, using process-tracing methods that involved interviews with 180 key informants and analysis of 1250 documents. This paper brings together results of the six case studies to present a framework on the determinants of the effectiveness of networks. The framework consists of four elements: network structure and strategy; conditions in the global policy environment; issue characteristics; and outcomes produced. The framework and findings highlight the fact that these four elements, far from operating in isolation, are mutually constitutive, and that networks both shape and are shaped by their environments.