战后利比里亚的网络权力与心理健康政策》。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Health policy and planning Pub Date : 2024-05-15 DOI:10.1093/heapol/czae020
Amy S Patterson, Mary A Clark, Al-Varney Rogers
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引用次数: 0

摘要

利比里亚是一个低收入、冲突后的西非国家,本文追溯了网络力量对该国心理健康政策的影响。基于关键信息提供者访谈、焦点小组讨论和文件分析,文章采用归纳法揭示了一个由民间团体、政府官员、侨民和国际非政府组织组成的网络是如何影响该国 2009 年和 2016 年精神卫生政策的通过、实施和修订的。该网络以信息、专业知识、资源、承诺和人际关系为纽带,围绕着卡特中心这一关键代理机构凝聚在一起,为成员们牵线搭桥,并为各项行动提供指导。当这些行动者利用专业知识、对战后创伤和心理健康作为一项人权的共同叙述以及财政资源来影响政策时,网络的力量就显而易见了。随着政策的实施,心理健康临床医生和服务使用者、研究实体和培训机构建立了新的联 系,反馈回路也随之出现。这些受益者为网络提供了来自生活经验的信息,同时也在随后的政策修订中提出了自己的利益诉求。随着网络的不断扩大,一些网络成员从关键代理人那里获得了更大的自主权。尽管随着时间的推移,出现了对网络过度扩张和关键代理人承诺的担忧,但网络力量的成果包括创建了政府心理健康机构、发展了劳动力、提高了公众意识、动员了民间社会,并在政府预算中设立了心理健康项目。利比里亚的案例说明,网络不一定会阻碍发展,在国家能力较低的情况下,网络力量也可以促进在被污名化、不受欢迎的问题上采取行动。对卫生领域网络权力的关注表明,权力如何不仅可以通过资金等离散资源,还可以通过网络联系使之成为可能的全部资产来运作。
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Network power and mental health policy in post-war Liberia.

This article traces the influence of network power on mental health policy in Liberia, a low-income, post-conflict West African country. Based on key informant interviews, focus group discussions and document analysis, the work uses an inductive approach to uncover how a network of civil society groups, government officials, diasporans and international NGOs shaped the passage, implementation and revision of the country's 2009 and 2016 mental health policies. With relations rooted in ties of information, expertise, resources, commitment and personal connections, the network coalesced around a key agent, the Carter Center, which connected members and guided initiatives. Network power was evident when these actors channelled expertise, shared narratives of post-war trauma and mental health as a human right, and financial resources to influence policy. Feedback loops appeared as policy implementation created new associations of mental health clinicians and service users, research entities and training institutes. These beneficiaries offered the network information from lived experiences, while also pressing their own interests in subsequent policy revisions. As the network expanded over time, some network members gained greater autonomy from the key agent. Network power outcomes included the creation of government mental health institutions, workforce development, increased public awareness, civil society mobilization and a line for mental health in the government budget, though concerns about network overstretch and key agent commitment emerged over time. The Liberian case illustrates how networks need not be inimical to development, and how network power may facilitate action on stigmatized, unpopular issues in contexts with low state capacity. A focus on network power in health shows how power can operate not only through discrete resources such as funding but also through the totality of assets that network linkages make possible.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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