The SDGs in middle-income countries : Setting or serving domestic development agendas? Evidence from Ecuador

The expansion of middle-income countries in the global South is now widely acknowledged as significant for international development research and practice. But, as yet, scholars have not fully considered how middle-income countries are responding to the new global goals on international development (the Sustainable Development Goals – SDGs) outlined in Agenda 2030. Equally, insufficient attention has been paid to how – if at all – the SDGs shape domestic development policies and practices in middle income countries. We ask these questions in Ecuador, a country that recently moved from being a lower middle-income and donor dependent country to a more autonomous higher middle-income country with the capacity to promote its own national domestic development approach, Buen Vivir (in English: living well). Deploying a qualitative case study methodology and drawing primarily on in-depth semi-structured interviews conducted with policy makers working in Ecuador's national government and in the capital Quito, we show that policy makers’ engagement with the SDGs is selective, with an emphasis on those goals and targets which are considered of domestic importance. Both the national government and Quito's local government are currently focussing mainly on SDGs 10.2 (breaking inequalities) and 11 (inclusive cities). We demonstrate that, in practice, how policy makers understand implementation of these “priority” goals is not consistent; it depends on political preferences, where policy makers are located in the architecture of decentralised governance and the context-specific challenges they face. Evidence from Ecuador suggests that the SDGs cannot be understood as a single coherent template for development that states will simply adopt. Rather they should be analysed in the context of a rapidly changing architecture of global power, shaped by the context-specific nature of national development challenges and national political structures, including decentralisation

Stakeholder engagement in the health policy process in a low income country : a qualitative study of stakeholder perceptions of the challenges to effective inclusion in Malawi

Abstract Background Inclusive engagement in healthcare policies and decision-making is essential to address the needs of patients and communities, reduce health inequities and increase the accountability of the government. In low income countries such as Malawi, with significant health challenges, stakeholder inclusion is particularly important to improve performance and service delivery. The 2017 National Health Plan II (NHP II) and accompanying Health Sector Strategic Plan II (HSSP II) aimed to improve the functioning of the healthcare system. The Ministry of Health for Malawi intended to involve all key health sector stakeholders in their development. This study explores the extent of stakeholder engagement in the health policy process through local level stakeholders’ perceptions of their involvement in the NHP II and HSSP II. Methods A qualitative study design was used. Interviews were conducted with 19 representatives of organisations operating at the local level, such as CSOs and local government. Open questions were asked about experiences and perceptions of the development of the NHP II and HSSP II. Inductive content analysis was performed. Results Stakeholders perceived barriers to inclusive and meaningful engagement in the health policy process. Five categories were identified: tokenistic involvement; stakeholder hierarchy; mutual distrust; preferred stakeholders; no culture of engagement. Conclusions Serious challenges to the meaningful and equitable engagement of local level stakeholder groups in the health policy process were identified. Issues of trust, accountability and hierarchy in donor-citizen-government relations must be addressed to support stakeholder engagement. Engagement must go beyond tokenism to embed a range of stakeholders in the process with feedback mechanisms to ensure impact from their contributions. Local level stakeholders can be empowered to advocate for and participate in consultation exercises alongside greater top-down efforts to engage stakeholders via diverse and inclusive methods. These issues are not unique to Malawi or to health policy-making

Failing Women and Girls during Covid-19: The Limits of Regional Gender Norms in Africa

How do we account for the ability or otherwise of regional organisations in the global South to enable equitable and inclusive responses to the COVID-19 pandemic? We answer this question with a focus on Africa and in relation to the rights of women and girls. Drawing on theoretical insights from Feminist Global Health Security and utilising data on the African Union and other regional organisations in Africa and from NGOs, local activists and medical centres, we show that regional organisations acted quickly to identify the gendered socio-economic and health needs of women and girls and alerted member states to the need to consider gender rights in their policy responses. However, we show that weak gender norms led to a disconnect between early recognition of the need for policies to protect women and girls and the failure of regional organisations to either lead that response or engineer it in member state governments