National responses to global health targets: exploring policy transfer in the context of the UNAIDS '90-90-90' treatment targets in Ghana and Uganda.

Global health organizations frequently set disease-specific targets with the goal of eliciting adoption at the national-level; consideration of the influence of target setting on national policies, programme and health budgets is of benefit to those setting targets and those intended to respond. In 2014, the Joint United Nations Programme on HIV/AIDS set 'ambitious' treatment targets for country adoption: 90% of HIV-positive persons should know their status; 90% of those on treatment; 90% of those achieving viral suppression. Using case studies from Ghana and Uganda, we explore how the target and its associated policy content have been adopted at the national level. That is whether adoption is in rhetoric only or supported by programme, policy or budgetary changes. We review 23 (14 from Ghana, 9 from Uganda) national policy, operational and strategic documents for the HIV response and assess commitments to '90-90-90'. In-person semi-structured interviews were conducted with purposively sampled key informants (17 in Ghana, 20 in Uganda) involved in programme-planning and resource allocation within HIV to gain insight into factors facilitating adoption of 90-90-90. Interviews were transcribed and analysed thematically, inductively and deductively, guided by pre-existing policy theories, including Dolowitz and Marsh's policy transfer framework to describe features of the transfer and the Global Health Advocacy and Policy Project framework to explain observations. Regardless of notable resource constraints, transfer of the 90-90-90 targets was evident beyond rhetoric with substantial shifts in policy and programme activities. In both countries, there was evidence of attempts to minimize resource constraints by seeking programme efficiencies, prioritization of programme activities and devising domestic financing mechanisms; however, significant resource gaps persist. An effective health network, comprised of global and local actors, mediated the adoption and adaptation, facilitating a shift in the HIV programme from 'business as usual' to approaches targeting geographies and populations

Consumption smoothing: institutions, incentives and economic outcomes : evidence from framed field experiments and panel data

Incomes of farmers and agricultural workers experience seasonal fluctuations. Due to limited access to formal insurance institutions, rural households rely on informal insurance institutions for instance tied labour and transfers from family and friends, to smooth consumption. Formal and informal insurance institutions offer differing incentives to households. This thesis investigates incentives pertaining to insurance institutions, their indirect and aggregate level outcomes. The overall objective of this thesis is to: identify incentive compatible solutions to smoothing consumption, examine the effect of intrinsic incentives on supply of effort, and analyse the aggregate level effects of microfinance institutions. Specifically this thesis assess (1) whether interacting savings institutions with rural labour markets improves incentives for labour tying, (2) how supply of self-image motivated effort can be more optimally elicited, (3) how insurance institutions can be aligned to elicit higher demand for formal insurance products, and (4) how microfinance institutions affect income inequality. This thesis makes use of framed field experiments to elicit incentive compatible preferences. A contextualised ultimatum game is applied to test rural labour market incentives and outcomes, and a contextualised risk game is applied to test moral hazard incentives under formal and informal insurance in risky production. This thesis also uses panel data to assess the effect of subgroups of microfinance institutions on income inequality. Main finding include (1) complementary savings institutions do not result into higher wages for labour tying, (2) self-signalling workers increase effort following higher and fairer wages, (3) lack of experience with formal insurance products impends their uptake, and (4) microfinance institutions do not contribute to enhancing the income status of the bottom poor. This thesis presumes that policy interventions to improve market outcomes of the poor should not focus on introducing complementary institutions, but rather on supporting cooperation and information programmes to enhance bargaining position of the poor.</p

Real Effort and Wage Data from Uganda

Real effort and Wage data from a framed-field Experiment in Ugand

Intensification/Diversification de VNS : Application au Problème de Coloration de Graphes

National audienc