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Accountability and Generating Evidence for Global Health: Misoprostol in Nepal

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posted on 2024-09-05, 22:09 authored by Jeevan Raj Sharma, Rekha Khatri, Ian Harper
Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality in Nepal. Compounded by the remote terrain, endemic poverty, and a lack of access to health facilities, the use of misoprostol has advantages over the standard use of oxytocin for PPH management. Drawing on our qualitative study of a pilot intervention managed by the Nepal Family Health Programme, we map the institutional relationships involved in the design, implementation, and practices for bringing misoprostol into national policy. In the intense and competitive global and national policy arena, sustained lobbying and getting the ‘right people’ on board were as powerful drivers as the quality of the intervention itself. The case study takes us to the heart of the debate around the politics of generation of evidence for interventions in global health programmes, and ultimately the question of accountability for health policy and practice.

Funding

Open Society Foundations, Vozes Desiguais/Unequal Voices, Future Health Systems consortium, the Impact Initiative and Health Systems Global

History

Publisher

Institute of Development Studies

Citation

Raj Sharma, J., Khatri, R. and Harper, I. (2018) 'Accountability and Generating Evidence for Global Health: Misoprostol in Nepal' in Nelson, E., Bloom, G and Shankland, A. (Eds) Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage, IDS Bulletin 49.2, Brighton: IDS

Series

IDS Bulletin 49.2

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  • VoR (Version of Record)

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Article

Copyright holder

Institute of Development Studies

Country

Nepal

Language

en

IDS team

Health and Nutrition

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Default project::9ce4e4dc-26e9-4d78-96e9-15e4dcac0642::600

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    Volume 49. Issue 2: Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage

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