About the project
A core tension in the history of international health is the balance between comprehensive primary healthcare and disease-specific approaches to public health. In recent years, new disease-focused global health initiatives like the Global Fund and GAVI have been criticised for damaging national health systems. In response, they have expanded their mandate to include health system strengthening.
Meanwhile, national governments increasingly acknowledge that health systems are in crisis and are developing their own strategies for health system strengthening, such as the National Rural Health Mission (NRHM) in India. Despite the global emphasis on health system strengthening, there is no consensus on what it means, how it should be pursued in different contexts, whether it is the responsibility of the state or of global health initiatives, and how best to reconcile the pursuit of disease-specific global health targets and overall health system strengthening.
Focusing on the vaccination field, the HEALVAC project examines how diverse actors understand and engage with these unresolved debates. Specifically, it charts the growing focus on health system strengthening within global and national vaccination policy and explores how debates about health systems play out in the interactions between global institutions and national actors. The research also addresses some of the on the ground challenges of integrating vaccination programmes within the NRHM in the state of Orissa.
The study takes an ethnographic approach, including open-ended qualitative interviews with key informants from the global health policy and vaccination fields at both international and national levels; participant observation at policy meetings; review and analysis of policy and scientific documents; and observation of implementation of the NRHM in the states of Orissa and Rajasthan, India.
Financing
HEALVAC is funded by the Research Council of Norway’s GLOBVAC Programme (2010-2013)
Cooperation
The project is a collaboration between the Centre for Development and Environment at the University of Oslo (Sidsel Roalkvam and Katerini T. Storeng) and the Institute of Public Health, Bangalore, India (Arima Mishra).