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Towards understanding the drivers of policy change: a case study of infection control policies for multi-drug resistant tuberculosis in South Africa

Overview of attention for article published in Health Research Policy and Systems, May 2017
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Mentioned by

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5 tweeters

Citations

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7 Dimensions

Readers on

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97 Mendeley
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Title
Towards understanding the drivers of policy change: a case study of infection control policies for multi-drug resistant tuberculosis in South Africa
Published in
Health Research Policy and Systems, May 2017
DOI 10.1186/s12961-017-0203-y
Pubmed ID
Authors

Trust Saidi, Faatiema Salie, Tania S. Douglas

Abstract

Explaining policy change is one of the central tasks of contemporary policy analysis. In this article, we examine the changes in infection control policies for multi-drug resistant tuberculosis (MDR-TB) in South Africa from the time the country made the transition to democracy in 1994, until 2015. We focus on MDR-TB infection control and refer to decentralised management as a form of infection control. Using Kingdon's theoretical framework of policy streams, we explore the temporal ordering of policy framework changes. We also consider the role of research in motivating policy changes. Policy documents addressing MDR-TB in South Africa over the period 1994 to 2014 were extracted. Literature on MDR-TB infection control in South Africa was extracted from PubMed using key search terms. The documents were analysed to identify the changes that occurred and the factors driving them. During the period under study, five different policy frameworks were implemented. The policies were meant to address the overwhelming challenge of MDR-TB in South Africa, contextualised by high prevalence of HIV infection, that threatened to undermine public health programmes and the success of antiretroviral therapy rollouts. Policy changes in MDR-TB infection control were supported by research evidence and driven by the high incidence and complexity of the disease, increasing levels of dissatisfaction among patients, challenges of physical, human and financial resources in public hospitals, and the ideologies of the political leadership. Activists and people living with HIV played an important role in highlighting the importance of MDR-TB as well as exerting pressure on policymakers, while the mass media drew public attention to infection control as both a cause of and a solution to MDR-TB. The critical factors for policy change for infection control of MDR-TB in South Africa were rooted in the socioeconomic and political environment, were supported by extensive research, and can be framed using Kingdon's policy streams approach as an interplay of the problem of the disease, political forces that prevailed and alternative proposals.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 97 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 97 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 28 29%
Student > Ph. D. Student 12 12%
Researcher 11 11%
Student > Doctoral Student 8 8%
Student > Bachelor 5 5%
Other 16 16%
Unknown 17 18%
Readers by discipline Count As %
Medicine and Dentistry 27 28%
Social Sciences 13 13%
Nursing and Health Professions 9 9%
Business, Management and Accounting 7 7%
Arts and Humanities 3 3%
Other 15 15%
Unknown 23 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 October 2017.
All research outputs
#3,125,420
of 11,902,314 outputs
Outputs from Health Research Policy and Systems
#401
of 622 outputs
Outputs of similar age
#85,932
of 271,932 outputs
Outputs of similar age from Health Research Policy and Systems
#16
of 31 outputs
Altmetric has tracked 11,902,314 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 622 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.9. This one is in the 34th percentile – i.e., 34% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 271,932 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 31 others from the same source and published within six weeks on either side of this one. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.