International Development, Community, and Environment

Title

Achieving Millennium Development Goals for Health: Building Understanding, Trust and Capacity to Respond

Document Type

Article

Abstract

Biomedical interventions promise achievement of health-related Millennium Development Goals provided social-, capacity- and knowledge-based constraints to scaling up and reaching marginalized people at risk, are addressed, and balance between prevention and treatment is struck. We argue for a new approach: multi-stakeholder capacity building and learning for empowerment: MuSCLE. MuSCLE is used as a way to frame three systemic weaknesses in traditional health science and policy approaches: (1) a lack of engagement with people at risk to build a collective understanding of the contexts of health problems, including social drivers; (2) a lack of multi-criteria evaluation of alternative interventions; (3) a lack of attention paid to integrated capacity building. The MuSCLE framework responds in three ways: (1) participatory assessment of the ecological, socio-cultural, economic and political contexts of health, identifying priorities using risk and vulnerability science, and modeling drivers; (2) selection among intervention alternatives that makes ecological, socio-cultural, economic and political tradeoffs transparent; (3) integrated capacity building for sustainable and adaptive interventions. Literature and field lessons support the argument, and guidelines are set down. A MuSCLE approach argues for a transformation in health science and policy in order to achieve Millennium Development Goals for health. © 2007 Elsevier Ireland Ltd. All rights reserved.

Publication Title

Health Policy

Publication Date

10-1-2007

Volume

83

Issue

2-3

First Page

144

Last Page

161

ISSN

0168-8510

DOI

10.1016/j.healthpol.2007.02.008

Keywords

capacity building, poverty, risk, vulnerability

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