Young scientist grant for Katerini T. Storeng: Advocacy and policy change for health equity in low-income countries

The GLOBVAC Young Scientist Grant awarded by the Norwegian Research Council (NRC) has supported the career development of Katerini Storeng, a medical anthropologist whose research focuses on the politics and practices of global health. It has done so by funding Storeng's research into advocacy and policy development designed to achieve health equity in low- and middle-income countries, focusing specifically on civil society movements and international non-governmental organisations (INGOs). The research advances the state of the art by challenging conventional thinking about the role that donor agencies and international NGOs play in developing and diffusing policies designed to advance health equity in low- and middle-income countries. At the country level, INGOs are political actors with considerable power to shape the policy agendas of governments in donor-recipient countries in Africa and Asia. At the global level, however, INGOs are important implementing agents for public-private partnerships for health, but their dependency on donors threatens their ability to hold powerful actors to account and to advocate for a progressive agenda. Together, Storeng's research provides insights into the challenges involved in balancing private interests and public health imperatives within global health policy. The Young Scientist Grant was implemented through a number of inter-related research projects. The main project was an ethnographic study of the People's Health Movement and allied progressive civil society movements seeking to influence global heath governance and to mobilise civil society action for health equity in Africa. The second major project was an external impact evaluation of a UK Department of International Development (DFID) programme to prevent deaths from unwanted pregnancies in Asia and Africa. Storeng led a sub-study investigating INGOs' influence on the reproductive health policy environments in selected programme countries (Malawi, South Sudan, Zambia, India and Pakistan). These projects complemented other international research collaborations focused on maternal health and policy, including the NRC-funded NGOMA project that examined INGOs' role in diffusing global maternal health policies to the national and local levels in Malawi. The various research activities funded by the Young Scientist Grant have resulted in academic articles in leading peer-reviewed publications including Social Science & Medicine, Global Public Health and Health Policy & Planning; commentaries in the scientific press; and presentations at leading international academic conferences. Storeng has disseminated findings to policy-makers through policy briefs, meetings and reports, and to general audiences through a number of popular science contributions in blogs and the popular press. The research has also fed into PhD degrees for several junior scholars and masters- and PhD-level teaching. An unanticipated benefit of the research has been to raise awareness of and debate about the behind-the-scenes ethical and political challenges of conducting donor-funded global health research, including through Storeng's Viewpoint article in The Lancet, which attracted the attention of the media and of policy-makers. The research funded by the Young Scientist Grant also demonstrated the value of in-depth, critical social scientific enquiry in studies of global health policy and governance. Finally, the research has fed into a project proposal (currently under review with NRC) to study civil society activism for Universal Health Coverage globally and in Malawi, Ghana and Senegal. The Grant has enabled Storeng to qualify for a permanent (tenured) position as Associate Professor of Global Health at the University of Oslo?s Centre for Development and the Environment (SUM). At SUM, she co-founded and now leads the interdisciplinary 'Power and Politics in Global Health' research group and oversees the group's external collaborations, including as Deputy Director of the Independent Panel on Global Governance for Health. With support from an NRC overseas research grant, she has consolidated strong international networks as visiting scholar at Columbia University's Mailman School of Public Heath in the US (2016) and at the London School of Hygiene of Tropical Medicine in the UK (2018), where she is currently Honorary Associate Professor. In recognition of her academic achievements and popular scientific engagement, Storeng was, in 2015, selected as one of twenty members to establish the Young Academy of Norway. She is currently the Academy's Chair, contributing actively to its work within science policy and interdisciplinary research dissemination.

Major outcomes of the Young Scientist Grant include new international research collaborations within social scientific studies of global health policy, and the recipient, Katerini Storeng's, appointment at the end of the grant period as Associate Professor at the Centre for Development and the Environment, University of Oslo and Honorary Associate Professor at the London School of Hygiene & Tropical Medicine. The various research projects Storeng has participated in as a Grant recipient make a strong contribution to the social scientific study of global health policy and practice, challenging conventional understandings about the international NGOs and donor agencies play in the pursuit of health equity. An unanticipated benefit of the research has been to raise debate about the ethical and political challenges of conducting donor-funded global health research, including through Storeng's 2019 Viewpoint in The Lancet, which attracted the attention of the media and of policy-makers.

The Young Scientist Grant will build the applicant's capacity within health systems and policy research in low-income countries. This will be achieved through inter-related research activities and a year-long research visit to the London School of Hygiene & Tropical Medicine. The main research project will be an ethnographic study of global civil society action on health equity, with a case study of the People's Health Movement (PHM). The overall aims of this project are: (1) To describe and analyse the P HM's action on health equity, including its use of rights-based and social determinants of health approaches; (2) To conduct a qualitative process evaluation of the impact of these activities on global health policy and discourse; and (3) To explore PHM's efforts to support national health equity campaigns in Burkina Faso. The applicant will be independently responsible for implementation of the project, supported by the Centre for Development and Environment at the University of Oslo and partners in Burk ina Faso. In addition, the applicant will participate in two ongoing research programmes led by leading international research consortia. The first, FEMHealth (funded by the European Commission) aims to assess the impact of reduction in user fees on mater nal health in Burkina Faso, Benin, Mali and Morocco, which have all recently introduced national policies to reduce financial barriers for delivery care. The applicant will contribute to a work package focusing on understanding what drives policy change. The second, EVA-PMUD, is funded by the UK Department for International Development and will evaluate an intervention to prevent maternal death from unwanted pregnancy in Africa and Asia. The applicant will design and coordinate a cross-country process eva luation of the intervention's policy and advocacy work in Nigeria, Malawi and South Sudan. Together, these research activities will enhance knowledge on, and efforts to improve, global health equity.