Identifying stakeholders through a multilevel analysis: Securing support for eye-health policy in low and middle income countries

Blindness and visual impairment is considered a public health problem in a vast majority of low- and middle-income countries. This paper empirically evaluates advocacy in low and middle income countries as the key tool to raising policy priority and securing high-level decision maker support in eye health. We use a dataset based on a survey conducted by WHO in 2011 among the Ministries of Health in order to collect information on policy and decision making in the area of eye care and prevention of blindness and includes the information on 82 low and middle income countries. The theoretical framework used in our analysis is based on the idea that pressure upon national government is exerted by a plethora of stakeholders both at local and global level, acting on the economic and the political context. Combining these two levels and contexts of stakeholders' action we build a 2X2 pressure matrix in order to assess the involvement of economic and political institutions in advocacy activities. Our empirical analysis identifies the existence of structural differences across countries with different income levels regarding the stakeholders' involvement and proposes a set of policy recommendations in order to secure high-level decision makers support and commitment to promoting eye-health.