Dr. Veena Sriram, a recently appointed Assistant Professor of Global Health Policy at the School of Population and Public Health and the School of Public Policy and Global Affairs, conducts research at the intersection of global health, social science, and public policy, including understanding power and politics in health policy processes in low- and middle-income countries. Her recent work looks at the healthcare workforce and tries to understand how associations of health care workers engage in the policy process.
When considering the decisions that shape healthcare systems and delivery, many think of governments, health authorities, or maybe doctors themselves. Stakeholders like health care worker associations are an underacknowledged and understudied factor in the policy process, despite their role and engagement.
“I observed in my doctoral research on medical specialization in India that doctors’ associations were pivotal to the policy processes that I was studying, and that these associations had a dynamic and arguably unique role due to their professional power, access to decision-makers, and elite networks within India and globally,” Dr. Sriram explains. “Examining these associations also needed an inter-disciplinary lens that combined history, political science, sociology, and other fields. I became very interested in pursuing further inter-disciplinary research on doctors’ associations in various contexts, as well as other types of health worker associations.”
Dr. Sriram brings an impressive background to this work, with experience spanning research, global health program management, and the social sciences. She completed her Master of Public Health at Columbia, PhD at Johns Hopkins University, and has worked at the US Centres for Disease Control and Prevention, and the Clinton Global Initiative, among other organizations. She has also consulted for the World Health Organization.
Along with collaborators in the United States and India, particularly Dr. Arima Mishra and Maya Elias, Dr. Sriram looked at how associations of doctors, hospitals, and other health care workers shape policy decisions through internal politics, relationships with decision-makers, and ideological affiliations. They explored differences across provider associations and between countries, asking questions about the pathways between these groups and those with the power to change health care policy. This work ultimately led to a special issue of the Journal of Health Politics, Policy and Law on the topic of physicians’ associations, which Dr. Sriram co-edited with Dr. Sorcha Brophy at the University of Chicago.
“Our policy analysis in Karnataka and the development of the special issue underscored the complexity of the contemporary politics of health provider associations – in low- and middle-income as well as high-income countries,” she notes. “The spaces in which these associations work – as well as the eco-systems of associations themselves – are changing quickly. There is a lot for us to do as researchers in understanding these dynamics and the impact on policy and equity.”
Health care workers have always played a crucial and respected role in society, but their position has become elevated during the COVID-19 pandemic due to their crucial role in treatment, as well as prevention. From evening cheers to pieces of art hung in windows to show appreciation for their work, frontline workers are being lauded as heroes in their communities.
Noticing this shift and public support, Dr. Sriram and her collaborators at UBC and other universities are now looking at whether decision-makers have modified their approach in engaging with health worker associations during the pandemic. Does the current position of frontline workers change and possibly improve their ability to advocate for changes in policy? How have policy demands or approaches to lobbying changed?
“Health worker associations are one piece in a larger puzzle of governance within health systems across the world. My goal is to work alongside my collaborators and understand how these pieces fit together and how this can be done optimally, keeping equity and inclusivity as our main objectives.”
Understanding how decisions are made – and how stakeholders influence those decisions – is a crucial area of research for those looking to shape future change and improve health. Dr. Sriram’s work is an important step towards gaining understanding and insight into these issues in order to improve accountability and transparency.