Translation of WHO-policy in Norway and Cuba: Directives from The Word Health Organization in states with different governance systems and economies

Abstract

Transnational governance is governance that takes place across national boundaries and involving a diverse set of actors. One such actor is the World Health Organization which is central to transnational collaboration and policy development globally. Recently the WHO played an integral role in the worldwide battle against the Covid-19 pandemic and the organization has been a central figure in global public health through its declarations and directives that effectively constitute transnational policies. Perhaps the most prevalent of these are the Ottawa Charter and the Health in All Policies that emerged after it. Norway and Cuba are two public health puzzles that despite their large differences in governance structures and economies both have good results in population health. Both are members of the WHO, but how have the two countries translated transnational policy in the form of WHO-policy into public health measures and policies? This thesis seeks to answer this question with the help of translation theory as a theoretical framework to interpret how WHO-policy is translated into the Norwegian and Cuban contexts, using a multi-case design. A literature review was conducted to acquire and systematize data that was analyzed through a content analysis of both cases. The aim of this study was to contribute to the literature about the implications and significance of transnational policy on the national levels. Some central findings are that national Norwegian public health policies that were found to be largely reproduced from WHO-policy elements. However, there is a level of conflict between the overarching policies of the national level and the municipal actors who work with implementing them. Additionally, Cuban public health work was found to largely be based around community involvement and situationally contingent public health measures that appear to be modified translations of WHO-policy. The main finding of this thesis as it pertains to transnational governance is that national translations of transnational policy are likely to be reproduced to a much larger degree than regional and local translations that are more likely to be modified by the recipient contexts.