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Table 1 Shiffman and Smith’s framework

From: Challenges and opportunities for eliminating tuberculosis – leveraging political momentum of the UN high-level meeting on tuberculosis





1. policy community cohesion

The degree of cohesion among stakeholders

2. leadership

The presence of individuals capable of raising awareness and mobilizing resources, and are widely acknowledged by the community

3. guiding institutions

The effectiveness of organizations or coordinating mechanisms with a mandate to lead the issue

4. civil society mobilization

The extent to which grassroots organizations have mobilized the necessary support from international and national political authorities


5. internal frame

The way policy community agree on the definition of, causes of, and solutions to the issue

6. external frame

The way to portray the issue outside of the policy community

Policy environment

7. policy window

Political momentum when global community favorably align the issue

8. global governance structure

The degree to which norms and institutions operating in a sector provide a platform for effective collective action

Issue characteristics

9. credible indicators

Clear and measurable indicators which can trace the severity and progress

10. severity

The size of the burden relative to other issues (i.e., mortality)

11. effective interventions

The extent to which proposed means of addressing the problem are clearly explained, cost-effective, evidence-based, easy to implement and affordable