MASTERS OF PUBLIC HEALTH
HCH606: HEALTH PLANNING AND POLICY DEVELOPMENT
JOY CHEMUTAI MOISENGO
From your reading list, read the following:
• Collins, T., 2005. Health policy analysis: a simple tool for policy makers. Health Policy, pp.192–196.
• Lagarde, M., 2012. How to do (or not to do) … Assessing the impact of a policy change with routine longitudinal data. Health policy and planning, 27(1), pp.76–83.
• Walt, G. et al., 2008. “Doing” health policy analysis: methodological and conceptual reflections and challenges. Health policy and planning, 23(5), pp.308–17.
• Buse, K et al Making Health Policy 2012, Chapter 1 and 10.
For each source prepare an annotated bibliography.
Find 5 other sources (not more than 5 years old) to explain:
1. The different concepts used in policy analysis.
2. Different types of policy analysis.
3. What are the aims of policy analysis?
Buse, Kent, et al. Making Health Policy. McGraw Hill/Open University Press, 2012. Chapter one of this book focuses on the importance of the actors who make health policy, contextual factors that affect health policy, the processes of making policy, and the content of policy, all of which make the ‘health policy triangle’. The authors also point out that ways in which politics affects health policy in Chapter 10 as well as the importance of both retrospective and prospective policy analysis. Activities in the analysis of stakeholders and data collected are also explored.
Collins, T. “Health Policy Analysis: a Simple Tool for Policy Makers.” Public Health, vol. 119, no. 3, 2005, pp. 192–196., doi:10.1016/j.puhe.2004.03.006. In this article, the author, Tea Collins, focuses on the analysis of policy content and mentions different approaches to policy analysis by different people like Dunn, Portney and Pal. He goes on to outline a health policy analysis framework of eight steps from Bardach E. These are: define the context; state the problem; search for evidence; consider different policy options; project the outcomes; apply evaluative criteria; weigh the outcomes; and make the decision. It is said that this framework is valuable to practitioners who have limited time, experience and/or resources.
Lagarde, M. “How to Do (or Not to Do) … Assessing the Impact of a Policy Change with Routine Longitudinal Data.” Health Policy and Planning, vol. 27, no. 1, 2011, pp. 76–83., doi:10.1093/heapol/czr004. Largarde provides insight on study designs that improve the quality of information collected on the impact of a policy change on outcomes using longitudinal data. These are randomized experiments and two types of quasi-experimental designs which are: controlled before and after studies and interrupted time-series (ITS) studies. The author also outlines the use of ARIMA modelling and a segmented linear regression as correct approaches to assessing the impact of a health policy change in low- and middle-income health systems through analysis of longitudinal data.
Walt, G., et al. “‘Doing’ Health Policy Analysis: Methodological and Conceptual Reflections and Challenges.” Health Policy and Planning, vol. 23, no. 5, 2008, pp. 308–317., doi:10.1093/heapol/czn024. This article discusses the reasons for the inadequacy in health policy analysis in low- and middle-income countries. The authors suggest ways in which research in health policy analysis can be strengthened in theory, methodology and positionality. They say that these will assist policy-makers in evaluating and planning current and future policies.
Buse et al. (2012) defined policy as a broad statement of goals, objectives and means that create the framework for activity. Policy analysis is the process of using a variety of tools to determine the characteristics, origin and consequences of current policies and also, which of these policies have achieved, or will achieve, a given set of goals in light of the relations between the policies and the goals (Wikipedia 2017). It is also defined as the systematic investigation of alternative policy options and the process of gathering and integrating the evidence for and against each option (Serban, 2015). The need for interventions that draw attention to important policy issues, improve the policy implementation process, and lead to better health outcomes is emphasized by policy analysis. (Collins 2017)
There are different elements of policy analysis whereby the best policy among other policies formed for the same purpose is chosen. Collins (2017) outlines a framework that is used for policy analysis which was proposed by Bardach E. in 2000. This framework has eight steps and the first one is to define the problem which makes an analysis possible. The second step is to assemble the evidence whereby the criteria for comparison of the results of the policies are formulated. The third step is constructing the alternatives which are compared and expressed in terms of the criteria specified in the second step. The steps that follow are selecting the criteria; projecting the outcomes of the alternative policies; dealing with the tradeoffs; making a decision which depends highly on the context; and ultimately, describing the whole process in detail. In the literature, it is noted that the process does not always follow the outlined steps in order.
Patton, Sawicki, and Clark (2016) also outline six steps that they call the rational model. These steps are: define the problem; determine evaluation criteria; identify alternative policies; evaluate these alternative policies; select the preferred policy; and implement it.
These stages are used to organize policymaking in a simple way by doing the following: identifying the aims of the policymaker; identifying the policies needed to achieve those aims; selecting a policy measure; ensuring that the selection is legitimized by the population or its legislature; identifying the necessary resources; implementing and then evaluating the policy. (Cairney 2013)
Walt et al. (2008) suggest ways in which policy analysis would be improved by more systematic approaches and have suggested using theoretical frameworks to help researchers in focusing their efforts to analyzing the policymaking process. Some of them are the stages heuristic, policy triangle framework and policy triangle framework. They say that these will assist policy-makers in evaluating and planning current and future policies.
Policy analysis can have different aspects and some of these are outlined by Collins (2017) as: the analysis of policy process, which focuses on policy formulation; and analysis of policy content, which focuses on the substance of policy and can be analytical, descriptive or prescriptive. Buse et al., (2005) summarize the analysis of policy as being prospective used to inform the formulation of a policy or to predict the outcome of this policy if introduced. They also point out that analysis for policy assesses the prospects and manages the politics of policy change in a way that meets their goals and if not, may lead to this policy being abandoned.
According to Patton, Sawicki, and Clark, (2016) descriptive analysis is used for existing policies that have been used in the past bringing reasons for the success and/or failure and insight is provided on how to approach the future using the existing data. Prescriptive policy analysis is the analysis of new policy and it suggests a number of different possible alternatives for a particular situation. It quantifies the effect of future decisions so as to advise on possible outcomes before the decisions are actually made. Recommendations on what actions should be taken are made.
Predictive analysis of policy is also mentioned as that which uses existing data to determine the probable future outcome of a particular policy. Since this is based on probabilities, the predicted outcomes are not always 100% certain.
Different sets of data are used in the techniques used in policy analysis. The use of longitudinal data is said to deliver robust results and is often reasonably easy to access. (Lagarde 2011) Randomized experiments are also advocated for the analysis of this data when available, in order to assess the impact of policy changes on outcomes that are routinely monitored by routine information systems.
The aims of policy analysis are outlined in Kenya by the Parliamentary Service Commission, (2017) as:
• Ensuring that policies are responding to the real needs of the community, which in turn, can lead to better outcomes for the population in the long-term.
• Highlighting the urgency of an issue or problem, which requires immediate attention as this is important in securing funding and resources for the policy to be developed, implemented and maintained.
• Enabling information sharing amongst other members of the public sector, in regard to what policies have or haven’t worked.
• Reduction of government expenditure, which may otherwise be directed into ineffective policies or programs, which could be costly and time consuming.
• Production of an acceptable return on the financial investment that is allocated toward public programs by improving service delivery and outcomes for the community.
• Ensuring that decisions are made in a way that is consistent with our democratic and political processes, which are characterized by transparency and accountability.?
Buse, Kent, Nicolas Mays, Gill Walt, Series Editors, Nick Black, and Rosalind Raine. 2005. Making Health Policy.
Cairney, Paul. 2013. “Politics and Public Policy.” 2013. https://paulcairney.wordpress.com/2013/11/11/polic.
Collins, T. 2017. “Health Policy Analysis?: A Simple Tool for Policy Makers,” no. April 2005. https://doi.org/10.1016/j.puhe.2004.03.006.
Lagarde, Mylene. 2011. “How to Do ( or Not to Do ) . . . Assessing the Impact of a Policy Change with Routine Longitudinal Data,” no. January 2011:76–83. https://doi.org/10.1093/heapol/czr004.
Parliamentary Service Commission. 2017. “GUIDELINES FOR EVIDENCE USE IN POLICY ANALYSIS AND DECISION-MAKING.”
Patton, Carl, David Sawicki, and Jennifer Clark. 2016. Basic Methods of Policy Analysis and Planning.
Serban, M. 2015. “Supporting Public Policy Making through Policy Analysis and Policy Learning.” http://www.etf.europa.eu/webatt.nsf/0/A490BF6FDAD1B387C1257EB3005E18D9/$file/Ex-ante impact assessment.pdf.
Walt, Gill, Jeremy Shiffman, Helen Schneider, Susan F Murray, and Ruairi Brugha. 2008. “‘ Doing ‘ Health Policy Analysis?: Methodological and Conceptual Reflections and Challenges,” no. 2000:308–17. https://doi.org/10.1093/heapol/czn024.
Wikipedia. 2017. “Policy Analysis.” 2017. https://en.wikipedia.org/wiki/Policy_analysis.