Technological Innovation, Entrepreneurship, Higher Education and Economic Regeneration in Wales: A Policy Study

ERIC Educational Resources Information Center

Thomas, Brychan; Packham, Gary; Miller, Christopher

2006-01-01

This paper presents the views of key policy makers concerning innovation and entrepreneurship in Wales. The development of innovation in SMEs and the policy implications for economic regeneration are also analysed. The role of a variety of actors (including users and suppliers) is considered, as is the impact of networks of SMEs linked together in…

Pathways of undue influence in health policy-making: a main actor's perspective.

PubMed

Hernández-Aguado, Ildefonso; Chilet-Rosell, Elisa

2018-02-01

It is crucial to know the extent to which influences lead to policy capture-by which the policy-making process is shifted away from the public interest towards narrow private interests. Using the case study of Spain, our aim was to identify interactions between public administration, civil society and private companies that could influence health policies. 54 semistructured interviews with key actors related to health policy. The interviews were used to gather information on main policy actors as well as on direct and subtle influences that could modify health policies. The analysis identified and described, from the interviewed persons' experiences, both the inappropriate influences exerted on the actors and those that they exerted. Inappropriate influences were identified at all levels of administration and policy. They included actions for personal benefits, pressure for blocking health policies and pressure from high levels of government in favour of private corporations. The private sector played a significant role in these strategies through bribery, personal gifts, revolving doors, negative campaigns and by blocking unfavourable political positions or determining the knowledge agenda. The interviewees reported subtle forms of influence (social events, offers of technical support, invitations, etc) that contributed to the intellectual and cultural capture of health officials. The health policy decision-making processes in Spain are subject to influences by stakeholders that determine a degree of policy capture, which is avoidable. The private sector uses different strategies, from subtle influences to outright corruption, taking advantage in many cases of flexible legislation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Dynamics of evidence-informed health policy making in Pakistan

PubMed Central

Haq, Zaeem; Hafeez, Assad; Zafar, Shamsa; Ghaffar, Abdul

2017-01-01

Abstract Incorporating evidence is fundamental to maintaining the general acceptance and efficiency in public policies. In Pakistan, different actors—local and global—strive to facilitate the development of evidence-informed health policies. Effective involvement however, requires knowledge of the country-context, i.e. knowing the intricacies of how policies are formulated in Pakistan. Obtaining this knowledge is one of the key steps to making interventions impactful.  We carried out a qualitative study to explore the environment of evidence-informed health policy in Pakistan. The study involved 89 participants and comprised three phases including: (1) literature review followed by a consultative meeting with key informants to explore the broad contours of policy formulation, (2) in-depth interviews with participants belonging to various levels of health system to discuss these contours and (3) a roundtable with experts to share and solidify the findings.  Policy development is a slow, non-linear process with variable room for incorporation of evidence. Political actors dominate decisions that impact all aspects of policy, i.e. context, process and content. Research contributions are mostly influenced by the priorities of donor agencies—the usual proponents and sponsors of the generation of evidence. Since the devolution of health system in 2012, Pakistan’s provinces continue to follow the same processes as before 2012, with little capacity to generate evidence and incorporate it into health policy.  This study highlights the non-systematic, nearly ad hoc way of developing health policy in the country, overly dominated by political actors. Health advocates need to understand the policy process and the actors involved if they are to identify points of impact where their interaction with policy brings the maximum leverage. Moreover, an environment is needed where generation of data gains the importance it deserves and where capacities are enhanced for communicating and understanding evidence, as well as its incorporation into policy. PMID:29045672

Ineffective Healthcare Technology Management in Benin’s Public Health Sector: The Perceptions of Key Actors and Their Ability to Address the Main Problems

PubMed Central

Houngbo, P. Thierry; De Cock Buning, Tjard; Bunders, Joske; Coleman, Harry L. S.; Medenou, Daton; Dakpanon, Laurent; Zweekhorst, Marjolein

2017-01-01

Background: Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and costeffectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems. Methods: We conducted 2 surveys in 117 selected health facilities. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at health facilities. The Temple-Bird Healthcare Technology Package System (TBHTPS), tailored to the context of Benin’s health system, was used as a conceptual framework. Results: The findings of the first survey show that 85% of key actors in Benin’s HTM sector characterized the system as failing in components of the TBHTPS framework. Biomedical, clinical, healthcare technology engineers and technicians perceived problems most severely, followed by users of equipment, managers and hospital directors, international organization officers, local and foreign suppliers, and finally policy-makers, planners and administrators at the Ministry of Health (MoH). The 5 most important challenges to be addressed are policy, strategic management and planning, and technology needs assessment and selection – categorized as major enabling inputs (MEI) in HTM by the TBHTPS framework – and installation and commissioning, training and skill development and procurement, which are import and use activities (IUA). The ability of each key actor to address these problems (the degree of political or administrative power they possess) was inversely proportional to their perception of the severity of the problems. Observational data gathered during site visits described a different set of challenges including maintenance and repair, distribution, installation and commissioning, use and training and personnel skill development. Conclusion: The lack of experiential and technical knowledge in policy development processes could underpin many of the continuing problems in Benin’s HTM system. Before solutions can be devised to these problems, it is necessary to investigate their root causes, and which problems are most amenable to policy development. PMID:28949474

Industry Actors, Think Tanks, and Alcohol Policy in the United Kingdom

PubMed Central

McCambridge, Jim

2014-01-01

Corporate actors seek to influence alcohol policies through various means, including attempts to shape the evidential content of policy debates. In this case study, we examined how SABMiller engaged the think tank Demos to produce reports on binge drinking, which were heavily promoted among policymakers at crucial stages in the development of the UK government’s 2012 alcohol strategy. One key report coincided with other SABMiller-funded publications, advocating measures to enhance parenting as an alternative to minimum unit pricing. In this instance, the perceived independence of an influential think tank was used to promote industry interests in tactics similar to those of transnational tobacco corporations. This approach is in keeping with other alcohol industry efforts to marginalize the peer-reviewed literature. PMID:24922137

Industry actors, think tanks, and alcohol policy in the United kingdom.

PubMed

Hawkins, Benjamin; McCambridge, Jim

2014-08-01

Corporate actors seek to influence alcohol policies through various means, including attempts to shape the evidential content of policy debates. In this case study, we examined how SABMiller engaged the think tank Demos to produce reports on binge drinking, which were heavily promoted among policymakers at crucial stages in the development of the UK government's 2012 alcohol strategy. One key report coincided with other SABMiller-funded publications, advocating measures to enhance parenting as an alternative to minimum unit pricing. In this instance, the perceived independence of an influential think tank was used to promote industry interests in tactics similar to those of transnational tobacco corporations. This approach is in keeping with other alcohol industry efforts to marginalize the peer-reviewed literature.

An Analysis of Virginia Transfer Policy and Articulation Agreements: A Comparative Study of Community College Transfer and Native Students--Enrollments and Outcomes in a Teacher Preparation Program

ERIC Educational Resources Information Center

Huffman, Michael Conway

2012-01-01

Transfer articulation is an important policy issue in Virginia. With increasing economic strains on federal and state budgets, pressure on key actors in higher education, and critical teacher shortages, an opportunity presented itself to investigate state transfer policy and articulation agreements designed to facilitate student transfer.…

Unpacking policy formulation and industry influence: the case of the draft control of marketing of alcoholic beverages bill in South Africa.

PubMed

Bertscher, Adam; London, Leslie; Orgill, Marsha

2018-06-21

Alcohol is a major contributor to the Non-Communicable Disease burden in South Africa. In 2000, 7.1% of all deaths and 7% of total disability-adjusted life years were ascribed to alcohol-related harm in the country. Regulations proposed to restrict alcohol advertising in South Africa present an evidence-based upstream intervention. Research on policy formulation in low- and middle-income countries is limited. This study aims to describe and explore the policy formulation process of the 2013 draft Control of Marketing of Alcoholic Beverages Bill in South Africa between March 2011 and May 2017. Recognising the centrality of affected actors in policy-making processes, the study focused on the alcohol industry as a central actor affected by the policy, to understand how they-together with other actors-may influence the policy formulation process. A qualitative case study approach was used, involving a stakeholder mapping, 10 in-depth interviews, and review of approximately 240 documents. A policy formulation conceptual framework was successfully applied as a lens to describe a complex policy formulation process. Key factors shaping policy formulation included: (1) competing and shared values-different stakeholders promote conflicting ideals for policymaking; (2) inter-department jostling-different government departments seek to protect their own functions, hindering policy development; (3) stakeholder consultation in democratic policymaking-policy formulation requires consultations even with those opposed to regulation and (4) battle for evidence-evidence is used strategically by all parties to shape perceptions and leverage positions. This research (1) contributes to building an integrated body of knowledge on policy formulation in low- and middle-income countries; (2) shows that achieving policy coherence across government departments poses a major challenge to achieving effective health policy formulation and (3) shows that networks of actors with commercial and financial interests use diverse strategies to influence policy formulation processes to avoid regulation.

Integrated community case management for childhood illnesses: explaining policy resistance in Kenya.

PubMed

Juma, Pamela A; Owuor, Karen; Bennett, Sara

2015-12-01

There has been a re-emphasis recently on community health workers to provide child health care services including integrated community case management for childhood illness (iCCM). This research analysed iCCM policy development in Kenya and in particular the types of decision-making criteria used by Kenyan policy-makers in considering whether to advance iCCM policy. Data were collected through document reviews (n = 41) and semi-structured interviews (n = 19) with key stakeholders in iCCM policy including government officials, development partners, bilateral donors, and civil society organizations. Initial analysis was guided by the policy triangle with further analysis of factors affecting policy decision-making drawing upon a simple framework developed by Grindle and Thomas (Policy makers, policy choices and policy outcomes: the political economy of reform in developing countries. 1989; Policy Sci 22: :213-48.). Policy development for iCCM has been slow in Kenya, compared with other Sub-Saharan African countries. At the time of the study, the Government had just completed the Community Health Training Manual which incorporated iCCM as a module, but this was the only formal expression of iCCM in Kenya. We found technical considerations, notably concerns about community health workers dispensing antibiotics to be a key factor slowing iCCM policy development, but this also overlapped with bureaucratic considerations, such as how the development of community health worker cadres may affect clinicians, as well as initial concerns about how an integrated approach might affect vertically oriented programs. International actors through agreements such as the Millennium Development Goals helped to get child survival onto the national policy agenda and such actors were active promoters of iCCM policy change. However international funders had not committed funding to scale-up iCCM policy, and this probably constrained their influence over iCCM policy debate. Kenyan actors' concerns about iCCM underline the importance of adapting global policies to local conditions, and also generating local evidence to inform decision-making. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Who is against prevention? A map of policy actors favoring smoking in Spain].

PubMed

Granero, Lluís; Villalbí, Joan Ramón; Gallego, Raquel

2004-01-01

For a comprehensive approach to policies on smoking, the map of actors related to tobacco and their political ties needs to be identified. The present article constitutes the first attempt at this task in Spain. Analysis of the press, industry publications, and interviews with key people. Active actors favoring smoking in Spain were identified and classified according to their characteristics, the sphere in which they act, and their preferred territorial arena. We identified tobacco companies (Altadis and Philip Morris dominate the market), tobacco trade organizations (tobacconists), front-line organizations created by the tobacco industry (The Smokers for Tolerance Club), organizations of tobacco growers, and processing companies. Distribution to retailers is dominated by Logista, owned by Altadis. Other sectors to take into account are vending companies and those manufacturing related products (cigarette paper, matches or lighters). The contacts of these actors with the public administration are reviewed, notable among which are the role of the Commissioner for the Tobacco Market, the Ministry of Agriculture, the Ministry of Finance and the Ministry of the Economy. Ties were also found with employers' organizations, some political parties, and unions, as well as with other sectors with social influence such as the media and advertising sectors. The map of actors favoring smoking in Spain is complex and goes beyond the confines of the tobacco industry. Understanding this web is crucial to promoting comprehensive prevention policies.

The Uncertainty of Policy Ambition: An Analysis of Key State Actor Perspectives on Seeking Equity through Facilities Funding

ERIC Educational Resources Information Center

Core, Brandon H.; Torres, Mario S., Jr.

2016-01-01

The purpose of the study was to broaden awareness of legislative intentions associated with a State's facilities funding policy (Texas' Instructional Facilities Allotment, IFA). Recognizing the politically contested nature of school funding, arguments in support and against investing in facilities appear equally replete. Be that as it may, some…

State legislative staff influence in health policy making.

PubMed

Weissert, C S; Weissert, W G

2000-12-01

State legislative staff may influence health policy by gathering intelligence, setting the agenda, and shaping the legislative proposals. But they may also be stymied in their roles by such institutional constraints as hiring practices and by turnover in committee leadership in the legislature. The intervening variable of trust between legislators and their support staff is also key to understanding influence and helps explain how staff-legislator relationships play an important role in designing state health policy. This study of legislative fiscal and health policy committee staff uses data from interviews with key actors in five states to model the factors important in explaining variation in the influence of committee staff on health policy.

The key role of supply chain actors in groundwater irrigation development in North Africa

NASA Astrophysics Data System (ADS)

Lejars, Caroline; Daoudi, Ali; Amichi, Hichem

2017-09-01

The role played by supply chain actors in the rapid development of groundwater-based irrigated agriculture is analyzed. Agricultural groundwater use has increased tremendously in the past 50 years, leading to the decline of water tables. Groundwater use has enabled intensification of existing farming systems and ensured economic growth. This "groundwater economy" has been growing rapidly due to the initiative of farmers and the involvement of a wide range of supply chain actors, including suppliers of equipment, inputs retailers, and distributors of irrigated agricultural products. In North Africa, the actors in irrigated production chains often operate at the margin of public policies and are usually described as "informal", "unstructured", and as participating in "groundwater anarchy". This paper underlines the crucial role of supply chain actors in the development of groundwater irrigation, a role largely ignored by public policies and rarely studied. The analysis is based on three case studies in Morocco, Tunisia and Algeria, and focuses on the horticultural sub-sector, in particular on onions and tomatoes, which are irrigated high value crops. The study demonstrates that although supply chain actors are catalyzers of the expansion of groundwater irrigation, they could also become actors in adaptation to the declining water tables. Through their informal activities, they help reduce market risks, facilitate credit and access to subsidies, and disseminate innovation. The interest associated with making these actors visible to agricultural institutions is discussed, along with methods of getting them involved in the management of the resource on which they depend.

Understanding how domestic health policy is integrated into foreign policy in South Africa: a case for accelerating access to antiretroviral medicines.

PubMed

Modisenyane, Simon Moeketsi; Hendricks, Stephen James Heinrich; Fineberg, Harvey

2017-01-01

South Africa, as an emerging middle-income country, is becoming increasingly influential in global health diplomacy (GHD). However, little empirical research has been conducted to inform arguments for the integration of domestic health into foreign policy by state and non-state actors. This study seeks to address this knowledge gap. It takes the form of an empirical case study which analyses how South Africa integrates domestic health into its foreign policy, using the lens of access to antiretroviral (ARV) medicines. To explore state and non-state actors' perceptions regarding how domestic health policy is integrated into foreign policy. The ultimate goal of this study was to achieve better insights into the health and foreign policy processes at the national level. Employing qualitative approaches, we examined changes in the South African and global AIDS policy environment. Purposive sampling was used to select key informants, a sample of state and non-state actors who participated in in-depth interviews. Secondary data were collected through a systematic literature review of documents retrieved from five electronic databases, including review of key policy documents. Qualitative data were analysed for content. This content was coded, and the codes were collated into tentative categories and sub-categories using Atlas.ti v.7 software. The findings of this work illustrate the interplay among social, political, economic and institutional conditions in determining the success of this integration process. Our study shows that a series of national and external developments, stakeholders, and advocacy efforts and collaboration created these integrative processes. South Africa's domestic HIV/AIDS constituencies, in partnership with the global advocacy movement, catalysed the mobilization of support for universal access to ARV treatment nationally and globally, and the promotion of access to healthcare as a human right. Transnational networks may influence government's decision making by providing information and moving issues up the agenda.

The emergence of the vertical birth in Ecuador: an analysis of agenda setting and policy windows for intercultural health

PubMed Central

Llamas, Ana; Mayhew, Susannah

2016-01-01

Maternal mortality continues to claim the lives of thousands of women in Latin America despite the availability of effective treatments to avert maternal death. In the past, efforts to acknowledge cultural diversity in birth practices had not been clearly integrated into policy. However, in Otavalo (Ecuador) a local hospital pioneered the implementation of the ‘Vertical Birth’—a practical manifestation of an intercultural health policy aimed at increasing indigenous women’s access to maternity care. Drawing on agenda-setting theory, this qualitative research explores how the vertical birth practice made it onto the local policy agenda and the processes that allowed actors to seize a window of opportunity allowing the vertical birth practice to emerge. Our results show that the processes that brought about the vertical birth practice took place over a prolonged period of time and resulted from the interplay between various factors. Firstly, a maternal health policy community involving indigenous actors played a key role in identifying maternal mortality as a policy problem, defining its causes and framing it as an indigenous rights issue. Secondly, previous initiatives to address maternal mortality provided a wealth of experience that gave these actors the knowledge and experience to formulate a feasible policy solution and consolidate support from powerful actors. Thirdly, the election of a new government that had incorporated the demands of the indigenous movement opened up a window of opportunity to push intercultural health policies such as the vertical birth. We conclude that the socioeconomic and political changes at both national and local level allowed the meaningful participation of indigenous actors that made a critical contribution to the emergence of the vertical birth practice. These findings can help us advance our knowledge of strategies to set the agenda for intercultural maternal health policy and inform future policy in similar settings. Our results also show that Kingdon’s model was useful in explaining how the VB practice emerged but also that it needs modifications when applied to low and middle income countries. PMID:26758539

Level of implementation of best practice policies for creating healthy food environments: assessment by state and non-state actors in Thailand.

PubMed

Phulkerd, Sirinya; Vandevijvere, Stefanie; Lawrence, Mark; Tangcharoensathien, Viroj; Sacks, Gary

2017-02-01

To determine and compare the level of implementation of policies for healthy food environments in Thailand with reference to international best practice by state and non-state actors. Data on the current level of implementation of food environment policies were assessed independently using the adapted Healthy Food Environment Policy Index (Food-EPI) by two groups of actors. Concrete actions were proposed for Thai Government. A joint meeting between both groups was subsequently held to reach consensus on priority actions. Thailand. Thirty state actors and twenty-seven non-state actors. Level of policy implementation varied across different domains and actor groups. State actors rated implementation levels higher than non-state actors. Both state and non-state actors rated level of implementation of monitoring of BMI highest. Level of implementation of policies promoting in-store availability of healthy foods and policies increasing tax on unhealthy foods were rated lowest by state and non-state actors, respectively. Both groups reached consensus on eleven priority actions for implementation, focusing on food provision in public-sector settings, food composition, food promotion, leadership, monitoring and intelligence, and food trade. Although the implementation gaps identified and priority actions proposed varied between state and non-state actors, both groups achieved consensus on a comprehensive food policy package to be implemented by the Thai Government to improve the healthiness of food environments. This consensus is a platform for continued policy dialogue towards cross-sectoral policy coherence and effective actions to address the growing burden of non-communicable diseases and obesity in Thailand.

Can policy analysis theories predict and inform policy change? Reflections on the battle for legal abortion in Indonesia

PubMed Central

Surjadjaja, Claudia; Mayhew, Susannah H

2011-01-01

The relevance and importance of research for understanding policy processes and influencing policies has been much debated, but studies on the effectiveness of policy theories for predicting and informing opportunities for policy change (i.e. prospective policy analysis) are rare. The case study presented in this paper is drawn from a policy analysis of a contemporary process of policy debate on legalization of abortion in Indonesia, which was in flux at the time of the research and provided a unique opportunity for prospective analysis. Applying a combination of policy analysis theories, this case study provides an analysis of processes, power and relationships between actors involved in the amendment of the Health Law in Indonesia. It uses a series of practical stakeholder mapping tools to identify power relations between key actors and what strategic approaches should be employed to manage these to enhance the possibility of policy change. The findings show how the moves to legalize abortion have been supported or constrained according to the balance of political and religious powers operating in a macro-political context defined increasingly by a polarized Islamic-authoritarian—Western-liberal agenda. The issue of reproductive health constituted a battlefield where these two ideologies met and the debate on the current health law amendment became a contest, which still continues, for the larger future of Indonesia. The findings confirm the utility of policy analysis theories and stakeholder mapping tools for predicting the likelihood of policy change and informing the strategic approaches for achieving such change. They also highlight opportunities and dilemmas in prospective policy analysis and raise questions about whether research on policy processes and actors can or should be used to inform, or even influence, policies in ‘real-time’. PMID:21183461

Can policy analysis theories predict and inform policy change? Reflections on the battle for legal abortion in Indonesia.

PubMed

Surjadjaja, Claudia; Mayhew, Susannah H

2011-09-01

The relevance and importance of research for understanding policy processes and influencing policies has been much debated, but studies on the effectiveness of policy theories for predicting and informing opportunities for policy change (i.e. prospective policy analysis) are rare. The case study presented in this paper is drawn from a policy analysis of a contemporary process of policy debate on legalization of abortion in Indonesia, which was in flux at the time of the research and provided a unique opportunity for prospective analysis. Applying a combination of policy analysis theories, this case study provides an analysis of processes, power and relationships between actors involved in the amendment of the Health Law in Indonesia. It uses a series of practical stakeholder mapping tools to identify power relations between key actors and what strategic approaches should be employed to manage these to enhance the possibility of policy change. The findings show how the moves to legalize abortion have been supported or constrained according to the balance of political and religious powers operating in a macro-political context defined increasingly by a polarized Islamic-authoritarian-Western-liberal agenda. The issue of reproductive health constituted a battlefield where these two ideologies met and the debate on the current health law amendment became a contest, which still continues, for the larger future of Indonesia. The findings confirm the utility of policy analysis theories and stakeholder mapping tools for predicting the likelihood of policy change and informing the strategic approaches for achieving such change. They also highlight opportunities and dilemmas in prospective policy analysis and raise questions about whether research on policy processes and actors can or should be used to inform, or even influence, policies in 'real-time'.

Exploring Context and the Factors Shaping Team-Based Primary Healthcare Policies in Three Canadian Provinces: A Comparative Analysis.

PubMed

Misfeldt, Renée; Suter, Esther; Mallinson, Sara; Boakye, Omenaa; Wong, Sabrina; Nasmith, Louise

2017-08-01

This paper discusses findings from a high-level scan of the contextual factors and actors that influenced policies on team-based primary healthcare in three Canadian provinces: British Columbia, Alberta and Saskatchewan. The team searched diverse sources (e.g., news reports, press releases, discussion papers) for contextual information relevant to primary healthcare teams. We also conducted qualitative interviews with key health system informants from the three provinces. Data from documents and interviews were analyzed qualitatively using thematic analysis. We then wrote narrative summaries highlighting pivotal policy and local system events and the influence of actors and context. Our overall findings highlight the value of reviewing the context, relationships and power dynamics, which come together and create "policy windows" at different points in time. We observed physician-centric policy processes with some recent moves to rebalance power and be inclusive of other actors and perspectives. The context review also highlighted the significant influence of changes in political leadership and prioritization in driving policies on team-based care. While this existed in different degrees in the three provinces, the push and pull of political and professional power dynamics shaped Canadian provincial policies governing team-based care. If we are to move team-based primary healthcare forward in Canada, the provinces need to review the external factors and the complex set of relationships and trade-offs that underscore the policy process. Copyright © 2017 Longwoods Publishing.

The evolution of HIV policy in Vietnam: from punitive control measures to a more rights-based approach

PubMed Central

Nguyen Ha, Pham; Pharris, Anastasia; Huong, Nguyen Thanh; Chuc, Nguyen Thi Kim; Brugha, Ruairi; Thorson, Anna

2010-01-01

Aim Policymaking in Vietnam has traditionally been the preserve of the political elite, not open to the scrutiny of those outside the Communist Party. This paper aims to analyse Vietnam's HIV policy development in order to describe and understand the policy content, policy-making processes, actors and obstacles to policy implementation. Methods Nine policy documents on HIV were analysed and 17 key informant interviews were conducted in Hanoi and Quang Ninh Province, based on a predesigned interview guide. Framework analysis, a type of qualitative content analysis, was applied for data analysis. Results Our main finding was that during the last two decades, developments in HIV policy in Vietnam were driven in a top-down way by the state organs, with support and resources coming from international agencies. Four major themes were identified: HIV policy content, the policy-making processes, the actors involved and human resources for policy implementation. Vietnam's HIV policy has evolved from one focused on punitive control measures to a more rights-based approach, encompassing harm reduction and payment of health insurance for medical costs of patients with HIV-related illness. Low salaries and staff reluctance to work with patients, many of whom are drug users and female sex workers, were described as the main barriers to low health staff motivation. Conclusion Health policy analysis approaches can be applied in a traditional one party state and can demonstrate how similar policy changes take place, as those found in pluralistic societies, but through more top-down and somewhat hidden processes. Enhanced participation of other actors, like civil society in the policy process, is likely to contribute to policy formulation and implementation that meets the diverse needs and concerns of its population. PMID:20824159

The evolution of HIV policy in Vietnam: from punitive control measures to a more rights-based approach.

PubMed

Nguyen Ha, Pham; Pharris, Anastasia; Huong, Nguyen Thanh; Chuc, Nguyen Thi Kim; Brugha, Ruairi; Thorson, Anna

2010-08-28

Policymaking in Vietnam has traditionally been the preserve of the political elite, not open to the scrutiny of those outside the Communist Party. This paper aims to analyse Vietnam's HIV policy development in order to describe and understand the policy content, policy-making processes, actors and obstacles to policy implementation. Nine policy documents on HIV were analysed and 17 key informant interviews were conducted in Hanoi and Quang Ninh Province, based on a predesigned interview guide. Framework analysis, a type of qualitative content analysis, was applied for data analysis. Our main finding was that during the last two decades, developments in HIV policy in Vietnam were driven in a top-down way by the state organs, with support and resources coming from international agencies. Four major themes were identified: HIV policy content, the policy-making processes, the actors involved and human resources for policy implementation. Vietnam's HIV policy has evolved from one focused on punitive control measures to a more rights-based approach, encompassing harm reduction and payment of health insurance for medical costs of patients with HIV-related illness. Low salaries and staff reluctance to work with patients, many of whom are drug users and female sex workers, were described as the main barriers to low health staff motivation. Health policy analysis approaches can be applied in a traditional one party state and can demonstrate how similar policy changes take place, as those found in pluralistic societies, but through more top-down and somewhat hidden processes. Enhanced participation of other actors, like civil society in the policy process, is likely to contribute to policy formulation and implementation that meets the diverse needs and concerns of its population.

Bologna 2010. The Moment of Truth?

ERIC Educational Resources Information Center

Veiga, Amelia

2012-01-01

Government policies are central factors shaping the environment of higher education institutions. European governments have included in their higher education political strategies the principal goal of implementing the European Higher Education Area (EHEA). The perceptions that key actors of higher education institutions (HEIs) have about…

Intentions and knowledge shaping local safety policy: A comparison of two Swedish cities.

PubMed

Hanberger, Anders; Lundström, Ulf; Mårald, Gunilla

2015-12-01

This article explores how intentions and knowledge shape two Swedish cities' local safety policy (LSP). The applied framework is derived from the integration of governance and implementation research and the theory of knowledge and its use. The study shows that LSPs are shaped by a mix of intentions and different kinds of knowledge, and intentions and knowledge interplay and intertwine in many ways. Key-persons construct LSPs when they work out solutions to urgent safety problems and take departure in the local context, its pre-conditions, and their experience-based and professional knowledge. The state governs LSP softly through management by objectives in the background, but more often key-actor intentions and commitments, local safety problems, and events initiated and influenced LSPs. The article contributes to a better understanding of conditions for LSPs in multi-level governance. The article can be used to improve governance, identify implementation problems and knowledge needs that will improve LSPs and the overall safety situation in the community. The study has implications for how LSPs should be evaluated; many different evaluation criteria can be appropriate, such as relevance, legitimacy, achievement of key actors' objectives, sustainability of policy solutions, and creation of a local safety culture. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan.

PubMed

Khan, Mishal S; Meghani, Ankita; Liverani, Marco; Roychowdhury, Imara; Parkhurst, Justin

2018-03-01

Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, Cambodia and Pakistan. It identifies mechanisms through which asymmetries in influence between donors and domestic policy actors emerge. We conducted 24 key informant interviews-14 in Pakistan and 10 in Cambodia-with high-level decision-makers who inform or authorize health priority setting, allocate resources and/or are responsible for policy implementation, identifying three routes of influence: financial resources, technical expertise and indirect financial and political incentives. We used both inductive and deductive approaches to analyse the data. Our findings indicate that different routes of influence emerged depending on the stage of the policy process. Control of financial resources was the most commonly identified route by which donors influenced priority setting and policy implementation. Greater (perceived) technical expertise played an important role in donor influence at the policy formulation stage. Donors' power in influencing decisions, particularly during the final (monitoring and evaluation) stage of the policy process, was mediated by their ability to control indirect financial and political incentives as well as direct control of financial resources. This study thus helps unpack the nuances of donor influence over health policymaking in these settings, and can potentially indicate areas that require attention to increase the ownership of domestic actors of their countries' health policy processes. © The Author(s) 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan

PubMed Central

Khan, Mishal S; Liverani, Marco; Roychowdhury, Imara; Parkhurst, Justin

2018-01-01

Abstract Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, Cambodia and Pakistan. It identifies mechanisms through which asymmetries in influence between donors and domestic policy actors emerge. We conducted 24 key informant interviews—14 in Pakistan and 10 in Cambodia—with high-level decision-makers who inform or authorize health priority setting, allocate resources and/or are responsible for policy implementation, identifying three routes of influence: financial resources, technical expertise and indirect financial and political incentives. We used both inductive and deductive approaches to analyse the data. Our findings indicate that different routes of influence emerged depending on the stage of the policy process. Control of financial resources was the most commonly identified route by which donors influenced priority setting and policy implementation. Greater (perceived) technical expertise played an important role in donor influence at the policy formulation stage. Donors’ power in influencing decisions, particularly during the final (monitoring and evaluation) stage of the policy process, was mediated by their ability to control indirect financial and political incentives as well as direct control of financial resources. This study thus helps unpack the nuances of donor influence over health policymaking in these settings, and can potentially indicate areas that require attention to increase the ownership of domestic actors of their countries’ health policy processes. PMID:29237026

An Actor-Network Theory Analysis of Policy Innovation for Smoke-Free Places: Understanding Change in Complex Systems

PubMed Central

Borland, Ron; Coghill, Ken

2010-01-01

Complex, transnational issues like the tobacco epidemic are major challenges that defy analysis and management by conventional methods, as are other public health issues, such as those associated with global food distribution and climate change. We examined the evolution of indoor smoke-free regulations, a tobacco control policy innovation, and identified the key attributes of those jurisdictions that successfully pursued this innovation and those that to date have not. In doing so, we employed the actor-network theory, a comprehensive framework for the analysis of fundamental system change. Through our analysis, we identified approaches to help overcome some systemic barriers to the solution of the tobacco problem and comment on other complex transnational problems. PMID:20466949

An actor-network theory analysis of policy innovation for smoke-free places: understanding change in complex systems.

PubMed

Young, David; Borland, Ron; Coghill, Ken

2010-07-01

Complex, transnational issues like the tobacco epidemic are major challenges that defy analysis and management by conventional methods, as are other public health issues, such as those associated with global food distribution and climate change. We examined the evolution of indoor smoke-free regulations, a tobacco control policy innovation, and identified the key attributes of those jurisdictions that successfully pursued this innovation and those that to date have not. In doing so, we employed the actor-network theory, a comprehensive framework for the analysis of fundamental system change. Through our analysis, we identified approaches to help overcome some systemic barriers to the solution of the tobacco problem and comment on other complex transnational problems.

Developing the national community health assistant strategy in Zambia: a policy analysis

PubMed Central

2013-01-01

Background In 2010, the Ministry of Health in Zambia developed the National Community Health Assistant strategy, aiming to integrate community health workers (CHWs) into national health plans by creating a new group of workers, called community health assistants (CHAs). The aim of the paper is to analyse the CHA policy development process and the factors that influenced its evolution and content. A policy analysis approach was used to analyse the policy reform process. Methodology Data were gathered through review of documents, participant observation and key informant interviews with CHA strategic team members in Lusaka district, and senior officials at the district level in Kapiri Mposhi district where some CHAs have been deployed. Results The strategy was developed in order to address the human resources for health shortage and the challenges facing the community-based health workforce in Zambia. However, some actors within the strategic team were more influential than others in informing the policy agenda, determining the process, and shaping the content. These actors negotiated with professional/statutory bodies and health unions on the need to develop the new cadre which resulted in compromises that enabled the policy process to move forward. International agencies also indirectly influenced the course as well as the content of the strategy. Some actors classified the process as both insufficiently consultative and rushed. Due to limited consultation, it was suggested that the policy content did not adequately address key policy content issues such as management of staff attrition, general professional development, and progression matters. Analysis of the process also showed that the strategy might create a new group of workers whose mandate is unclear to the existing group of health workers. Conclusions This paper highlights the complex nature of policy-making processes for integrating CHWs into the health system. It reiterates the need for recognising the fact that actors’ power or position in the political hierarchy may, more than their knowledge and understanding of the issue, play a disproportionate role in shaping the process as well as content of health policy reform. PMID:23870454

Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process.

PubMed

Etiaba, Enyi; Uguru, Nkoli; Ebenso, Bassey; Russo, Giuliano; Ezumah, Nkoli; Uzochukwu, Benjamin; Onwujekwe, Obinna

2015-05-06

In Nigeria, there is a high burden of oral health diseases, poor coordination of health services and human resources for delivery of oral health services. Previous attempts to develop an Oral Health Policy (OHP) to decrease the oral disease burden failed. However, a policy was eventually developed in November 2012. This paper explores the role of contextual factors, actors and the policy process in the development of the OHP and possible reasons why the current approved OHP succeeded. The study was undertaken across Nigeria; information gathered through document reviews and in-depth interviews with five groups of purposively selected respondents. Analysis of the policy development process was guided by the policy triangle framework, examining context, policy process and actors involved in the policy development. The foremost enabling factor was the yearning among policy actors for a policy, having had four failed attempts. Other factors were the presence of a democratically elected government, a framework for health sector reform instituted by the Federal Ministry of Health (FMOH). The approved OHP went through all stages required for policy development unlike the previous attempts. Three groups of actors played crucial roles in the process, namely academics/researchers, development partners and policy makers. They either had decision making powers or influenced policy through funding or technical ability to generate credible research evidence, all sharing a common interest in developing the OHP. Although evidence was used to inform the development of the policy, the complex interactions between the context and actors facilitated its approval. The OHP development succeeded through a complex inter-relationship of context, process and actors, clearly illustrating that none of these factors could have, in isolation, catalyzed the policy development. Availability of evidence is necessary but not sufficient for developing policies in this area. Wider socio-political contexts in which actors develop policy can facilitate and/or constrain actors' roles and interests as well as policy process. These must be taken into consideration at stages of policy development in order to produce policies that will strengthen the health system, especially in low and middle-income countries, where policy processes and influences can be often less than transparent.

Alcohol policy in a Russian region: a stakeholder analysis.

PubMed

Gil, Artyom; Polikina, Olga; Koroleva, Natalia; Leon, David A; McKee, Martin

2010-10-01

Male life expectancy in the Russian Federation, at 60 years, is the lowest in Europe. Several factors contribute to this situation, but hazardous consumption of alcohol is especially a key factor. We undertook a stakeholder analysis in a typical Russian region located on the western side of the Urals. Organizations with a stake in alcohol policy in the region were identified by snowball sampling and information on their position and influence on alcohol policy was elicited from interviews with key informants. Their interests and influence were mapped and their relationships plotted. Twenty-nine stakeholder organizations were identified and 43 interviews were conducted with their staff. The most influential actors were the Federal and regional governments, large beer producers and manufacturers of strong alcohols. However, the majority of organizations that might be expected to play a role in developing or implementing alcohol control policies were almost entirely disengaged and fragmented. No evidence was found of an existing or emerging multi-sectoral coalition for developing alcohol policy to improve health. Organizations that might be expected to contribute to tackling hazardous drinking had little understanding of what might be effective. While stakeholders with an interest in maintaining or increasing alcohol consumption are engaged and influential, those who might seek to reduce it either take a very narrow perspective or are disengaged from the policy agenda. There is a need to mobilize actors who might contribute to effective policies while challenging those who can block them.

Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases.

PubMed

Peters, D T J M; Raab, J; Grêaux, K M; Stronks, K; Harting, J

2017-12-01

Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as addressing environmental determinants of health. This study examines these relations in different phases of the policy process. A multiple-case study was performed on four public health-related policy networks. Using a snowball method among network actors, overall and sub-networks per policy phase were identified and the policy sector of each actor was assigned. To operationalise the outcome variable, interventions were classified by the proportion of environmental determinants they addressed. In the overall networks, no relation was found between structural network characteristics and network performance. In most effective cases, the policy development sub-networks were characterised by integration with less interrelations between actors (low cohesion), more equally distributed distances between the actors (low closeness centralisation), and horizontal integration in inter-sectoral cliques. The most effective case had non-public health central actors with less connections in all sub-networks. The results suggest that, to address environmental determinants of health, sub-networks should be inter-sectorally composed in the policy development rather than in the intervention development and implementation phases, and that policy development actors should have the opportunity to connect with other actors, without strong direction from a central actor. Copyright © 2017 Elsevier B.V. All rights reserved.

Democracy in the country but not in the home? Religion, politics and women's rights in Chile.

PubMed

Guzmán, Virginia; Seibert, Ute; Staab, Silke

2010-01-01

This article explores the influence of religious actors on the elaboration of two public policies that are key to the advancement of women's rights and have long formed part of the women's movement's agenda in Chile: the introduction of sexual education in secondary schools in the 1990s and the distribution of emergency contraception in the 2000s. Our analysis of how different actors-from a variety of ideological and power positions-have influenced the two policy debates suggests that their discourses and strategies are highly contingent on the political environment. While conservative religious forces retain an enormous capacity to hinder policy making and implementation in the arena of family and sexuality, the government's determination to confront such interference seems to have grown in a context of fewer authoritarian enclaves, a more pluralist society and a strong sexual and reproductive rights movement. The diversification of religious positions on issues of family and sexuality has also affected the room for manoeuvre in the policy arena.

"Five hundred years of medicine gone to waste"? Negotiating the implementation of an intercultural health policy in the Ecuadorian Andes.

PubMed

Llamas, Ana; Mayhew, Susannah

2018-06-04

In Ecuador, indigenous women have poorer maternal health outcomes and access to maternity services. This is partly due to cultural barriers. A hospital in Ecuador implemented the Vertical Birth (VB) policy to address such inequities by adapting services to the local culture. This included conducting upright deliveries, introducing Traditional Birth Attendants (TBAs) and making physical adaptations to hospital facilities. Using qualitative methods, we studied the VB policy implementation in an Ecuadorian hospital to analyse the factors that affect effective implementation of intercultural health policies at the local level. We collected data through observation, in-depth interviews, a focus group discussion, and documentation review. We conducted 46 interviews with healthcare workers, managers, TBAs, key informants and policy-makers involved in maternal health. Data analysis was guided by grounded theory and drew heavily on concepts of "street-level bureaucracy" to interpret policy implementation. The VB policy was highly controversial; actors' values (including concerns over patient safety) motivated their support or opposition to the Vertical Birth policy. For those who supported the policy, managers, policy-makers, indigenous actors and a minority of healthcare workers supported the policy, it was critical to address ethnic discrimination to improve indigenous women's access to the health service. Most healthcare workers initially resisted the policy because they believed vertical births led to poorer clinical outcomes and because they resented working alongside TBAs. Healthcare workers developed coping strategies and effectively modified the policy. Managers accepted these as a compromise to enable implementation. Although contentious, intercultural health policies such as the VB policy have the potential to improve maternity services and access for indigenous women. Evidence-base medicine should be used as a lever to facilitate the dialogue between healthcare workers and TBAs and to promote best practice and patient safety. Actors' values influenced policy implementation; policy implementation resulted from an ongoing negotiation between healthcare workers and managers.

Teacher Education Reform in Palestine: Policy Challenges Amid Donor Expectations

ERIC Educational Resources Information Center

Shinn, Chris

2012-01-01

This essay explores the role of UNESCO, the World Bank, and the US Agency for International Development as key international actors shaping teacher development in Palestine. The argument presented is that international influence, particularly through donor-funded projects, combined with limited capacity within the Ministry of Education and local…

Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda.

PubMed

Nabyonga-Orem, Juliet; Mijumbi, Rhona

2015-03-08

Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors' views regarding what evidence they deemed appropriate to guide health policy development. Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. © 2015 by Kerman University of Medical Sciences.

Teachers as Language-Policy Actors: Contending with the Erasure of Lesser-Used Languages in Schools

ERIC Educational Resources Information Center

Brown, Kara

2010-01-01

On the basis of an ethnographic study of the Voro-language revitalization in Estonia, this article explores the way teachers function as policy actors in the broader context of the school. As policy actors, the language teachers' appropriation of regional-language policy helps simultaneously to reproduce and challenge existing ideologies in the…

Banning shisha smoking in public places in Iran: an advocacy coalition framework perspective on policy process and change.

PubMed

Khayatzadeh-Mahani, Akram; Breton, Eric; Ruckert, Arne; Labonté, Ronald

2017-07-01

Shisha smoking is a widespread custom in Iran with a rapidly growing prevalence especially among the youth. In this article, we analyze the policy process of enforcing a federal/state ban on shisha smoking in all public places in Kerman Province, Iran. Guided by the Advocacy Coalition Framework (ACF), we investigate how a shisha smoking ban reached the political agenda in 2011, how it was framed by different policy actors, and why no significant breakthrough took place despite its inclusion on the agenda. We conducted a qualitative study using a case study approach. Two main sources of data were employed: face-to-face in-depth interviews and document analysis of key policy texts. We interviewed 24 policy actors from diverse sectors. A qualitative thematic framework, incorporating both inductive and deductive analyses, was employed to analyze our data. We found that the health sector was the main actor pushing the issue of shisha smoking onto the political agenda by framing it as a public health risk. The health sector and its allies advocated enforcement of a federal law to ban shisha smoking in all public places including teahouses and traditional restaurants whereas another group of actors opposed the ban. The pro-ban group was unable to neutralize the strategies of the anti-ban group and to steer the debate towards the health harms of shisha smoking. Our analysis uncovers three main reasons behind the policy stasis: lack of policy learning due to lack of agreement over evidence and related analytical conflicts between the two groups linked to differences in core and policy beliefs; the inability of the pro-ban group to exploit opportunities in the external policy subsystem through generating stronger public support for enforcement of the shisha smoking ban; and the nature of the institutional setting, in particular the autocratic governance of CHFS which contributed to a lack of policy learning within the policy subsystem. Our research demonstrated the utility of ACF as a theoretical framework for analyzing the policy process and policy change to promote tobacco control. It shows the importance of accounting for policy actors' belief systems and issue-framing in understanding how some issues get more prominence in the policy-making process than others. Our findings further indicate a need for significant resources employed by the state through public awareness campaigns to change public perceptions of shisha smoking in Iran which is a deeply anchored cultural practice. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2017; all rights reserved.

Historical account of the national health insurance formulation in Kenya: experiences from the past decade.

PubMed

Abuya, Timothy; Maina, Thomas; Chuma, Jane

2015-02-12

Many Low-and-Middle-Income countries are considering reviewing their health financing systems to meet the principles of Universal Health Coverage (UHC). One financing mechanism, which has dominated UHC reforms, is the development of health insurance schemes. We trace the historical development of the National Health Insurance (NHI) policy, illuminate stakeholders' perceptions on the design to inform future development of health financing policies in Kenya. We conducted a retrospective policy analysis of the development of a NHI policy in Kenya using data from document reviews and seven in depth interviews with key stakeholders involved in the NHI design. Analysis was conducted using a thematic framework. The design of a NHI scheme was marked by complex interaction of the actor's understanding of the design, proposed implementation strategies and the covert opposition of the reform due to several reasons. First, actor's perception of the cost of the NHI design and its implication to the economy generated opposition. This was due to inadequate communication strategies to articulate the policy, leading to a vacuum of factual information flow to various players. Secondly, perceived fear of implications of the changes among private sector players threatened support and success gained. Thirdly, underlying mistrust associated with perceived lack of government's commitment towards transparency and good governance affected active engagement of all key players dampening the spirit of collective bargain breeding opposition. Finally, some international actors perceived a clash of their role and that of international programs based on vertical approaches that were inherent in the health system. The thrust towards UHC using NHI schemes should not only focus on the design of a viable NHI package but should also involve stakeholder engagements, devise ways of improving the health care system, enhance transparency and develop adequate governance structures to institutions mandated to provide leadership in the reform process to overcome covert opposition.

Teaching, Learning, and Leading: Preparing Teachers as Educational Policy Actors

ERIC Educational Resources Information Center

Heineke, Amy J.; Ryan, Ann Marie; Tocci, Charles

2015-01-01

Within the current federal, state, and local contexts of educational reform, teachers must be recognized as central actors in policy work, but rarely do we explicitly consider preparing teachers to become policy actors. Understanding these implications for teacher education, we investigate teacher candidates' learning of the complexity and…

[The Hospital, patients, health and territories Act and the recentralisation of the social and long term care sector].

PubMed

Jourdain, Alain; Muñoz, Jorge; Hudebine, Hervé

2017-07-10

Hypothesis: The 2009 Hospital, Patients, Health and Territories Act crystallises a central government attempt to regain control over the social and long term care sector, which involves the utilisation of policy instruments borrowed from the hospital sector: capped budgets, agreements on targets and resources, competitive tendering or quasi-market mechanisms involving hospitals and services, etc. This paper is therefore based on the hypothesis of a recentralisation and healthicization of the social and long term care sector, with a key role for the regional health authorities. Method and data: 27 semi-structured interviews were conducted with actors operating within and outside the regional health agencies and thereafter analysed using Alceste. The aim was to describe and to analyse the positioning of the RHAs in relation to key actors of the social and long-term care sector in 2 regions in 2011. Results: Key issues for public organisations include the style of planning and knowhow transfer, while the professionals were chiefly concerned with the intensity of the ambulatory turn and needs analysis methodology. The compromises forged were related to types of democratic legitimacy, namely representative or participatory democracy. Conclusion: There is little evidence to support the initial hypothesis, namely the existence of a link between the creation of RHAs and a recentralisation of health policy between 2009 and 2013. One may rather suggest that a reconfiguration of the activities and resources of the actors operating at the centre (RHAs and conseils départementaux) and at the periphery (territorial units of the RHAs and third sector umbrella organisations) has occurred.

Knowledge and power in policy-making for child survival in Niger.

PubMed

Dalglish, Sarah L; Rodríguez, Daniela C; Harouna, Abdoutan; Surkan, Pamela J

2017-03-01

Calls to enhance the use of scientific evidence in international health and development policy have increased in recent years; however, analytic frameworks for understanding evidence use focus narrowly on scientific research and were created using data and observations nearly exclusively from Western countries. We examine processes of health policy development in a case study of Niger, a low-income West African country that adopted integrated community case management of childhood illness (iCCM) beginning in 2007, resulting in measurable declines in child mortality. Data collection included in-depth interviews with policy actors in Niger (N = 32), document review (N = 103) and direct observation of policy forums (N = 3). Data analysis used process tracing methodology and applied an Aristotelian definition of "knowledge" as 1) episteme (facts), 2) techne (skills) and 3) phronesis (practical wisdom), while also using a critical perspective to understand issues of power. We found sharp differentials in policy-makers' possession and use of codified forms of knowledge (episteme), with Nigerien policy officers' access highly mediated by actors at international agencies. Government policy-makers possessed skills and capacities (techne) to negotiate with donors and deliberate and weigh conflicting considerations; however they lacked capacity and resources to formally evaluate and document programs and thus reliably draw lessons from them. Practical wisdom (phronesis) emerged as key to the iCCM policy enterprise, particularly among Nigerien government actors, who used logical and ethical arguments to make decisions later found to be critical to iCCM's success. While codified knowledge confers power on members of policy discussions who can access it, this represents only one form of knowledge used in the policy process and perhaps not the most important. Future research on evidence-based policy should use broader definitions of evidence or knowledge, examine on how power conditions the use of knowledge, and examine challenges specific to low-resource policy environments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Political Influence Networks and Kentucky School Finance Reform. Draft.

ERIC Educational Resources Information Center

Kuo, Victor

In 1989, national attention was given to the unusual amount of cooperation and social connections among key policy actors in a major school-finance lawsuit in Kentucky. The case resulted in a judicial ruling declaring the entire state's school system unconstitutional. Accounts of this ruling attributed the unprecedented decision partly to…

Multi-actor involvement for integrating ecosystem services in strategic environmental assessment of spatial plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rozas-Vásquez, Daniel, E-mail: danielrozas@gmail.com; Laboratorio de Planificación Territorial, Universidad Católica de Temuco, Rudecindo ortega, 02950 Temuco; Fürst, Christine

Integrating an ecosystem services (ES) approach into Strategic Environmental Assessment (SEA) of spatial plans potentially enhances the consideration of the value of nature in decision making and policy processes. However, there is increasing concern about the institutional context and a lack of a common understanding of SEA and ecosystem services for adopting them as an integrated framework. This paper addresses this concern by analysing the current understanding and network relations in a multi-actor arrangement as a first step towards a successful integration of ES in SEA and spatial planning. Our analysis focuses on a case study in Chile, where wemore » administered a questionnaire survey to some of the main actors involved in the spatial planning process. The questionnaire focused on issues such as network relations among actors and on conceptual understanding, perceptions and challenges for integrating ES in SEA and spatial planning, knowledge on methodological approaches, and the connections and gaps in the science-policy interface. Our findings suggest that a common understanding of SEA and especially of ES in a context of multiple actors is still at an initial stage in Chile. Additionally, the lack of institutional guidelines and methodological support is considered the main challenge for integration. We conclude that preconditions exist in Chile for integrating ES in SEA for spatial planning, but they strongly depend on appropriate governance schemes that promote a close science-policy interaction, as well as collaborative work and learning. - Highlights: • Linking ecosystem services in SEA is an effective framework for sustainability. • Multi-actor understanding and networks in ecosystem services and SEA were analyzed. • Understanding of SEA and especially of ES is still in an initial stage in Chile. • A lack of institutional guidelines is one of the key challenges for this link.« less

An intersectionality-based policy analysis framework: critical reflections on a methodology for advancing equity.

PubMed

Hankivsky, Olena; Grace, Daniel; Hunting, Gemma; Giesbrecht, Melissa; Fridkin, Alycia; Rudrum, Sarah; Ferlatte, Olivier; Clark, Natalie

2014-12-10

In the field of health, numerous frameworks have emerged that advance understandings of the differential impacts of health policies to produce inclusive and socially just health outcomes. In this paper, we present the development of an important contribution to these efforts - an Intersectionality-Based Policy Analysis (IBPA) Framework. Developed over the course of two years in consultation with key stakeholders and drawing on best and promising practices of other equity-informed approaches, this participatory and iterative IBPA Framework provides guidance and direction for researchers, civil society, public health professionals and policy actors seeking to address the challenges of health inequities across diverse populations. Importantly, we present the application of the IBPA Framework in seven priority health-related policy case studies. The analysis of each case study is focused on explaining how IBPA: 1) provides an innovative structure for critical policy analysis; 2) captures the different dimensions of policy contexts including history, politics, everyday lived experiences, diverse knowledges and intersecting social locations; and 3) generates transformative insights, knowledge, policy solutions and actions that cannot be gleaned from other equity-focused policy frameworks. The aim of this paper is to inspire a range of policy actors to recognize the potential of IBPA to foreground the complex contexts of health and social problems, and ultimately to transform how policy analysis is undertaken.

Agenda setting and framing of gender-based violence in Nepal: how it became a health issue

PubMed Central

Colombini, Manuela; Mayhew, Susannah H; Hawkins, Ben; Bista, Meera; Joshi, Sunil Kumar; Schei, Berit; Watts, Charlotte

2016-01-01

Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women’s groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country’s new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model. PMID:26412857

Agenda setting and framing of gender-based violence in Nepal: how it became a health issue.

PubMed

Colombini, Manuela; Mayhew, Susannah H; Hawkins, Ben; Bista, Meera; Joshi, Sunil Kumar; Schei, Berit; Watts, Charlotte

2016-05-01

Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women's groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country's new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

How did policy actors use mass media to influence the Scottish alcohol minimum unit pricing debate? Comparative analysis of newspapers, evidence submissions and interviews

PubMed Central

Hilton, Shona

2015-01-01

Aims: To explore how policy actors attempted to deliberately frame public debate around alcohol minimum unit pricing (MUP) in the UK by comparing and contrasting their constructions of the policy in public (newspapers), semi-public (evidence submissions) and private (interviews). Methods: Content analysis was conducted on articles published in ten national newspapers between 1 January 2005 and 30 June 2012. Newsprint data were contrasted with alcohol policy documents, evidence submissions to the Scottish Parliament's Health and Sport Committee and 36 confidential interviews with policy stakeholders (academics, advocates, industry representatives, politicians and civil servants). Findings: A range of policy actors exerted influence both directly (through Parliamentary institutions and political representatives) and indirectly through the mass media. Policy actors were acutely aware of mass media's importance in shaping public opinion and used it tactically to influence policy. They often framed messages in subtly different ways, depending on target audiences. In general, newspapers presented the policy debate in a “balanced” way, but this arguably over-represented hostile perspective and suggested greater disagreement around the evidence base than is the case. Conclusions: The roles of policy actors vary between public and policy spheres, and how messages are communicated in policy debates depends on perceived strategic advantage. PMID:26045639

Harm reduction as a complex adaptive system: A dynamic framework for analyzing Tanzanian policies concerning heroin use.

PubMed

Ratliff, Eric A; Kaduri, Pamela; Masao, Frank; Mbwambo, Jessie K K; McCurdy, Sheryl A

2016-04-01

Contrary to popular belief, policies on drug use are not always based on scientific evidence or composed in a rational manner. Rather, decisions concerning drug policies reflect the negotiation of actors' ambitions, values, and facts as they organize in different ways around the perceived problems associated with illicit drug use. Drug policy is thus best represented as a complex adaptive system (CAS) that is dynamic, self-organizing, and coevolving. In this analysis, we use a CAS framework to examine how harm reduction emerged around heroin trafficking and use in Tanzania over the past thirty years (1985-present). This account is an organizational ethnography based on of the observant participation of the authors as actors within this system. We review the dynamic history and self-organizing nature of harm reduction, noting how interactions among system actors and components have coevolved with patterns of heroin us, policing, and treatment activities over time. Using a CAS framework, we describe harm reduction as a complex process where ambitions, values, facts, and technologies interact in the Tanzanian sociopolitical environment. We review the dynamic history and self-organizing nature of heroin policies, noting how the interactions within and between competing prohibitionist and harm reduction policies have changed with patterns of heroin use, policing, and treatment activities over time. Actors learn from their experiences to organize with other actors, align their values and facts, and implement new policies. Using a CAS approach provides researchers and policy actors a better understanding of patterns and intricacies in drug policy. This knowledge of how the system works can help improve the policy process through adaptive action to introduce new actors, different ideas, and avenues for communication into the system. Copyright © 2015 Elsevier B.V. All rights reserved.

HPV vaccine introduction at the local level in a developing country: attitudes and criteria among key actors.

PubMed

Piñeros, Marion; Wiesner, Carolina; Cortés, Claudia; Trujillo, Lina María

2010-05-01

In most developing countries, HPV vaccines have been licensed but there are no national policy recommendations, nor is it clear how decisions on the introduction of this new vaccine are made. Decentralization processes in many Latin American countries favor decision-making at the local level. Through a qualitative study we explored knowledge regarding the HPV vaccine and the criteria that influence decision-making among local health actors in four regions of Colombia. We conducted a total of 14 in-depths interviews with different actors; for the analysis we performed content analysis. Results indicate that decision-making on the HPV vaccine at the local level has mainly been driven by pressure from local political actors, in a setting where there is low technical knowledge of the vaccine. This increases the risk of initiatives that may foster inequity. Local decisions and initiatives need to be strengthened technically and supported by national-level decisions, guidelines and follow-up.

Policy Actors: Doing Policy Work in Schools

ERIC Educational Resources Information Center

Ball, Stephen J.; Maguire, Meg; Braun, Annette; Hoskins, Kate

2011-01-01

This paper considers the "policy work" of teacher actors in schools. It focuses on the "problem of meaning" and offers a typology of roles and positions through which teachers engage with policy and with which policies get "enacted". It argues that "policy work" is made up of a set of complex and…

From Capitol Hill to Dupont Circle and Beyond: The Influence of Policy Actors in the Federal Higher Education Rulemaking Process

ERIC Educational Resources Information Center

Natow, Rebecca S.

2015-01-01

The federal higher education rulemaking process develops policies that can profoundly affect college students, higher education institutions, and other actors in the higher education policy community. But little has been researched about the influence that different types of actors have on higher education rulemaking. By analyzing interviews with…

Altering state policy: interest group effectiveness among state-level advocacy groups.

PubMed

Hoefer, Richard

2005-07-01

Because social policy making continues to devolve to the state level, social workers should understand how advocacy and policy making occur at that level. Interest groups active in the human services arena were surveyed and data were used to test a model of interest group effectiveness in four states. The independent variables were amount of resources invested, strategy used, relationships with key actors, use of coalitions, and policy positions taken. Results indicate that the model explains low to middling amounts of the variation in group effectiveness. Results also show that the model fits different states to different degrees, indicating that social workers need to approach advocacy in different ways to achieve maximum effectiveness in altering state policy. Implications for altering state policy are provided.

A qualitative exploration of the human resource policy implications of voluntary counselling and testing scale-up in Kenya: applying a model for policy analysis

PubMed Central

2011-01-01

Background Kenya experienced rapid scale up of HIV testing and counselling services in government health services from 2001. We set out to examine the human resource policy implications of scaling up HIV testing and counselling in Kenya and to analyse the resultant policy against a recognised theoretical framework of health policy reform (policy analysis triangle). Methods Qualitative methods were used to gain in-depth insights from policy makers who shaped scale up. This included 22 in-depth interviews with Voluntary Counselling and Testing (VCT) task force members, critical analysis of 53 sets of minutes and diary notes. We explore points of consensus and conflict amongst policymakers in Kenya and analyse this content to assess who favoured and resisted new policies, how scale up was achieved and the importance of the local context in which scale up occurred. Results The scale up of VCT in Kenya had a number of human resource policy implications resulting from the introduction of lay counsellors and their authorisation to conduct rapid HIV testing using newly introduced rapid testing technologies. Our findings indicate that three key groups of actors were critical: laboratory professionals, counselling associations and the Ministry of Health. Strategic alliances between donors, NGOs and these three key groups underpinned the process. The process of reaching consensus required compromise and time commitment but was critical to a unified nationwide approach. Policies around quality assurance were integral in ensuring standardisation of content and approach. Conclusion The introduction and scale up of new health service initiatives such as HIV voluntary counselling and testing necessitates changes to existing health systems and modification of entrenched interests around professional counselling and laboratory testing. Our methodological approach enabled exploration of complexities of scale up of HIV testing and counselling in Kenya. We argue that a better understanding of the diverse actors, the context and the process, is required to mitigate risks and maximise impact. PMID:22008721

Devolution and human resources in primary healthcare in rural Mali

PubMed Central

2011-01-01

Devolution, as other types of decentralization (e.g. deconcentration, delegation, privatization), profoundly changes governance relations in the health system. Devolution is meant to affect performance of the health system by transferring responsibilities and authority to locally elected governments. The key question of this article is: what does devolution mean for human resources for health in Mali? This article assesses the key advantages and dilemmas associated with devolution such as responsiveness to local needs, downward accountability and health worker retention. Challenges of politics and capacities are also addressed in relation to human resources for health at the local level. Examples are derived from experiences in Mali with a capacity development programme and from case studies of other countries. It is not research findings that are presented, but highlights of key issues at stake aimed at inspiring the debate in Mali and elsewhere. A first lesson from the discussion suggests that in the context of human resources for health, decentralization of authority and resources is not the main issue. The challenge is to develop or strengthen accountability of those who decide and act, whether they are local politicians, bureaucrats or community representatives. If decentralization policies do not address public accountability, they will not fundamentally change human resource management, quality and equity of staffing. A second lesson is that successful devolution requires innovations in capacity development of all actors involved and in designing effective incentive measures. A final key conclusion is that the topic of devolution policy and its effects on human resources for health, and vice versa, merit more attention. A better understanding may lead to more appropriate policy designs and better preparation for the actors involved in countries that are embarking on decentralization, as is the case in Mali. PMID:21651817

Intelligent policy making? Key actors' perspectives on the development and implementation of an early years' initiative in Scotland's public health arena.

PubMed

Deas, L; Mattu, L; Gnich, W

2013-11-01

Increased political enthusiasm for evidence-based policy and action has re-ignited interest in the use of evidence within political and practitioner networks. Theories of evidence-based policy making and practice are being re-considered in an attempt to better understand the processes through which knowledge translation occurs. Understanding how policy develops, and practice results, has the potential to facilitate effective evidence use. Further knowledge of the factors which shape healthcare delivery and their influence in different contexts is needed. This paper explores the processes involved in the development of a complex intervention in Scotland's National Health Service (NHS). It uses a national oral health programme for children (Childsmile) as a case study, drawing upon key actors' perceptions of the influence of different drivers (research evidence, practitioner knowledge and values, policy, and political and local context) to programme development. Framework analysis is used to analyse stakeholder accounts from in-depth interviews. Documentary review is also undertaken. Findings suggest that Childsmile can be described as an 'evidence-informed' intervention, blending available research evidence with knowledge from practitioner experience and continual learning through evaluation, to plan delivery. The importance of context was underscored, in terms of the need to align with prevailing political ideology and in the facilitative strength of networks within the relatively small public health community in Scotland. Respondents' perceptions support several existing theoretical models of translation, however no single theory offered a comprehensive framework covering all aspects of the complex processes reported. Childsmile's use of best available evidence and on-going contribution to knowledge suggest that the programme is an example of intelligent policy making with international relevance. Copyright © 2013 Elsevier Ltd. All rights reserved.

Competing actors in the climate change arena in Mexico: A network analysis.

PubMed

Ortega Díaz, Araceli; Gutiérrez, Erika Casamadrid

2018-06-01

This paper analyzes the actors in the climate change arena and their influence in directing Mexico toward policies that decrease greenhouse gas emissions, such as the carbon tax and climate change law. The network analysis of the agreement of these laws and public policies in Mexico is a lesson for any country that is in the process of designing and adopting environmental laws. The research is performed using a network analysis that is derived from interviews with various main actors and a discourse analysis of the media. Results show that actors do not coordinate their efforts-they meet frequently but in different inter-ministerial commissions-and do not enforce the same policies. The actors in the industry have formed strong coalitions against the carbon tax and the General Law on Climate Change, whereas international institutions have formed coalitions that support these policies and laws. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adding to the HIV Prevention Portfolio – the Achievement of Structural Changes by 13 Connect to Protect® Coalitions

PubMed Central

Chutuape, Kate S.; Muyeed, Adaline Z.; Willard, Nancy; Greenberg, Lauren; Ellen, Jonathan M.

2015-01-01

Opportunities to control risk factors that contribute to HIV transmission and acquisition extend far beyond individuals and include addressing social and structural determinants of HIV risk, such as inadequate housing, poor access to healthcare and economic insecurity. The infrastructure within communities, including the policies and practices that guide institutions and organizations, should be considered crucial targets for change. This paper examines the extent to which 13 community coalitions across the U.S. and Puerto Rico were able to achieve “structural change” objectives (i.e., new or modified practices or policies) as an intermediate step toward the long-term goal of reducing HIV risk among adolescents and young adults (12-24 years old). The study resulted in the completion of 245 objectives with 70% categorized as structural in nature. Coalitions targeted social services, education and government as primary community sectors to adopt structural changes. A median of 12 key actors and six new key actors contributed to accomplishing structural changes. Structural change objectives required a median of seven months to complete. The structural changes achieved offer new ideas for community health educators and practitioners seeking to bolster their HIV prevention agenda. PMID:25632407

Understanding how domestic health policy is integrated into foreign policy in South Africa: a case for accelerating access to antiretroviral medicines

PubMed Central

Modisenyane, Simon Moeketsi; Hendricks, Stephen James Heinrich; Fineberg, Harvey

2017-01-01

ABSTRACT Background: South Africa, as an emerging middle-income country, is becoming increasingly influential in global health diplomacy (GHD). However, little empirical research has been conducted to inform arguments for the integration of domestic health into foreign policy by state and non-state actors. This study seeks to address this knowledge gap. It takes the form of an empirical case study which analyses how South Africa integrates domestic health into its foreign policy, using the lens of access to antiretroviral (ARV) medicines. Objective: To explore state and non-state actors’ perceptions regarding how domestic health policy is integrated into foreign policy. The ultimate goal of this study was to achieve better insights into the health and foreign policy processes at the national level. Methods: Employing qualitative approaches, we examined changes in the South African and global AIDS policy environment. Purposive sampling was used to select key informants, a sample of state and non-state actors who participated in in-depth interviews. Secondary data were collected through a systematic literature review of documents retrieved from five electronic databases, including review of key policy documents. Qualitative data were analysed for content. This content was coded, and the codes were collated into tentative categories and sub-categories using Atlas.ti v.7 software. Results: The findings of this work illustrate the interplay among social, political, economic and institutional conditions in determining the success of this integration process. Our study shows that a series of national and external developments, stakeholders, and advocacy efforts and collaboration created these integrative processes. South Africa’s domestic HIV/AIDS constituencies, in partnership with the global advocacy movement, catalysed the mobilization of support for universal access to ARV treatment nationally and globally, and the promotion of access to healthcare as a human right. Conclusions: Transnational networks may influence government’s decision making by providing information and moving issues up the agenda. PMID:28685669

Coordination of the health policy dialogue process in Guinea: pre- and post-Ebola.

PubMed

Ade, Nadege; Réne, Adzodo; Khalifa, Mara; Babila, Kevin Ousman; Monono, Martin Ekeke; Tarcisse, Elongo; Nabyonga-Orem, Juliet

2016-07-18

Policy dialogue can be defined as an iterative process that involves a broad range of stakeholders discussing a particular issue with a concrete purpose in mind. Policy dialogue in health is increasingly being recognised by health stakeholders in developing countries, as an important process or mechanism for improving collaboration and harmonization in health and for developing comprehensive and evidence-based health sector strategies and plans. It is with this perspective in mind that Guinea, in 2013, started a policy dialogue process, engaging a plethora of actors to revise the country's national health policy and develop a new national health development plan (2015-2024). This study examines the coordination of the policy dialogue process in developing these key strategic governance documents of the Guinean health sector from the actors' perspective. A qualitative case study approach was undertaken, comprising of interviews with key stakeholders who participated in the policy dialogue process. A review of the literature informed the development of a conceptual framework and the data collection survey questionnaire. The results were analysed both inductively and deductively. A total of 22 out of 32 individuals were interviewed. The results suggest both areas of strengths and weaknesses in the coordination of the policy dialogue process in Guinea. The aspects of good coordination observed were the iterative nature of the dialogue and the availability of neutral and well-experienced facilitators. Weak coordination was perceived through the unavailability of supporting documentation, time and financial constraints experienced during the dialogue process. The onset of the Ebola epidemic in Guinea impacted on coordination dynamics by causing a slowdown of its activities and then its virtual halt. The findings herein highlight the need for policy dialogue coordination structures to have the necessary administrative and institutional support to facilitate their effective functioning. The findings also point to the need for further research on the practical and operational aspects of national dialogue coordination structures to determine how to best strengthen their capacities.

Harm reduction as a complex adaptive system: A dynamic framework for analyzing Tanzanian policies concerning heroin use

PubMed Central

Ratliff, Eric A.; Kaduri, Pamela; Masao, Frank; Mbwambo, Jessie K.K.; McCurdy, Sheryl A.

2016-01-01

Contrary to popular belief, policies on drug use are not always based on scientific evidence or composed in a rational manner. Rather, decisions concerning drug policies reflect the negotiation of actors’ ambitions, values, and facts as they organize in different ways around the perceived problems associated with illicit drug use. Drug policy is thus best represented as a complex adaptive system (CAS) that is dynamic, self-organizing, and coevolving. In this analysis, we use a CAS framework to examine how harm reduction emerged around heroin trafficking and use in Tanzania over the past thirty years (1985-present). This account is an organizational ethnography based on of the observant participation of the authors as actors within this system. We review the dynamic history and self-organizing nature of harm reduction, noting how interactions among system actors and components have coevolved with patterns of heroin us, policing, and treatment activities over time. Using a CAS framework, we describe harm reduction as a complex process where ambitions, values, facts, and technologies interact in the Tanzanian socio-political environment. We review the dynamic history and self-organizing nature of heroin policies, noting how the interactions within and between competing prohibitionist and harm reduction policies have changed with patterns of heroin use, policing, and treatment activities over time. Actors learn from their experiences to organize with other actors, align their values and facts, and implement new policies. Using a CAS approach provides researchers and policy actors a better understanding of patterns and intricacies in drug policy. This knowledge of how the system works can help improve the policy process through adaptive action to introduce new actors, different ideas, and avenues for communication into the system. PMID:26790689

E-learning policies, practices and challenges in two Norwegian organizations.

PubMed

Welle-Strand, Anne; Thune, Taran

2003-05-01

This article reports a pilot study on the uses of technology to enable learning within a formal educational setting in a higher education institution and within a corporation. These two Norwegian cases were selected due to their commitment to technology-enabled learning, as expressed in policy and strategy documents. The aim was to investigate the commitment and actual use of information and communications technology (ICT) for learning as well as what key actors think are the major challenges for successful large scale implementation of ICT for learning. The findings indicate that there is insufficient follow-up on e-learning policies and that there is a general lack of strategic direction and leadership in this area. The key challenges respondents highlight relate to the need for a systematic and pedagogical approach to e-learning in which three equally important considerations must be balanced: organization, pedagogy and technology. Key perspectives of a coherent pedagogical and organizational framework for planning e-learning are discussed.

Who runs public health? A mixed-methods study combining qualitative and network analyses.

PubMed

Oliver, Kathryn; de Vocht, Frank; Money, Annemarie; Everett, Martin

2013-09-01

Persistent health inequalities encourage researchers to identify new ways of understanding the policy process. Informal relationships are implicated in finding evidence and making decisions for public health policy (PHP), but few studies use specialized methods to identify key actors in the policy process. We combined network and qualitative data to identify the most influential individuals in PHP in a UK conurbation and describe their strategies to influence policy. Network data were collected by asking for nominations of powerful and influential people in PHP (n = 152, response rate 80%), and 23 semi-structured interviews were analysed using a framework approach. The most influential PHP makers in this conurbation were mid-level managers in the National Health Service and local government, characterized by managerial skills: controlling policy processes through gate keeping key organizations, providing policy content and managing selected experts and executives to lead on policies. Public health professionals and academics are indirectly connected to policy via managers. The most powerful individuals in public health are managers, not usually considered targets for research. As we show, they are highly influential through all stages of the policy process. This study shows the importance of understanding the daily activities of influential policy individuals.

Aligning faith-based and national HIV/AIDS prevention responses? Factors influencing the HIV/AIDS prevention policy process and response of faith-based NGOs in Tanzania.

PubMed

Morgan, Rosemary; Green, Andrew; Boesten, Jelke

2014-05-01

Faith-based organizations (FBOs) have a long tradition of providing HIV/AIDS prevention and mitigation services in Africa. The overall response of FBOs, however, has been controversial, particularly in regard to HIV/AIDS prevention and FBO's rejection of condom use and promotion, which can conflict with and negatively influence national HIV/AIDS prevention response efforts. This article reports the findings from a study that explored the factors influencing the HIV/AIDS prevention policy process within faith-based non-governmental organizations (NGOs) of different faiths. These factors were examined within three faith-based NGOs in Dar es Salaam, Tanzania-a Catholic, Anglican and Muslim organization. The research used an exploratory, qualitative case-study approach, and employed a health policy analysis framework, examining the context, actor and process factors and how they interact to form content in terms of policy and its implementation within each organization. Three key factors were found to influence faith-based NGOs' HIV/AIDS prevention response in terms of both policy and its implementation: (1) the faith structure in which the organizations are a part, (2) the presence or absence of organizational policy and (3) the professional nature of the organizations and its actors. The interaction between these factors, and how actors negotiate between them, was found to shape the organizations' HIV/AIDS prevention response. This article reports on these factors and analyses the different HIV/AIDS prevention responses found within each organization. By understanding the factors that influence faith-based NGOs' HIV/AIDS prevention policy process, the overall faith-based response to HIV/AIDS, and how it corresponds to national response efforts, is better understood. It is hoped that by doing so the government will be better able to identify how to best work with FBOs to meet national HIV/AIDS prevention targets, improving the overall role of FBOs in the fight against HIV/AIDS.

Integrating horizon scanning and strategic risk prioritisation using a weight of evidence framework to inform policy decisions.

PubMed

Garnett, K; Lickorish, F A; Rocks, S A; Prpich, G; Rathe, A A; Pollard, S J T

2016-08-01

Poor connection between data on emerging issues and credible policy decisions continues to challenge governments, and is only likely to grow as demands on time and resources increase. Here we summarise recent efforts to integrate horizon scanning and risk prioritisation approaches to better connect emerging issues to the political discourse on environmental and food-related issues. Our categorisation of insights including potential future risks and opportunities to inform policy discussions has emerged from a structured three-year programme of horizon scanning for a UK pan-governmental futures partnership led by the Department for Environment, Food and Rural Affairs (Defra). Our efforts to integrate horizon scanning and risk prioritisation, utilising a qualitative weight of evidence framework, has created a systematic process for identifying all signals of potential future change with significant impact for the strategic mission and underlying values of policy actors. Our approach encourages an exploration of factors out of the control of organisations, recognising that resilience depends on the flexibility of management strategies and the preparedness to deal with a variety of unexpected outcomes. We discuss how this approach addresses key cultural and evaluative challenges that policy actors have had in embedding horizon scanning in evidence-based policy processes, and suggest further developments to build confidence in the use of horizon scanning for strategic planning. Copyright © 2016 Elsevier B.V. All rights reserved.

Researching the Habitus of Global Policy Actors in Education

ERIC Educational Resources Information Center

Lingard, Bob; Sellar, Sam; Baroutsis, Aspa

2015-01-01

This paper reprises the argument for the emergence of a global education policy field and then focuses on the shared habitus of global and national policy actors and technicians. It is argued that this shared habitus is constituted as a reflection of and a contribution to the creation of the global education policy field. Bourdieu's approach to…

Recent Trends in Intergovernmental Relations: The Resurgence of Local Actors in Education Policy

ERIC Educational Resources Information Center

Marsh, Julie A.; Wohlstetter, Priscilla

2013-01-01

In this essay, the authors explore trends in intergovernmental relations (IGR) by analyzing recent education policies--No Child Left Behind Act, Common Core State Standards, and local empowerment policies. Identifying a resurgent role for local actors in education policy, the authors argue that recent federal efforts to exert more control have in…

Frames in contestation: gendering domestic violence policies in five central and eastern European countries.

PubMed

Krizsan, Andrea; Popa, Raluca Maria

2014-07-01

The article looks at the translation of international norms on domestic violence to the national level in five Central and Eastern European countries. It argues that translation brings a concept of domestic violence, which stretches gender equality ideas underpinning international norms so as to be easier to endorse by mainstream policy actors, and results in policies framed in degendered individual rights terms. The potential for keeping gender equality in focus is then guaranteed by gendering policy processes through empowerment of gender equality actors at all stages. Absence of ownership of the policy by gender equality actors risks co-optation by frames contesting gender equality. © The Author(s) 2014.

Structural Location and Reputed Influence in State Reading Policy Issue Networks

ERIC Educational Resources Information Center

Young, Tamara V.; Lewis, Wayne D.; Sanders, Marla S.

2010-01-01

Using data about collaborative relationships among 109 reading policy actors from four states, this study investigated the extent to which social capital, operationalized as spanning structural holes, predicted a policy actor's reputed influence. Regression analysis showed that after controlling for state, centrality, and government entity, having…

Education Policy for Social Justice in Cyprus: The Role of Stakeholders' Values

ERIC Educational Resources Information Center

Hajisoteriou, Christina; Angelides, Panayiotis

2014-01-01

This article examines (a) the official policy for social justice as developed by the Ministry of Education and Culture and its policy-makers, (b) the ways in which school leaders (head teachers) and school actors (teachers) understand education policy for social justice, and (c) the impact of this process on school leaders' and actors' action or…

Tobacco Control and Health Advocacy in the European Union: Understanding Effective Coalition-Building

PubMed Central

Collin, Jeff; Amos, Amanda

2016-01-01

Introduction: Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood. Methods: Qualitative semi-structured, narrative interviews with 35 stakeholders involved in developing the European Council Recommendation on smoke-free environments. These were thematically analyzed to examine the dynamics of coalition-building, collaboration and leadership in the alliance of organizations which successfully called for the development of comprehensive European Union (EU) smoke-free policy. Results: An alliance of tobacco control and public health advocacy organizations, scientific institutions, professional bodies, pharmaceutical companies, and other actors shared the goal of fighting the harms caused by second-hand smoke. Alliance members jointly called for comprehensive EU smoke-free policy and the protection of the political debates from tobacco industry interference. The alliance’s success was enabled by a core group of national and European actors with long-standing experience in tobacco control, who facilitated consensus-building, mobilized allies and synchronized the actions of policy supporters. Representatives of Brussels-based organizations emerged as crucial strategic leaders. Conclusions: The insights gained and identification of key enablers of successful tobacco control advocacy highlight the strategic importance of investing into tobacco control at European level. Those interested in effective health policy can apply lessons learned from EU smoke-free policy to build effective alliances in tobacco control and other areas of public health. PMID:25634938

Tobacco Control and Health Advocacy in the European Union: Understanding Effective Coalition-Building.

PubMed

Weishaar, Heide; Collin, Jeff; Amos, Amanda

2016-02-01

Coalitions of supporters of comprehensive tobacco control policy have been crucial in achieving policy success nationally and internationally, but the dynamics of such alliances are not well understood. Qualitative semi-structured, narrative interviews with 35 stakeholders involved in developing the European Council Recommendation on smoke-free environments. These were thematically analyzed to examine the dynamics of coalition-building, collaboration and leadership in the alliance of organizations which successfully called for the development of comprehensive European Union (EU) smoke-free policy. An alliance of tobacco control and public health advocacy organizations, scientific institutions, professional bodies, pharmaceutical companies, and other actors shared the goal of fighting the harms caused by second-hand smoke. Alliance members jointly called for comprehensive EU smoke-free policy and the protection of the political debates from tobacco industry interference. The alliance's success was enabled by a core group of national and European actors with long-standing experience in tobacco control, who facilitated consensus-building, mobilized allies and synchronized the actions of policy supporters. Representatives of Brussels-based organizations emerged as crucial strategic leaders. The insights gained and identification of key enablers of successful tobacco control advocacy highlight the strategic importance of investing into tobacco control at European level. Those interested in effective health policy can apply lessons learned from EU smoke-free policy to build effective alliances in tobacco control and other areas of public health. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

Rolling in the Dough, Running from Reform: An Analysis and Critique of the 1994 Utah Legislative Session and Its Impact on Education.

ERIC Educational Resources Information Center

Johnson, Bob L., Jr.

This paper provides a critical review of the 1994 Utah Legislative session as it relates to public and higher education in the state. The paper discusses the defining contextual features of the 1994 Legislative Session, the agendas of key state educational policy actors for the 1994 session, and significant issues and legislation in the…

Understanding the dynamics of the Seguro Popular de Salud policy implementation in Mexico from a complex adaptive systems perspective.

PubMed

Nigenda, Gustavo; González-Robledo, Luz María; Juárez-Ramírez, Clara; Adam, Taghreed

2016-05-13

In 2003, Mexico's Seguro Popular de Salud (SPS), was launched as an innovative financial mechanism implemented to channel new funds to provide health insurance to 50 million Mexicans and to reduce systemic financial inequities. The objective of this article is to understand the complexity and dynamics that contributed to the adaptation of the policy in the implementation stage, how these changes occurred, and why, from a complex and adaptive systems perspective. A complex adaptive systems (CAS) framework was used to carry out a secondary analysis of data obtained from four SPS's implementation evaluations. We first identified key actors, their roles, incentives and power, and their responses to the policy and guidelines. We then developed a causal loop diagram to disentangle the feedback dynamics associated with the modifications of the policy implementation which we then analyzed using a CAS perspective. Implementation variations were identified in seven core design features during the first 10 years of implementation period, and in each case, the SPS's central coordination introduced modifications in response to the reactions of the different actors. We identified several CAS phenomena associated with these changes including phase transitions, network emergence, resistance to change, history dependence, and feedback loops. Our findings generate valuable lessons to policy implementation processes, especially those involving a monetary component, where the emergence of coping mechanisms and other CAS phenomena inevitably lead to modifications of policies and their interpretation by those who implement them. These include the difficulty of implementing strategies that aim to pool funds through solidarity among beneficiaries where the rich support the poor when there are no incentives for the rich to do so. Also, how resistance to change and history dependence can pose significant challenges to implementing changes, where the local actors use their significant power to oppose or modify these changes.

The political effects of ideas and markets on China's economic reforms: The case of electrical power

NASA Astrophysics Data System (ADS)

Dodge, Laura Washington

This study examines factors influencing contemporary economic policy-making and reform in China's electric power industry. Results of the study suggest that there is an ongoing paradigm change in China's policy-making. However, institutional resistance to changes in the policy process is strong. Policy outcomes in the case of electric power reforms reflect the interaction of both dynamics. In the early 1990s, the central government in Beijing began to consider restructuring the electric power industry to introduce competition and establish markets for electricity supply. Until then, economic policies had resulted from a process of deliberation within the upper echelons of the Communist Party. Although the Party considered the interests of dominant economic actors, particularly the large State-owned sector, its channels for participation in the policy process were closed to most economic actors. Central bureaucratic and provincial interests largely governed policy processes, leading observers to describe the Chinese State as bureaucratic authoritarian. Bureaucracy's heavy role in the economy led to what some called a corporatist State, whereby organs of government infiltrated most aspects of the economy. This institutional arrangement perpetuated bureaucracy's influence in policy-making. This study hypothesizes that transformation in domestic financial markets poses a threat to the entrenched institutions of the electric power industry. The integration of China's economy with foreign firms and markets enabled actors outside of the dominant State-owned economy to improve their positions vis-a-vis the state-owned sector, and eventually to play a role in the policy process. At the same time, Beijing's adaptation of foreign-designed restructuring policies threatened the deep-rooted institutions. The study analyzes the behavior, statements and channels utilized by those actors affected by power sector policies. Based on interviews conducted between 2000 through 2002, documents and reports from various power industry actors, and available academic literature analyzing current developments in the industry, I analyze the process of making deregulatory policies in electric power. Specifically, I ask whether or not the developments described above resulted in a shift in the relative power of contending actors in the industry, and consequently influenced policy outcomes.

Global health: governance and policy development.

PubMed

Kelley, Patrick W

2011-06-01

Global health policy is now being influenced by an ever-increasing number of nonstate and non-intergovernmental actors to include influential foundations, multinational corporations, multi-sectoral partnerships, and civil society organizations. This article reviews how globalization is a key driver for the ongoing evolution of global health governance. It describes the massive increases in bilateral and multilateral investments in global health and it highlights the current global and US architecture for performing global health programs. The article closes describing some of the challenges and prospects that characterize global health governance today. Copyright © 2011 Elsevier Inc. All rights reserved.

Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda

PubMed Central

Nabyonga-Orem, Juliet; Mijumbi, Rhona

2015-01-01

Background: Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors’ views regarding what evidence they deemed appropriate to guide health policy development. Methods: Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Results: Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. Conclusion: What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. PMID:25905479

Dominant and Emerging Approaches in the Study of Higher Education Policy Change

ERIC Educational Resources Information Center

Saarinen, Taina; Ursin, Jani

2012-01-01

The purpose of the article is to analyse recent literature on higher education policy change. Based on the review, three different approaches are distinguished: structural, actor and agency. In the structural approach the dynamic of policy change originates in well-established structures. The actor approach focuses on either individual or…

The emerging mental health strategy of the European Union: a multi-level work-in-progress.

PubMed

Kelly, Brendan D

2008-01-01

Policy-making in the European Union (EU) is a complex process that can appear impenetrable and opaque. This paper examines the ongoing process of mental health policy-making in the EU. In 2005, the Health and Consumer Protectorate Director-General of the European Commission published a Green Paper and launched a consultation process aimed at mental health service-users, advocates, providers, business, social services and governments. While there were varying levels of participation between member states, a range of trans-national, national and infra-national actors made contributions. Based on these consultations, a 'Consultative Platform' was created and made 10 recommendations centered on the principles of partnership; establishing policy competencies; integrating mental health into national policies; involving stakeholders; and protecting human rights. This ongoing process illustrates many features of EU policy-making: (a) the European Commission generates an initiative; (b) policy focuses on EU standardization, with member states remaining central actors in service-delivery; (c) policy focuses on social inclusion; (d) the European Commission coordinates diverse networks of actors; and (e) there is 'multi-level' involvement, with direct interaction between trans-national, national and infra-national actors. An enhanced focus on epidemiological data and 'evidence-based policy' would increase rigor and focus further attention on this relatively neglected policy area.

The establishment of marine protected areas in Senegal: untangling the interactions between international institutions and national actors.

PubMed

Ferraro, Gianluca; Brans, Marleen; Dème, Moustapha; Failler, Pierre

2011-04-01

International institutions, understood as sets of rules contained in international agreements, are aimed at orienting national governments towards specific policy options. Nevertheless, they can determine a change in national policies and practices only if states are willing and capable of incorporating international obligations into their national legislations and ensuring their application and enforcement in areas that follow completely under national jurisdiction. The establishment of marine protected areas promoted by international agreements as a tool for the protection of marine resources represents an interesting case for revealing the complex interactions between international institutions and national actors. Particularly, the establishment of these areas in Senegal shows the salience of domestic constellations of actors who may support or undercut national commitments to international regimes: political elites, bureaucracies, the general public and target groups. By anchoring the empirical analysis to an actor-centred institutionalist perspective, the article explains how dynamic constellations of actors can distort the penetration of international objectives in the national policy framework. Different constellations of national actors can indeed bend international institutions at different moments: during the formulation of a new law in line with international obligations; in the definition of its implementation framework; and in the enforcement of national policies.

Integrating Water, Actors, and Structure to Study Socio-Hydro-Ecological Systems

NASA Astrophysics Data System (ADS)

Hale, R. L.; Armstrong, A.; Baker, M. A.; Bedingfield, S.; Betts, D.; Buahin, C. A.; Buchert, M.; Crowl, T.; Dupont, R.; Endter-Wada, J.; Flint, C.; Grant, J.; Hinners, S.; Horns, D.; Horsburgh, J. S.; Jackson-Smith, D.; Jones, A. S.; Licon, C.; Null, S. E.; Odame, A.; Pataki, D. E.; Rosenberg, D. E.; Runburg, M.; Stoker, P.; Strong, C.

2014-12-01

Urbanization, climate uncertainty, and ecosystem change represent major challenges for managing water resources. Water systems and the forces acting upon them are complex, and there is a need to understand and generically represent the most important system components and linkages. We developed a framework to facilitate understanding of water systems including potential vulnerabilities and opportunities for sustainability. Our goal was to produce an interdisciplinary framework for water resources research to address water issues across scales (e.g., city to region) and domains (e.g., water supply and quality, urban and transitioning landscapes). An interdisciplinary project (iUTAH - innovative Urban Transitions and Aridregion Hydro-sustainability) with a large (N=~100), diverse team having expertise spanning the hydrologic, biological, ecological, engineering, social, planning, and policy sciences motivated the development of this framework. The framework was developed through review of the literature, meetings with individual researchers, and workshops with participants. The Structure-Water-Actor Framework (SWAF) includes three main components: water (quality and quantity), structure (natural, built, and social), and actors (individual and organizational). Key linkages include: 1) ecological and hydrological processes, 2) ecosystem and geomorphic change, 3) planning, design, and policy, 4) perceptions, information, and experience, 5) resource access, and 6) operational water use and management. Our expansive view of structure includes natural, built, and social components, allowing us to examine a broad set of tools and levers for water managers and decision-makers to affect system sustainability and understand system outcomes. We validate the SWAF and illustrate its flexibility to generate insights for three research and management problems: green stormwater infrastructure in an arid environment, regional water supply and demand, and urban river restoration. These applications show that the framework can help identify key components and linkages across diverse water systems.

The road to smoke-free legislation in Ireland.

PubMed

Currie, Laura M; Clancy, Luke

2011-01-01

To describe the process through which Ireland changed its policies towards smoking in work-places and distil lessons for others implementing or extending smoke-free laws. This analysis is informed by a review of secondary sources including a commissioned media analysis, documentary analysis and key informant interviews with policy actors who provide insight into the process of smoke-free policy development. The policy analysis techniques used include the development of a time-line for policy reform, stakeholder analysis, policy mapping techniques, impact analysis through use of secondary data and a review process. The policy analysis triangle, which highlights the importance of examining policy content, context, actors and processes, will be used as an analytical framework. The importance of the political, economic, social and cultural context emerged clearly. The interaction of the context with the policy process both in identification of need for policy and its formulation demonstrated the opportunity for advocates to exert influence at all points of the process. The campaign to support the legislation had the following characteristics: a sustained consistent simple health message, sustained political leadership/commitment, a strong coalition between the Health Alliance, the Office of Tobacco Control and the Department of Health and Children, with cross-party political support and trade union support. The public and the media support clearly defined the benefit of deliberate and consistent planning and organization of a communication strategy. The Irish smoke-free legislation was a success as a policy initiative because of timing, dedication, planning, implementation and the existence of strong leadership and a powerful convinced credible political champion. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

The Problem of Simplification: Think-Tanks, Recipes, Equity and "Turning around Low-Performing Schools"

ERIC Educational Resources Information Center

Loughland, Tony; Thompson, Greg

2016-01-01

Non-government actors such as think-tanks are playing an important role in Australian policy work. As governments increasingly outsource policy work previously done by education departments and academics to these new policy actors, more think-tanks have emerged that represent a wide range of political views and ideological positions. This paper…

Policy entrepreneurship in the development of public sector strategy: the case of London health reform.

PubMed

Oborn, Eivor; Barrett, Michael; Exworthy, Mark

2011-01-01

The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform.

Workplace exposure to engineered nanomaterials: the Italian path for the definition of occupational health and safety policies.

PubMed

Mirabile, Marco; Boccuni, Fabio; Gagliardi, Diana; Rondinone, Bruna Maria; Iavicoli, Sergio

2014-07-01

This study explores the way the publication of a National White Book on health and safety risks that affect workers in jobs involving Nanotechnologies and Nanomaterials influenced the key Italian stakeholders attitude toward this issue and identifies the standpoints and priorities shared among researchers and stakeholders to develop a policy framework to address this issue. The study not only highlights some important assumptions (i.e. the acknowledgment by the key stakeholders of the need for actions and the identification of objectives which can gain a wide consensus) for the establishment of a policy community that sustains the development of a policymaking process on the issue but, through the interaction between stakeholders and OSH researchers, it also identifies some in nuce proposals that represent the starting point for policy interventions aimed at meeting the needs of both stakeholders and scientific community. Results obtained in terms of clarification of interests at stake, identification of potential areas of consensus and level of key national actors' engagement achieved, show the potentialities of adopting a knowledge based and inclusive approach to policy-making to address the issue of prevention and management of health and safety risks related to technological innovation within a framework of scientific uncertainty. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A glossary of theories for understanding policymaking.

PubMed

Smith, Katherine Elizabeth; Katikireddi, Srinivasa Vittal

2013-02-01

Public health practitioners and researchers often seek to influence public policies in order to improve population health and/or reduce health inequalities. However, these efforts frequently appear to be uninformed by the many empirically-based theories about policymaking that have been developed within political science. This glossary provides a brief overview of some of the most popular of these theories, describing how each: frames the policymaking process; portrays the relationships and influence of specific policy actors; and depicts the potential for policy change (or inertia). Examples of their application to public health are provided to help improve understanding of the material presented. Throughout the article, the implications of the different theories for public health researchers and advocates seeking to inform policy decisions are emphasised. The glossary aims to provide an accessible overview to key theories about policy and decision-making, with a view to supporting public health efforts to achieve healthier public policies.

Budget-makers and health care systems.

PubMed

White, Joseph

2013-10-01

Health programs are shaped by the decisions made in budget processes, so how budget-makers view health programs is an important part of making health policy. Budgeting in any country involves its own policy community, with key players including budgeting professionals and political authorities. This article reviews the typical pressures on and attitudes of these actors when they address health policy choices. The worldview of budget professionals includes attitudes that are congenial to particular policy perspectives, such as the desire to select packages of programs that maximize population health. The pressures on political authorities, however, are very different: most importantly, public demand for health care services is stronger than for virtually any other government activity. The norms and procedures of budgeting also tend to discourage adoption of some of the more enthusiastically promoted health policy reforms. Therefore talk about rationalizing systems is not matched by action; and action is better explained by the need to minimize blame. The budget-maker's perspective provides insight about key controversies in healthcare policy such as decentralization, competition, health service systems as opposed to health insurance systems, and dedicated vs. general revenue finance. It also explains the frequency of various "gaming" behaviors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Introducing payment for performance in the health sector of Tanzania- the policy process.

PubMed

Chimhutu, Victor; Tjomsland, Marit; Songstad, Nils Gunnar; Mrisho, Mwifadhi; Moland, Karen Marie

2015-09-02

Prompted by the need to achieve progress in health outcomes, payment for performance (P4P) schemes are becoming popular policy options in the health systems in many low income countries. This paper describes the policy process behind the introduction of a payment for performance scheme in the health sector of Tanzania illuminating in particular the interests of and roles played by the Government of Norway, the Government of Tanzania and the other development partners. The study employed a qualitative research design using in-depth interviews (IDIs), observations and document reviews. Thirteen IDIs with key-informants representing the views of ten donor agencies and government departments influential in the process of introducing the P4P scheme in Tanzania were conducted in Dar es Salaam, Tanzania and Oslo, Norway. Data was collected on the main trends and thematic priorities in development aid policy, countries and actors perceived to be proponents and opponents to the P4P scheme, and P4P agenda setting in Tanzania. The initial introduction of P4P in the health sector of Tanzania was controversial. The actors involved including the bilateral donors in the Health Basket Fund, the World Bank, the Tanzanian Government and high level politicians outside the Health Basket Fund fought for their values and interests and formed alliances that shifted in the course of the process. The process was characterized by high political pressure, conflicts, changing alliances, and, as it evolved, consensus building. The P4P policy process was highly political with external actors playing a significant role in influencing the agenda in Tanzania, leaving less space for the Government of Tanzania to provide leadership in the process. Norway in particular, took a leading role in setting the agenda. The process of introducing P4P became long and frustrating causing mistrust among partners in the Health Basket Fund.

Consensus and contention in the priority setting process: examining the health sector in Uganda.

PubMed

Colenbrander, Sarah; Birungi, Charles; Mbonye, Anthony K

2015-06-01

Health priority setting is a critical and contentious issue in low-income countries because of the high burden of disease relative to the limited resource envelope. Many sophisticated quantitative tools and policy frameworks have been developed to promote transparent priority setting processes and allocative efficiency. However, low-income countries frequently lack effective governance systems or implementation capacity, so high-level priorities are not determined through evidence-based decision-making processes. This study uses qualitative research methods to explore how key actors' priorities differ in low-income countries, using Uganda as a case study. Human resources for health, disease prevention and family planning emerge as the common priorities among actors in the health sector (although the last of these is particularly emphasized by international agencies) because of their contribution to the long-term sustainability of health-care provision. Financing health-care services is the most disputed issue. Participants from the Ugandan Ministry of Health preferentially sought to increase net health expenditure and government ownership of the health sector, while non-state actors prioritized improving the efficiency of resource use. Ultimately it is apparent that the power to influence national health outcomes lies with only a handful of decision-makers within key institutions in the health sector, such as the Ministries of Health, the largest bilateral donors and the multilateral development agencies. These power relations reinforce the need for ongoing research into the paradigms and strategic interests of these actors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Compositional schedulability analysis of real-time actor-based systems.

PubMed

Jaghoori, Mohammad Mahdi; de Boer, Frank; Longuet, Delphine; Chothia, Tom; Sirjani, Marjan

2017-01-01

We present an extension of the actor model with real-time, including deadlines associated with messages, and explicit application-level scheduling policies, e.g.,"earliest deadline first" which can be associated with individual actors. Schedulability analysis in this setting amounts to checking whether, given a scheduling policy for each actor, every task is processed within its designated deadline. To check schedulability, we introduce a compositional automata-theoretic approach, based on maximal use of model checking combined with testing. Behavioral interfaces define what an actor expects from the environment, and the deadlines for messages given these assumptions. We use model checking to verify that actors match their behavioral interfaces. We extend timed automata refinement with the notion of deadlines and use it to define compatibility of actor environments with the behavioral interfaces. Model checking of compatibility is computationally hard, so we propose a special testing process. We show that the analyses are decidable and automate the process using the Uppaal model checker.

Factors for success in mental health advocacy

PubMed Central

Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian

2015-01-01

Background Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition – Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. Design The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Results Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. Conclusions The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings. PMID:26689456

Factors for success in mental health advocacy.

PubMed

Hann, Katrina; Pearson, Heather; Campbell, Doris; Sesay, Daniel; Eaton, Julian

2015-01-01

Mental health advocacy groups are an effective way of pushing the mental health agenda and putting pressure on national governments to observe the right to health; however, there is limited research that highlights best practices for such groups in low-resource settings. In an effort to improve the scaling up of mental health in Sierra Leone, stakeholders came together to form the country's first mental health advocacy group: the Mental Health Coalition - Sierra Leone. Since its inception, the group has worked towards raising the profile of mental health in Sierra Leone and developing as an advocacy organisation. The study's aim was to investigate views on enabling factors and barriers associated with mental health advocacy in a low-income country using a community-based participatory approach and qualitative methodology. Focus groups (N=9) were held with mental health stakeholders, and key informant interviews (N=15) were conducted with advocacy targets. Investigators analysed the data collaboratively using coding techniques informed by grounded theory. Investigators reveal viewpoints on key factors in networking, interacting with government actors, and awareness raising that enabled mental health advocacy aims of supporting policy, service delivery, service user rights, training for service delivery, and awareness raising. The investigators outline viewpoints on barriers for advocacy aims in framing the issue of mental health, networking, interacting with government actors, resource mobilization, and awareness raising. The findings outline enabling factors, such as networking with key stakeholders, and barriers, such as lack of political will, for achieving mental health advocacy aims within a low-resource setting, Sierra Leone. Stakeholder coalitions can further key policy development aims that are essential to strengthen mental health systems in low-resource settings.

Building Stronger State Partnerships with the US Department of Energy (Energy Assurance)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mike Keogh

2011-09-30

From 2007 until 2011, the National Association of Regulatory Utility Commissioners (NARUC) engaged in a partnership with the National Energy Technology Lab (NETL) to improve State-Federal coordination on electricity policy and energy assurance issues. This project allowed State Public Utility Commissioners and their staffs to engage on the most cutting-edge level in the arenas of energy assurance and electricity policy. Four tasks were outlined in the Statement of Performance Objectives: Task 1 - Training for Commissions on Critical Infrastructure Topics; Task 2 - Analyze and Implement Recommendations on Energy Assurance Issues; Task 3 - Ongoing liaison activities & outreach tomore » build stronger networks between federal agencies and state regulators; and Task 4 - Additional Activities. Although four tasks were prescribed, in practice these tasks were carried out under two major activity areas: the critical infrastructure and energy assurance partnership with the US Department of Energy's Infrastructure Security and Emergency Response office, and the National Council on Electricity Policy, a collaborative which since 1994 has brought together State and Federal policymakers to address the most pressing issues facing the grid from restructuring to smart grid implementation. On Critical Infrastructure protection, this cooperative agreement helped State officials yield several important advances. The lead role on NARUC's side was played by our Committee on Critical Infrastructure Protection. Key lessons learned in this arena include the following: (1) Tabletops and exercises work - They improve the capacity of policymakers and their industry counterparts to face the most challenging energy emergencies, and thereby equip these actors with the capacity to face everything up to that point as well. (2) Information sharing is critical - Connecting people who need information with people who have information is a key success factor. However, exposure of critical infrastructure information to bad actors also creates new vulnerabilities. (3) Tensions exist between the transparency-driven basis of regulatory activity and the information-protection requirements of asset protection. (4) Coordination between states is a key success factor - Because comparatively little federal authority exists over electricity and other energy infrastructure, the interstate nature of these energy grids defy centralized command and control governance. Patchwork responses are a risk when addressed at a state-by-state level. Coordination is the key to ensuring consistent response to shared threats. In Electricity Policy, the National Council on Electricity Policy continued to make important strides forward. Coordinated electricity policy among States remains the best surrogate for an absent national electricity policy. In every area from energy efficiency to clean coal, State policies are driving the country's electricity policy, and regional responses to climate change, infrastructure planning, market operation, and new technology deployment depend on a forum for bringing the States together.« less

Global-to-local policy transfer in the introduction of new molecular tuberculosis diagnostics in South Africa.

PubMed

Colvin, C J; Leon, N; Wills, C; van Niekerk, M; Bissell, K; Naidoo, P

2015-11-01

Lack of innovation in diagnostics has contributed to tuberculosis (TB) remaining a global health challenge. It is critical to understand how new diagnostic technologies are translated into policies and how these are implemented. To examine policy transfer for two rapid molecular diagnostic tests, GenoType(®) MDRTBplus and Xpert(®) MTB/RIF, to understand policy development, uptake and implementation in South Africa. A policy transfer analysis framework integrating the key dimensions of policy transfer into one coherent model was used. Two phases of key informant interviews were undertaken with a wide range of stakeholders. Both tests were developed through innovative partnerships and responded to urgent public health needs. GenoType was introduced through a process that was more inclusive than that for Xpert. National policy and planning processes were opaque for both tests. Their implementation, maintenance and expansion suffered from poor communication and coordination, insufficient attention to resource implications, technical challenges and a lack of broader health systems thinking. Our analysis identified the risks and benefits of partnerships for technological innovation, the complex intersections between global and national actors and the impact of health systems on policy transfer, and the risks of rescue- and technology-focused thinking in addressing public health challenges.

Stakeholder learning for health sector reform in Lao PDR.

PubMed

Phillips, Simone; Pholsena, Soulivanh; Gao, Jun; Oliveira Cruz, Valeria

2016-09-01

Development organizations and academic institutions have expressed the need for increased research to guide the development and implementation of policies to strengthen health systems in low- and middle-income countries. The extent to which evidence-based policies alone can produce changes in health systems remains a point of debate; other factors, such as a country's political climate and the level of actor engagement, have been identified as influential variables in effective policy development and implementation. In response to this debate, this article contends that the success of health sector reform depends largely on policy learning-the degree to which research recommendations saturate a given political environment in order to successfully inform the ideas, opinions and perceived interests of relevant actors. Using a stakeholder analysis approach to analyze the case of health sector reform in Lao PDR, we examine the ways that actors' understanding and interests affect the success of reform-and how attitudes towards reform can be shaped by exposure to policy research and international health policy priorities. The stakeholder analysis was conducted by the WHO during the early stages of health sector reform in Lao PDR, with the purpose of providing the Ministry of Health with concrete recommendations for increasing actor involvement and strengthening stakeholder support. We found that dissemination of research findings to a broad array of actors and the inclusion of diverse stakeholder groups in policy design and implementation increases the probability of a sustainable and successful health sector reform. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand

PubMed Central

Teerawattananon, Yot; Russell, Steve

2008-01-01

Background This paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC) for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources. Methods Semi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics. Results Twenty six out of 36 (72%) respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC) in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17%) whose decisions were influenced by economic evaluation evidence. Conclusion This paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions. PMID:18817579

Public accountability needs to be enforced -a case study of the governance arrangements and accountability practices in a rural health district in Ghana.

PubMed

Van Belle, Sara; Mayhew, Susannah H

2016-10-12

Improving public accountability is currently high on the global agenda. At the same time, the organisation of health services in low- and middle-income countries is taking place in fragmented institutional landscapes. State and non-state actors are involved in increasingly complex governance arrangements. This often leads to coordination problems, confusion of roles and responsibilities and possibly accountability gaps. This study aimed at assessing the governance arrangements and the accountability practices of key health actors at the level of a Ghanaian health district with the aim to understand how far public accountability is achieved. We adopted the case study design as it allows for in-depth analysis of the governance arrangements and accountability relations between actors, their formal policies and actual accountability practices towards the public and towards stakeholders. Data were collected at a rural health district using in-depth interviews, observation and document review. In the analysis, we used a four-step sequence: identification of the key actors and their relationships, description of the multi-level governance arrangements, identification of the actual accountability relations and practices between all actors and finally appraisal of the public accountability practices, which we define as those practices that ensure direct accountability towards the public. In this rural health district with few (international) non-governmental organisations and private sector providers, accountability linkages towards management and partners in health programmes were found to be strong. Direct accountability towards the public, however, was woefully underdeveloped. This study shows that in settings where there is a small number of actors involved in organising health care, and where the state actors are underfunded, the intense interaction can lead to a web of relations that favours collaboration between partners in health service delivery, but fails public accountability. It is clear that new formal channels need to be created by all actors involved in health service delivery to address the demand of the public for accountability. If the public does not find an adequate response to its genuine concerns, distrust between communities and service users on one hand, and providers, international non-governmental organisations and District Health Management Teams on the other is likely to increase to the detriment of all parties' interests.

Institutional change and political decision-making in the creation of the Brazilian National Health Surveillance Agency.

PubMed

Piovesan, Márcia Franke; Labra, Maria Eliana

2007-06-01

This article examines the decision-making process that led to the creation of the Brazilian National Health Surveillance Agency (ANVISA) in 1999. The authors begin by discussing the history of the Agency's predecessor, the Health Surveillance Secretariat, and the need for its modernization to adjust the quality of the products under its control to domestic and international demands. From the theoretical perspective of neo-institutionalism, the article goes on to analyze the social and political context surrounding the debate on the proposed alternatives to adjust Health Surveillance to new rules in line with such requirements, focusing especially on the formulation of the new policy, the decision-making arena, and the actors with specific interests in the sector. The research drew on extensive documentary and media material, plus interviews with key actors. The article concludes that a determinant factor for the creation of ANVISA was the favorable domestic political context, fostering a positive correlation of forces that (in an extremely short timeframe, 1998-1999) allowed the creation of the first regulatory agency in the social policies area in Brazil.

Partnership in Knowledge Creation: Lessons Learned from a Researcher-Policy Actor Partnership to Co-Produce a Rapid Appraisal Case Study of South Australia's Social Inclusion Initiative

ERIC Educational Resources Information Center

Newman, Lareen; Biedrzycki, Kate; Patterson, Jan; Baum, Fran

2011-01-01

This paper describes a partnership between researchers and policy actors that was developed within a short timeframe to produce a rapid appraisal case study of a government policy initiative--South Australia's "Social Inclusion Initiative"--for the Social Exclusion Knowledge Network of the international Commission on Social Determinants…

Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process.

PubMed

McDougall, Lori

2016-01-30

Advocacy coalitions play an increasingly prominent role within the global health landscape, linking actors and institutions to attract political attention and resources. This paper examines how coalitions negotiate among themselves and exercise hidden forms of power to produce policy on the basis of their beliefs and strategic interests. This paper examines the beliefs and behaviours of health advocacy coalitions using Sabatier's Advocacy Coalition Framework (ACF) as an informal theoretical lens. Coalitions are further explored in relation to the concept of transnational advocacy networks (Keck and Sikkink) and of productive power (Shiffman). The ACF focuses on explaining how policy change takes place when there is conflict concerning goals and technical approaches among different actors. This study uses participant observation methods, self-reported survey results and semi-structured qualitative interviews to trace how a major policy project of the Millennium Development Goal (MDG) era, the Global Strategy for Women's and Children's Health, was constructed through negotiations among maternal, newborn, and child health (MNCH) and sexual and reproductive health and rights (SRHR) advocacy coalitions. The Global Strategy represented a new opportunity for high-level political attention. Despite differing policy beliefs, MNCH and SRHR actors collaborated to produce this strategy because of anticipated gains in political attention. While core beliefs did not shift fundamentally and collaboration was primarily a short-term tactical response to a time-bound opportunity, MNCH actors began to focus more on human rights perspectives and SRHR actors adopted greater use of quantifiable indicators and economic argumentation. This shift emphasises the inherent importance of SRHR to maternal and child health survival. As opportunities arise, coalitions respond based on principles and policy beliefs, as well as to perceptions of advantage. Global health policy-making is an arena of contested interests, power and ideas, shaped by the interaction of coalitions. Although policy-making is often seen as a process that should be guided by evidence rather than interest-based politics, this study concludes that a participatory process of debate among different actor-coalitions is vital to progress and can lend greater legitimacy, accountability and transparency to the policy process. © 2016 by Kerman University of Medical Sciences.

Science-policy processes for transboundary water governance.

PubMed

Armitage, Derek; de Loë, Rob C; Morris, Michelle; Edwards, Tom W D; Gerlak, Andrea K; Hall, Roland I; Huitema, Dave; Ison, Ray; Livingstone, David; MacDonald, Glen; Mirumachi, Naho; Plummer, Ryan; Wolfe, Brent B

2015-09-01

In this policy perspective, we outline several conditions to support effective science-policy interaction, with a particular emphasis on improving water governance in transboundary basins. Key conditions include (1) recognizing that science is a crucial but bounded input into water resource decision-making processes; (2) establishing conditions for collaboration and shared commitment among actors; (3) understanding that social or group-learning processes linked to science-policy interaction are enhanced through greater collaboration; (4) accepting that the collaborative production of knowledge about hydrological issues and associated socioeconomic change and institutional responses is essential to build legitimate decision-making processes; and (5) engaging boundary organizations and informal networks of scientists, policy makers, and civil society. We elaborate on these conditions with a diverse set of international examples drawn from a synthesis of our collective experiences in assessing the opportunities and constraints (including the role of power relations) related to governance for water in transboundary settings.

Actor interfaces and practices of power in a community health worker programme: a South African study of unintended policy outcomes.

PubMed

Lehmann, Uta; Gilson, Lucy

2013-07-01

This paper makes a contribution to a much-neglected aspect of policy analysis: the practice of power in implementation. Practices of power are at the heart of every policy process, yet are rarely explicitly explored in the health policy literature. This paper provides a detailed study of micro-practices of power by those at the frontline of service delivery in the implementation of a national community health worker policy in one rural South African sub-district. The paper is based on a small-scale qualitative study which collected data through observations, interviews and focus group discussions with health services and facility managers, community health workers and community members. Practices of power were analysed using VeneKlasen and Miller's categorization of multiple dimensions of power, as power over, power with, power to and power within. Furthermore, the concept of 'actor interface analysis' allowed exploration of different actors' experience, interests and their specific location in the landscape of local health system governance. The study revealed that almost all policy actors exercised some form of power, from authoritative power, derived from hierarchy and budget control, to the discretionary power of those working at lower levels to withhold labour or organize in-service training. Each of these practices of power had their rationale in different actors' efforts to make the intervention 'fit' their understandings of local reality. While each had a limited impact on policy outcomes, their cumulative effect produced a significant thinning down of the policy's intent. However, discretionary power was not always used to undermine policy. One manager's use of discretionary power in fact led to a partial reconstruction of the original policy intent. The paper concludes that understanding and being responsive to the complexity of local realities, interests and contexts and the multi-layered practices of power may allow managers to adopt more appropriate management strategies.

Are we expecting too much from print media? An analysis of newspaper coverage of the 2002 Canadian healthcare reform debate.

PubMed

Collins, Patricia A; Abelson, Julia; Pyman, Heather; Lavis, John N

2006-07-01

News media effects on their audiences are complex. Four commonly cited effects are: informing audiences; agenda-setting; framing; and persuading. The release in autumn 2002 of two reports on options for reforming Canada's healthcare system attracted widespread media attention. We explored the potential for each of the four media effects by examining Canadian newspaper representation of this healthcare policy debate. Clippings were gathered from regional and national newspapers. Two data collection methodologies were employed: the first involved two staggered "constructed weeks" designed to capture thematic news framing styles; the second collected "intensive" or episodic coverage immediately following the report releases. Health reform articles with a financing and/or delivery focus were included. Using a codebook, articles were coded to track article characteristics, tone, healthcare sector and reform themes, and key actors. A greater quantity of episodic (n=341 clippings) versus thematic coverage (n=77) was documented. Coverage type did not vary significantly by newspaper, reporting source (e.g., staff reporter versus staff editorialist) or article type (e.g., news versus letter). Thematic articles were significantly shorter in length compared to episodic clippings. Episodic coverage tended to have a positive tone, while thematic coverage ranged in tone. Most coverage was general in scope. Sector-specific coverage favoured physician and hospital care--the two providers accorded privileged financing arrangements under Canada's universal, provincially administered health-insurance plans. Coverage of healthcare financing arrangements favoured broad discussions of publicly financed healthcare, federal-provincial governmental relations, and the Canada Health Act that governs provincial plans. Governmental actors and the political institutions that they represent were the dominant actors. Professional associations were also visible, but played a less dominant role. Given its non-specific scope, it is unclear how informative this coverage was. The large quantity and short duration of the episodic coverage, and the preponderance of governmental actors, suggests these newspapers acted as conduits for the policy agenda. Differences in framing styles were observed by coverage type, newspaper, reporting source, article length and type of article. Finally, the dominance of governmental actors provided these actors with numerous opportunities to persuade the public.

Being around and knowing the players: networks of influence in health policy.

PubMed

Lewis, Jenny M

2006-05-01

The accumulation and use of power is crucial to the health policy process. This paper examines the power of the medical profession in the health policy arena, by analysing which actors are perceived as influential, and how influence is structured in health policy. It combines an analysis of policy networks and social networks, to examine positional and personal influence in health policy in the state of Victoria, Australia. In the sub-graph of the influence network examined here, those most widely regarded as influential are academics, medically qualified and male. Positional actors (the top politician, political advisor and bureaucrat in health and the top nursing official) form part of a core group within this network structure. A second central group consists of medical influentials working in academia, research institutes and health-related NGOs. In this network locale overall, medical academics appear to combine positional and personal influence, and play significant intermediary roles across the network. While many claim that the medical profession has lost power in health policy and politics, this analysis yields few signs that the power of medicine to shape the health policy process has been greatly diminished in Victoria. Medical expertise is a potent embedded resource connecting actors through ties of association, making it difficult for actors with other resources and different knowledge to be considered influential. The network concepts and analytical techniques used here provide a novel means for uncovering different types of influence in health policy.

The role of policy actors and contextual factors in policy agenda setting and formulation: maternal fee exemption policies in Ghana over four and a half decades.

PubMed

Koduah, Augustina; van Dijk, Han; Agyepong, Irene Akua

2015-05-30

Development of health policy is a complex process that does not necessarily follow a particular format and a predictable trajectory. Therefore, agenda setting and selecting of alternatives are critical processes of policy development and can give insights into how and why policies are made. Understanding why some policy issues remain and are maintained whiles others drop off the agenda is an important enquiry. This paper aims to advance understanding of health policy agenda setting and formulation in Ghana, a lower middle-income country, by exploring how and why the maternal (antenatal, delivery and postnatal) fee exemption policy agenda in the health sector has been maintained over the four and half decades since a 'free antenatal care in government facilities' policy was first introduced in October 1963. A mix of historical and contemporary qualitative case studies of nine policy agenda setting and formulation processes was used. Data collection methods involved reviews of archival materials, contemporary records, media content, in-depth interviews, and participant observation. Data was analysed drawing on a combination of policy analysis theories and frameworks. Contextual factors, acting in an interrelating manner, shaped how policy actors acted in a timely manner and closely linked policy content to the intended agenda. Contextual factors that served as bases for the policymaking process were: political ideology, economic crisis, data about health outcomes, historical events, social unrest, change in government, election year, austerity measures, and international agendas. Nkrumah's socialist ideology first set the agenda for free antenatal service in 1963. This policy trajectory taken in 1963 was not reversed by subsequent policy actors because contextual factors and policy actors created a network of influence to maintain this issue on the agenda. Politicians over the years participated in the process to direct and approve the agenda. Donors increasingly gained agenda access within the Ghanaian health sector as they used financial support as leverage. Influencers of policy agenda setting must recognise that the process is complex and intertwined with a mix of political, evidence-based, finance-based, path-dependent, and donor-driven processes. Therefore, influencers need to pay attention to context and policy actors in any strategy.

Evolving norms at the intersection of health and trade.

PubMed

Drope, Jeffrey; Lencucha, Raphael

2014-06-01

There has been growing tension at the intersection of health and economic policy making as global governance has increased across sectors. This tension has been particularly evident between tobacco control and trade policy, as the international norms that frame them -- particularly the Framework Convention on Tobacco Control and the World Trade Organization (WTO) -- have continued to institutionalize. Using five case studies of major tobacco-related trade disputes from the principal multilateral system of trade governance -- the WTO/General Agreement on Tariffs and Trade -- we trace the evolution of these interacting norms over nearly twenty-five years. Our analytic framework focuses on the actors that advance, defend, and challenge these norms. We find that an increasingly broad network, which includes governments, intergovernmental organizations, nongovernmental organizations, and members of the epistemic community, is playing a more active role in seeking to resolve these tensions. Moreover, key economic actors are beginning to incorporate health more actively into their messaging and activities. We also demonstrate that the most recent resonant messages reflect a more nuanced integration of the two norms. The tobacco control example has direct relevance to related policy areas, including environment, safety, access to medicines, diet, and alcohol. Copyright © 2014 by Duke University Press.

The social interaction of return to work explored from co-workers experiences.

PubMed

Tjulin, Åsa; MacEachen, Ellen; Stiwne, Elinor Edvardsson; Ekberg, Kerstin

2011-01-01

The objective was to explore the role and contribution of co-workers in the return-to-work process. The social interaction of co-workers in the return-to-work process are analysed within the framework of the Swedish national and local employer organisational return-to-work policies. An exploratory qualitative method was used, consisting of open-ended interviews with 33 workplace actors across seven work units. Organisational return-to-work policies were collected from the three public sector employers. The key findings that emerged during analysis showed that some co-workers have a more work-task oriented approach towards the return-to-work process, whilst others had a more social relational approach. In both situations, the social relations worked hand in hand with job tasks (how task were allocated, and how returning workers were supported by others) and could make or break the return-to-work process. A suggestion for improvement of return-to-work models and policies is the need to take into account the social relations amongst workplace actors, especially involving co-workers when planning for return-to-work interventions. Otherwise the proper attention to work arrangements, social communication and the role of co-workers in the return-to-work process might not be seen.

Uptake of evidence in policy development: the case of user fees for health care in public health facilities in Uganda.

PubMed

Nabyonga-Orem, Juliet; Ssengooba, Freddie; Mijumbi, Rhona; Tashobya, Christine Kirunga; Marchal, Bruno; Criel, Bart

2014-12-18

Several countries in Sub Saharan Africa have abolished user fees for health care but the extent to which such a policy decision is guided by evidence needs further exploration. We explored the barriers and facilitating factors to uptake of evidence in the process of user fee abolition in Uganda and how the context and stakeholders involved shaped the uptake of evidence. This study builds on previous work in Uganda that led to the development of a middle range theory (MRT) outlining the main facilitating factors for knowledge translation (KT). Application of the MRT to the case of abolition of user fees contributes to its refining. Employing a theory-driven inquiry and case study approach given the need for in-depth investigation, we reviewed documents and conducted interviews with 32 purposefully selected key informants. We assessed whether evidence was available, had or had not been considered in policy development and the reasons why and; assessed how the actors and the context shaped the uptake of evidence. Symbolic, conceptual and instrumental uses of evidence were manifest. Different actors were influenced by different types of evidence. While technocrats in the ministry of health (MoH) relied on formal research, politicians relied on community complaints. The capacity of the MoH to lead the KT process was weak and the partnerships for KT were informal. The political window and alignment of the evidence with overall government discourse enhanced uptake of evidence. Stakeholders were divided, seemed to be polarized for various reasons and had varying levels of support and influence impacting the uptake of evidence. Evidence will be taken up in policy development in instances where the MoH leads the KT process, there are partnerships for KT in place, and the overall government policy and the political situation can be expected to play a role. Different actors will be influenced by different types of evidence and their level of support and influence will impact the uptake of evidence. In addition, the extent to which a policy issue is contested and, whether stakeholders share similar opinions and preferences will impact the uptake of evidence.

A network approach for researching political feasibility of healthcare reform: the case of universal healthcare system in Taiwan.

PubMed

Wang, Guang-Xu

2012-12-01

This study evaluates the political feasibility of healthcare reform taking place in Taiwan in the past decade. Since Taiwan adopted National Health Insurance (NHI) in 1995, it has provided coverage for virtually all of the island's citizens. However, the imbalance between expenditure and revenue has resulted in a cycle of unsustainable spending which has necessitated financial reforms and political confrontations. By applying social network analysis, this paper examines multiple types of ties between policy elites and power distribution that have evolved in crucial policy events of the NHI's financial reforms between 1998 and 2010. Data sources include official documents and 62 social network interviews that were held with government officials and related unofficial policy participants. Blockmodeling and multidimensional scaling (MDS) are used to determine the major participants and network structures in the NHI domain, as well as the influential policy actors, based on information transmission, resource exchange, reputation attribution and action-set coalition networks in Taiwan's current political situation. The results show that although both public actors and all medical associations are the leading actors in the NHI reform, without good communication with societal actors, the promotion of reform proposals ends in failure. As a tool of political feasibility evaluation, social network analysis can map the political conflict between policy stakeholders systematically when policy makers pursue the result of policy adoption. Copyright © 2012 Elsevier Ltd. All rights reserved.

Whose policy is it anyway? International and national influences on health policy development in Uganda.

PubMed

Okuonzi, S A; Macrae, J

1995-06-01

As national resources for health decline, so dependence on international resources to finance the capital and recurrent costs is increasing. This dependence, combined with an increasing emphasis on policy-based, as opposed to project-based, lending and grant-making has been accompanied by greater involvement of international actors in the formation of national health policy. This paper explores the process of health policy development in Uganda and examines how major donors are influencing and conflicting with national policy-making bodies. Focusing on two examples of user fees and drugs policies, it argues that while the content of international prescriptions to strengthen the health system may not be bad in itself, the process by which they are applied potentially threatens national sovereignty and weakens mechanisms for ensuring accountability. It concludes by proposing that in order to increase the sustainability of policy reforms, much greater emphasis should be placed on strengthening national capacity for policy analysis and research, building up policy networks and enhancing the quality of information available to the public concerning key policy changes.

Involving new actors to achieve ART scaling-up: difficulties in an HIV/AIDS counselling and testing centre in Cameroon.

PubMed

Yakam, J C Y Tantchou; Gruénais, M-E

2009-03-01

The high HIV/AIDS-related mortality among young adults is devastating countries in sub-Saharan Africa. The implementing capacity of the health systems is the main limiting factor of antiretroviral treatment (ART) scaling-up;(1) this capacity depends mainly on the health workforce. Tackling the issue of human resources for health is thus of paramount importance to achieve universal access to ART and for the survival of health systems in time of AIDS. To support such a process, the World Health Organization stresses the importance of task shifting(2) from medical doctors to nurses and from nurses to community health workers. Such task shifting is not easy to achieve but undoubtedly needed. This paper raises issues about the involvement of new actors(3) without precise redefinitions of roles and task-shifting procedures. We take the example of a 'Centre de Prévention et de Dépistage Volontaire du VIH/sida'(4) in one major town of the Far-North province of Cameroon (Central Africa). The study was qualitative. Observations were carried out in the service and in-depth interviews conducted with health workers and actors of Cameroon's National AIDS Control Committee. These interviews were recorded and transcribed. The material was analysed using keywords. KEY RESULT: The involvement of new actors in a context of human resources for health shortage and health system crisis creates confusion and role conflicts, which lead to frustration. It favours the appearance of chinks within which these new actors slip and 'find their way' in the system; it finally raises problems related to their legitimacy and position within the existing hierarchy. KEY POLICY MESSAGE: It is necessary, when involving new staff members (particularly when they do not belong to internationally recognized health professionals such as nurses, doctors and pharmacists), to redefine roles and build precise task-shifting procedures so that everyone may still have a place in the whole system and feel useful.

Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process

PubMed Central

McDougall, Lori

2016-01-01

Background: Advocacy coalitions play an increasingly prominent role within the global health landscape, linking actors and institutions to attract political attention and resources. This paper examines how coalitions negotiate among themselves and exercise hidden forms of power to produce policy on the basis of their beliefs and strategic interests. Methods: This paper examines the beliefs and behaviours of health advocacy coalitions using Sabatier’s Advocacy Coalition Framework (ACF) as an informal theoretical lens. Coalitions are further explored in relation to the concept of transnational advocacy networks (Keck and Sikkink) and of productive power (Shiffman). The ACF focuses on explaining how policy change takes place when there is conflict concerning goals and technical approaches among different actors. This study uses participant observation methods, self-reported survey results and semi-structured qualitative interviews to trace how a major policy project of the Millennium Development Goal (MDG) era, the Global Strategy for Women’s and Children’s Health, was constructed through negotiations among maternal, newborn, and child health (MNCH) and sexual and reproductive health and rights (SRHR) advocacy coalitions. Results: The Global Strategy represented a new opportunity for high-level political attention. Despite differing policy beliefs, MNCH and SRHR actors collaborated to produce this strategy because of anticipated gains in political attention. While core beliefs did not shift fundamentally and collaboration was primarily a short-term tactical response to a time-bound opportunity, MNCH actors began to focus more on human rights perspectives and SRHR actors adopted greater use of quantifiable indicators and economic argumentation. This shift emphasises the inherent importance of SRHR to maternal and child health survival. Conclusion: As opportunities arise, coalitions respond based on principles and policy beliefs, as well as to perceptions of advantage. Global health policy-making is an arena of contested interests, power and ideas, shaped by the interaction of coalitions. Although policy-making is often seen as a process that should be guided by evidence rather than interest-based politics, this study concludes that a participatory process of debate among different actor-coalitions is vital to progress and can lend greater legitimacy, accountability and transparency to the policy process. PMID:27239880

Public Health Knowledge Utilisation by Policy Actors: An Evaluation Study in Midden-Holland, the Netherlands

ERIC Educational Resources Information Center

de Goede, Joyce; Steenkamer, Betty; Treurniet, Henriëtte; Putters, Kim; van Oers, Hans

2011-01-01

A comprehensive report has been prepared on the state of public health and healthcare in the Midden-Holland region of the Netherlands. This study describes the development of the report and the mechanisms behind public health knowledge utilisation by three groups of health policy actors: local authorities, public health professionals and regional…

Managing the Dynamics of the Bologna Reforms: How Institutional Actors Re-Construct the Policy Framework

ERIC Educational Resources Information Center

Veiga, Amélia; Neave, Guy

2015-01-01

How do the constituencies in higher education re-interpret Bologna's function with regard to the European Higher Education Area? This research examines how institutional actors re-construct the policy framework in the light of their own institutional agendas. Drawing on empirical data from a survey of academics, students and administrative and…

An Anatomy of Authority: The Bologna and ASEM Education Secretariats as Policy Actors and Region Builders

ERIC Educational Resources Information Center

Dang, Que Anh

2018-01-01

This paper examines the sources of authority behind the Bologna and ASEM secretariats' technocratic appearance and administrative routines, and argues that they are transnational policy actors in their own right. By drawing on principal-agent theory and the concept of "authority," it offers an alternative framework for understanding the…

Lifelong Learning in the EU: Changing Conceptualisations, Actors, and Policies

ERIC Educational Resources Information Center

Volles, Nina

2016-01-01

This paper explores the changing conceptualisations, actors, and policies of lifelong learning (LLL) in the European Union (EU) from the time the topic first emerged and was promoted by international organisations in the 1960s. The author uses Kingdon's Multiple Streams Framework to analyse how the LLL discourse became an important part of the EU…

U.S. Foreign Policy in Southern Africa

DTIC Science & Technology

1980-06-01

Union Carter Foreign Policy - Africa United States Foreign Policy Carter - World View u.s. - Soviet Relatio n s AaSTI’ACT (Cotttl-- reY«aa elde II... International boundarie5 0 I 0 Railway5 SOO Kilometers I SOO Miles •:rce: International Institute for Strate&ic Studies, Stratezk Sur11r...collective actor in international affairs, we are the individual actor in domestic affairs and politics and the receptor-spectator of what we see or think

Urban gray vs. urban green vs. soil protection — Development of a systemic solution to soil sealing management on the example of Germany

DOE Office of Scientific and Technical Information (OSTI.GOV)

Artmann, Martina, E-mail: m.artmann@ioer.de

Managing urban soil sealing is a difficult venture due to its spatial heterogeneity and embedding in a socio-ecological system. A systemic solution is needed to tackle its spatial, ecological and social sub-systems. This study develops a guideline for urban actors to find a systemic solution to soil sealing management based on two case studies in Germany: Munich and Leipzig. Legal-planning, informal-planning, economic-fiscal, co-operative and informational responses were evaluated by indicators to proof which strategy considers the spatial complexity of urban soil sealing (systemic spatial efficiency) and, while considering spatial complexity, to assess what the key management areas for action aremore » to reduce the ecological impacts by urban soil sealing (ecological impact efficiency) and to support an efficient implementation by urban actors (social implementation efficiency). Results suggest framing the systemic solution to soil sealing management through a cross-scale, legal-planning development strategy embedded in higher European policies. Within the socio-ecological system, the key management area for action should focus on the protection of green infrastructure being of high value for actors from the European to local scales. Further efforts are necessary to establish a systemic monitoring concept to optimize socio-ecological benefits and avoid trade-offs such as between urban infill development and urban green protection. This place-based study can be regarded as a stepping stone on how to develop systemic strategies by considering different spatial sub-targets and socio-ecological systems. - Highlights: • Urban soil sealing management is spatially complex. • The legal-planning strategy supports a systemic sealing management. • Urban green infrastructure protection should be in the management focus. • Soil protection requires policies from higher levels of government. • A systemic urban soil sealing monitoring concept is needed.« less

The Governance of Indigenous Natural Products in Namibia: A Policy Network Analysis.

PubMed

Ndeinoma, Albertina; Wiersum, K Freerk; Arts, Bas

2018-01-09

At the end of the 20th century, optimism existed that non-timber forest products (NTFPs) can form an integral part in conservation and development strategies. However, there is limited knowledge on how the different stakeholders could relate to the state or to each other in promoting commercialization of NTFPs. Applying the policy network as an analytical framework, we investigated the structural patterns of actor relations in the governance structure of indigenous natural products (INPs) in Namibia, to understand the implications of such relations on INP policy process. The findings indicate that the INP policy network in Namibia is multi-dimensional, consisting of the Indigenous Plant Task Team (IPTT)-the key governance structure for resource mobilization and information sharing; and functional relations which serve specific roles in the INP value chain. The existing relations have facilitated policy development particularly for heavily regulated species, such as devil's claw; but for other species, only incremental changes are observed in terms of small-scale processing facilities for value addition and exclusive purchase agreements for sustainable sourcing of INPs. Participation of primary producers, private actors and quality standardization bodies is limited in INPs governance structures, which narrow the scope of information sharing. Consequently, despite that the IPTT has fostered publicly funded explorative pilot projects, ranging from production to marketing of INPs, there are no clear guidelines how these projects results can be transferred to private entities for possible commercialization. Further collaboration and information sharing is needed to guide public sector relations with the private entities and cooperatives.

Inherit the policy: A sociocultural approach to understanding evolutionary biology policy in South Carolina

NASA Astrophysics Data System (ADS)

Moore, Gregory D.

South Carolina biology Indicator 5.6 calls for students to "Summarize ways that scientists use data from a variety of sources to investigate and critically analyze aspects of evolutionary theory" (South Carolina Department of Education, 2006). Levinson and Sutton (2001) offered a sociocultural approach to policy that considers cultural and historical influences at all levels of the policy process. Lipsky (1980/2010) and others have identified teachers as de facto policy makers, exercising broad discretion in the execution of their work. This study looks to Ajzen's Theory of Planned Behavior as an initial framework to inform how evolutionary biology policy in South Carolina is conceptualized and understood at different levels of the policy process. The results of this study indicate that actors in the state's evolutionary biology policy process draw upon a myriad of Discourses (Gee, 1999/2005). These Discourses shape cultural dynamics and the agency of the policy actors as they navigate conflicting messages between testing mandates and evolutionary biology policy. There indeed exist gaps between how evolutionary biology policy in South Carolina is conceptualized and understood at the different levels of the policy process. Evidence from this study suggests that appropriation-level policy actors must be brought into the Discourse related to the critical analysis of evolutionary biology and academic freedom legislation must be enacted if South Carolina biology Indicator 5.6 is to realize practical significance in educational policy.

Exploring Scientific Information for Policy Making under Deep Uncertainty

NASA Astrophysics Data System (ADS)

Forni, L.; Galaitsi, S.; Mehta, V. K.; Escobar, M.; Purkey, D. R.; Depsky, N. J.; Lima, N. A.

2016-12-01

Each actor evaluating potential management strategies brings her/his own distinct set of objectives to a complex decision space of system uncertainties. The diversity of these objectives require detailed and rigorous analyses that responds to multifaceted challenges. However, the utility of this information depends on the accessibility of scientific information to decision makers. This paper demonstrates data visualization tools for presenting scientific results to decision makers in two case studies, La Paz/ El Alto, Bolivia, and Yuba County,California. Visualization output from the case studies combines spatiotemporal, multivariate and multirun/multiscenario information to produce information corresponding to the objectives defined by key actors and stakeholders. These tools can manage complex data and distill scientific information into accessible formats. Using the visualizations, scientists and decision makers can navigate the decision space and potential objective trade-offs to facilitate discussion and consensus building. These efforts can support identifying stable negotiatedagreements between different stakeholders.

Economists, capitalists, and the making of globalization: North American free trade in comparative-historical perspective.

PubMed

Fairbrother, Malcolm

2014-03-01

Why did globalization happen? Current explanations point to a variety of conditions under which states have made the free market policy changes driving international economic integration since the 1980s. Such accounts disagree, however, about the key actors involved. This article provides a reconciliation, showing how two different combinations of actors, and two different political economic pathways, have led to globalization in recent decades. In developed countries, mobilization by business has been central; elsewhere, technocrats both constrained and empowered by international finance have pursued globalization more independently of business. In both contexts, economists' technical authority has helped legitimate liberalization, despite the limited diffusion of their ideas. The article validates and elaborates this model using a comparative-historical study of how the United States, Canada, and Mexico proposed, negotiated, and ratified agreements for free trade in North America.

Discourse, ideas and power in global health policy networks: political attention for maternal and child health in the millennium development goal era.

PubMed

McDougall, Lori

2016-05-18

Maternal and child health issues have gained global political attention and resources in the past 10 years, due in part to their prominence on the Millennium Development Goal agenda and the use of evidence-based advocacy by policy networks. This paper identifies key factors for this achievement, and raises questions about prospective challenges for sustaining attention in the transition to the post-2015 Sustainable Development Goals, far broader in scope than the Millennium Development Goals. This paper relies on participant observation methods and document analysis to develop a case study of the behaviours of global maternal and child health advocacy networks during 2005-2015. The development of coordinated networks of heterogeneous actors facilitated the rise in attention to maternal and child health during the past 10 years. The strategic use of epidemiological and economic evidence by these networks enabled policy attention and promoted network cohesion. The time-bound opportunity of reaching the 2015 Millennium Development Goals created a window of opportunity for joint action. As the new post-2015 goals emerge, networks seek to sustain attention by repositioning their framing of issues, network structures, and external alliances, including with networks that lay both inside and outside of the health domain. Issues rise on global policy agendas because of how ideas are constructed, portrayed and positioned by actors within given contexts. Policy networks play a critical role by uniting stakeholders to promote persuasive ideas about policy problems and solutions. The behaviours of networks in issue-framing, member-alignment, and strategic outreach can force open windows of opportunity for political attention -- or prevent them from closing.

Evolving Norms at the Intersection of Health and Trade

PubMed Central

Drope, Jeffrey; Lencucha, Raphael

2014-01-01

There has been growing tension at the intersection of health and economic policymaking as global governance has increased across sectors. This tension has been particularly evident between tobacco control and trade policy, as the international norms that frame them – particularly the Framework Convention on Tobacco Control and the World Trade Organization (WTO) – have continued to institutionalize. Using five case studies of major tobacco-related trade disputes from the principal multilateral system of trade governance – the WTO/General Agreement on Tariffs and Trade – we trace the evolution of these interacting norms over nearly 25 years. Our analytic framework particularly focuses on the actors that advance, defend and challenge these norms. We find that an increasingly broad network, which includes governments, intergovernmental organizations, non-governmental organizations and members of the epistemic community, is playing a more active role in seeking to resolve these tensions. Moreover, key economic actors are beginning to incorporate health more actively in their messaging and activities. We also demonstrate that the most recent resonant messages reflect a more nuanced integration of the two norms. The tobacco control example has direct relevance to related policy areas, including environment, safety, access to medicines, diet, and alcohol. PMID:24603086

Commentary: Moving towards policy coherence in trade and health.

PubMed

Walls, Helen; Baker, Phillip; Smith, Richard

2015-11-01

International trade has brought economic benefits to many countries, but the association of trade and investment liberalisation with poor health outcomes concerns the public health community. The need to secure more 'healthy' trade is a recognised priority, especially as countries move from global to regional/bilateral trade agreements - with greater public health risks. However, a transition towards 'healthier trade' may be hindered by worldview differences between the trade and health communities. There is a tendency for health actors to perceive trade as a threat to population health, and for trade actors to view health as a constraint to trade objectives of reducing barriers to cross-border commercial flows and economic growth. Unless such differing worldviews can be aligned, finding ways forward for addressing public health in trade policy is likely to be difficult. Moving forward will involve understanding the values and drivers of the respective groups, and developing solutions palatable to their various interests. Given the power imbalances between the two areas, it is likely that the health community will have to make the first moves in this respect. This article outlines the key issues involved and suggests areas where such moves have been, and may be made.

What should we call instruments commonly known as payments for environmental services? A review of the literature and a proposal.

PubMed

Shelley, Barry G

2011-02-01

Researchers, policy makers, and practitioners have used various terms to describe instruments that reward the stewardship of ecosystem services that benefit "external" actors. Payments for environmental services, or PES, has been the predominant name. However, critics have challenged both the payments and environmental components of this nomenclature, most commonly proposing markets, compensation, or rewards as alternatives for the former, and ecosystem for the latter. Additional questions arise regarding what to call the agents directly involved in the transaction: sellers and buyers, or stewards and beneficiaries? For some, concerns about this terminology have emerged from so-called "pro-poor PES" debates that ask if actors could and should incorporate poverty alleviation goals into PES instruments. This review of the modulating use of terms and the arguments about which best fit theory and experience points to the key policy and ethical issues at stake as PES programs face critical and timely questions about the direction they will head. The author contends that the choices of terms will influence that direction and proposes a new alternative-rewards for ecosystem service stewardship (RESS)-that better encompasses pro-poor options. © 2011 New York Academy of Sciences.

Implementing multiple intervention strategies in Dutch public health-related policy networks.

PubMed

Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

2017-10-13

Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to implement an intervention mix. Data were collected (2009-14) from 29 Dutch public health policy networks. Surveys were used to identify the number of policy sectors, participation of actors, level of trust, networking by the project leader, and intervention strategies implemented. Conditions sufficient for an intervention mix (≥3 of 4 non-educational strategies present) were determined in a fuzzy-set qualitative comparative analysis. A multisectoral policy network (≥7 of 14 sectors present) was neither a necessary nor a sufficient condition. In multisectoral networks, additionally required was either the active participation of network actors (≥50% actively involved) or active networking by the project leader (≥monthly contacts with network actors). In policy networks that included few sectors, a high level of trust (positive perceptions of each other's intentions) was needed-in the absence though of any of the other conditions. If the network actors were also actively involved, an extra requirement was active networking by the project leader. We conclude that the multisectoral composition of policy networks can contribute to the implementation of a variety of intervention strategies, but not without additional efforts. However, policy networks that include only few sectors are also able to implement an intervention mix. Here, trust seems to be the most important condition. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Challenges in diabetology research in India.

PubMed

Jena, Swarup; Mishra, Brijesh; Yadav, Anamika; Desai, Pranav

2018-05-01

Diabetes emerges out to be a major epidemic in recent years that engulfs both developed and developing countries across the globe. India, a country witnessing rapid socioeconomic progress and urbanization carries a considerable share of the global diabetes burden. There has been an incongruity between disease burden and the technical capacity to make use of existing knowledge or to generate new knowledge to combat diabetes in India. This paper examines the role of different actors, organizations & institutions in shaping diabetology research in India using arrays of scientific indicators such as research output (publications and patents), research finance and role of policy-making bodies. This paper also identifies research gaps and challenges pertinent to this sector. A combination of three methods patent data analysis, publication data analysis and primary survey corroborated with secondary data to obtain desire objectives. We made an in-depth study of the patent and publication data (2000-2016) to know the research output and direction of Indian actors, institutions and organizations in the area of diabetes research. This paper identifies some key structural barriers and institutional challenges pertinent to diabetology research in India that will help in canvassing and formulating science, technology and policy guidelines for diabetology research in India CONCLUSION: Multilevel intervention requires bridging the gap between knowledge and action hence policy-making should align to balance resources with innovation capabilities. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Institutional policy learning and public consultation: the Canadian xenotransplantation experience.

PubMed

Jones, Mavis; Einsiedel, Edna

2011-09-01

Attempts to evaluate public consultations, participatory technology assessment, and deliberative democracy have typically considered impacts on either policy or participants. The determination of impacts on policy institutions has been limited due to the challenges of tracing effects through the policy process, or penetrating bureaucratic walls. This paper presents findings from a retrospective study exploring the institutional lessons learned from a 2001 Canadian national public consultation on xenotransplantation. The consultation was conducted through an arm's-length process and involved the use of citizen juries in six regional sites. We conducted in-depth interviews of regulatory and policy actors who were engaged in early policy discussions and the consultation process. We reviewed evaluations of this process, both internal and external, which gave us richer insights into what institutional actors saw as the impacts of this consultative experience on their policy environment. Participants in our research identified a broader shift toward openness in policy culture which they linked specifically to the innovative consultation process employed for xenotransplantation. We argue that beyond input into policy decisions, a consultation may have an impact in terms of its contribution to overall shifts in institutional culture (related to institutional learning), such as an "opening" of technological decision processes to a broader range of actors, knowledge, and values. Copyright © 2011 Elsevier Ltd. All rights reserved.

Policy content and stakeholder network analysis for infant and young child feeding in India.

PubMed

Puri, Seema; Fernandez, Sylvia; Puranik, Amrita; Anand, Deepika; Gaidhane, Abhay; Quazi Syed, Zahiruddin; Patel, Archana; Uddin, Shahadat; Thow, Anne Marie

2017-06-13

Over the last decade, infant and young child feeding (IYCF) indicators in India have improved. However, poor IYCF practices are still apparent, associated with pervasive high rates of child under-nutrition. Interventions to improve IYCF need augmentation by appropriate policy support to consolidate gains. The aim of this study was to identify opportunities to strengthen and support IYCF policies through a policy content and stakeholder network analysis. IYCF policies and guidelines were systematically mapped and coded using predetermined themes. Six 'net-map' group interviews were conducted for stakeholder analysis with data analyzed using ORA (organizational risk analyzer, copyright Carley, Carnegie Mellon University) software. The study was carried out at a national level and in the states of Maharashtra and unified Andhra Pradesh. Thirty relevant policy documents were identified. Support for IYCF was clearly apparent and was actioned within sectoral policies and strategic plans. We identified support for provision of information to mothers and caregivers in both sectoral and high-level/strategic policy documents. At a sectoral level, there was support for training health care workers and for enabling mothers to access IYCF. Opportunities to strengthen policy included expanding coverage and translating policy goals into implementation level documents. At the national level, Ministry of Women and Child Development [MoWCD], Ministry of Health and Family Welfare [MoHFW] and the Prime Minister's Nutrition Council [PMNC] were the most influential actors in providing technical support while MoHFW, MoWCD, and Bill Melinda Gates Foundation were the most influential actors in providing funding and were therefore influential stakeholders in shaping IYCF policies and programs. We identified a wide range of strengths in the IYCF policy environment in India and also opportunities for improvement. One key strength is the integration of IYCF policies into a range of agendas and guidelines related to health and child development service delivery at the national and state level. However, the lack of a specific national policy on IYCF means that there is no formal mechanism for review and monitoring implementation across sectors and jurisdictions. Another opportunity identified is the development of IYCF policy guidelines in emergencies and for tribal populations.

Lessons from wind policy in Portugal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Peña, Ivonne; L. Azevedo, Inês; Marcelino Ferreira, Luís António Fialho

Wind capacity and generation grew rapidly in several European countries, such as Portugal. Wind power adoption in Portugal began in the early 2000s, incentivized by a continuous feed-in tariff policy mechanism, coupled with public tenders for connection licenses in 2001, 2002, and 2005. These policies led to an enormous success in terms of having a large share of renewables providing electricity services: wind alone accounts today for ~23.5% of electricity demand in Portugal. We explain the reasons wind power became a key part of Portugal's strategy to comply with European Commission climate and energy goals, and provide a detailed reviewmore » of the wind feed-in tariff mechanism. We describe the actors involved in wind power production growth. We estimate the environmental and energy dependency gains achieved through wind power generation, and highlight the correlation between wind electricity generation and electricity exports. Finally, we compare the Portuguese wind policies with others countries' policy designs and discuss the relevance of a feed-in tariff reform for subsequent wind power additions.« less

Drug policy constellations: A Habermasian approach for understanding English drug policy.

PubMed

Stevens, Alex; Zampini, Giulia Federica

2018-07-01

It is increasingly accepted that a view of policy as a rational process of fitting evidence-based means to rationally justified ends is inadequate for understanding the actual processes of drug policy making. We aim to provide a better description and explanation of recent English drug policy decisions. We develop the policy constellation concept from the work of Habermas, in dialogue with data from two contemporary debates in English policy; on decriminalisation of drug possession and on recovery in drug treatment. We collect data on these debates through long-term participant observation, stakeholder interviews (n = 15) and documentary analysis. We show the importance of social asymmetries in power in enabling structurally advantaged groups to achieve the institutionalisation of their moral preferences as well as the reproduction of their social and economic power through the deployment of policies that reflect their material interests and normative beliefs. The most influential actors in English drug policy come together in a 'medico-penal constellation', in which the aims and practices of public health and social control overlap. Formal decriminalisation of possession has not occurred, despite the efforts of members of a challenging constellation which supports it. Recovery was put forward as the aim of drug treatment by members of a more powerfully connected constellation. It has been absorbed into the practice of 'recovery-oriented' drug treatment in a way that maintains the power of public health professionals to determine the form of treatment. Actors who share interests and norms come together in policy constellations. Strategic action within and between constellations creates policies that may not take the form that was intended by any individual actor. These policies do not result from purely rational deliberation, but are produced through 'systematically distorted communication'. They enable the most structurally favoured actors to institutionalise their own normative preferences and structural positions. Copyright © 2018. Published by Elsevier B.V.

UNICEF's contribution to the adoption and implementation of option B+ for preventing mother-to-child transmission of HIV: a policy analysis.

PubMed

Chersich, M F; Newbatt, E; Ng'oma, K; de Zoysa, I

2018-06-01

Between 2011 and 2013, global and national guidelines for preventing mother-to-child transmission (PMTCT) of HIV shifted to recommend Option B+, the provision of lifelong antiretroviral treatment for all HIV-infected pregnant women. We aimed to analyse how Option B+ reached the policy agenda, and unpack the processes, actors and politics that explain its adoption, with a focus on examining UNICEF's contribution to these events. Analysis drew on published articles and other documentation, 30 key informants interviews with staff at UNICEF, partner organisations and government officials, and country case studies. Cameroon, India, South Africa and Zimbabwe were each visited for 5-8 days. Interview transcripts were analysed using Dedoose software, reviewed several times and then coded thematically. A national policy initiative in Malawi in 2011, in which the country adopted Option B+, rather than existing WHO recommended regimens, irrevocably placed the policy on the global agenda. UNICEF and other organisations recognised the policy's potential impact and strategically crafted arguments to support it, framing these around operational considerations, cost-effectiveness and values. As 'policy entrepreneurs', these organisations vigorously promoted the policy through a variety of channels and means, overcoming concerted opposition. WHO, on the basis of scanty evidence, released a series of documents towards the policy's endorsement, paving the way for its widespread adoption. National-level policy transformation was rapid and definitive, distinct from previous incremental policy processes. Many organisations, including UNICEF, facilitated these changes in country, acting individually, or in concert. The adoption of the Option B+ policy marked a departure from established processes for PMTCT policy formulation which had been led by WHO with the support of technical experts, and in which recommendations were developed following shifts in evidence. Rather, changes were spurred by a country-level initiative, and a set of strategically framed arguments that resonated with funders and country-level actors. This bottom-up approach, supported by normative agencies, was transformative. For UNICEF, alignment between the organisation's country focus and the policy's underpinning values, enabled it to work with partners and accelerate widespread policy change.

A policy framework for accelerating adoption of new vaccines

PubMed Central

Hajjeh, Rana; Wecker, John; Cherian, Thomas; O'Brien, Katherine L; Knoll, Maria Deloria; Privor-Dumm, Lois; Kvist, Hans; Nanni, Angeline; Bear, Allyson P; Santosham, Mathuram

2010-01-01

Rapid uptake of new vaccines can improve health and wealth and contribute to meeting Millennium Development Goals. In the past, however, the introduction and use of new vaccines has been characterized by delayed uptake in the countries where the need is greatest. Based on experience with accelerating the adoption of Hib, pneumococcal and rotavirus vaccines, we propose here a framework for new vaccine adoption that may be useful for future efforts. The framework organizes the major steps in the process into a continuum from evidence to policy, implementation and finally access. It highlights the important roles of different actors at various times in the process and may allow new vaccine initiatives to save time and improve their efficiency by anticipating key steps and actions. PMID:21150269

A policy framework for accelerating adoption of new vaccines.

PubMed

Levine, Orin S; Hajjeh, Rana; Wecker, John; Cherian, Thomas; O'Brien, Katherine L; Knoll, Maria Deloria; Privor-Dumm, Lois; Kvist, Hans; Nanni, Angeline; Bear, Allyson P; Santosham, Mathuram

2010-12-01

Rapid uptake of new vaccines can improve health and wealth and contribute to meeting Millennium Development Goals. In the past, however, the introduction and use of new vaccines has been characterized by delayed uptake in the countries where the need is greatest. Based on experience with accelerating the adoption of Hib, pneumococcal and rotavirus vaccines, we propose here a framework for new vaccine adoption that may be useful for future efforts. The framework organizes the major steps in the process into a continuum from evidence to policy, implementation and finally access. It highlights the important roles of different actors at various times in the process and may allow new vaccine initiatives to save time and improve their efficiency by anticipating key steps and actions.

A concept in flux: questioning accountability in the context of global health cooperation.

PubMed

Bruen, Carlos; Brugha, Ruairí; Kageni, Angela; Wafula, Francis

2014-12-09

Accountability in global health is a commonly invoked though less commonly questioned concept. Critically reflecting on the concept and how it is put into practice, this paper focuses on the who, what, how, and where of accountability, mapping its defining features and considering them with respect to real-world circumstances. Changing dynamics in global health cooperation - such as the emergence of new health public-private partnerships and the formal inclusion of non-state actors in policy making processes - provides the backdrop to this discussion. Accountability is frequently reduced to one set of actors holding another to account. Changes in the global health landscape and in relations between actors have however made the practice of accountability more complex and contested. Currently undergoing a reframing process, participation and transparency have become core elements of a new accountability agenda alongside evaluation and redress or enforcement mechanisms. However, while accountability is about holding actors responsible for their actions, the mechanisms through which this might be done vary substantially and are far from politically neutral.Accountability in global health cooperation involves multipolar relationships between a large number of stakeholders with varying degrees of power and influence, where not all interests are realised in that relationship. Moreover, accountability differs across finance, programme and governance subfields, where each has its own set of policy processes, institutional structures, accountability relations and power asymmetries to contend with. With reference to the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, this paper contributes to discussions on accountability by mapping out key elements of the concept and how it is put into practice, where different types of accountability battle for recognition and legitimacy. In mapping some defining features, accountability in global health cooperation is shown to be a complex problem not necessarily reducible to one set of actors holding another to account. Clear tensions are observed between multi-stakeholder participatory models and more traditional vertical models that prioritise accountability upwards to donors, both of which are embodied in initiatives like the Global Fund. For multi-constituency organisations, this poses challenges not only for future financing but also for future legitimacy.

Evolution of the knowledge system for agricultural development in the Yaqui Valley, Sonora, Mexico.

PubMed

McCullough, Ellen B; Matson, Pamela A

2016-04-26

Knowledge systems-networks of linked actors, organizations, and objects that perform a number of knowledge-related functions that link knowledge and know how with action-have played a key role in fostering agricultural development over the last 50 years. We examine the evolution of the knowledge system of the Yaqui Valley, Mexico, a region often described as the home of the green revolution for wheat, tracing changes in the functions of critical knowledge system participants, information flows, and research priorities. Most of the knowledge system's key players have been in place for many decades, although their roles have changed in response to exogenous and endogenous shocks and trends (e.g., drought, policy shifts, and price trends). The system has been agile and able to respond to challenges, in part because of the diversity of players (evolving roles of actors spanning research-decision maker boundaries) and also because of the strong and consistent role of innovative farmers. Although the agricultural research agenda in the Valley is primarily controlled from within the agricultural sector, outside voices have become an important influence in broadening development- and production-oriented perspectives to sustainability perspectives.

Evolution of the knowledge system for agricultural development in the Yaqui Valley, Sonora, Mexico

PubMed Central

McCullough, Ellen B.; Matson, Pamela A.

2016-01-01

Knowledge systems—networks of linked actors, organizations, and objects that perform a number of knowledge-related functions that link knowledge and know how with action—have played a key role in fostering agricultural development over the last 50 years. We examine the evolution of the knowledge system of the Yaqui Valley, Mexico, a region often described as the home of the green revolution for wheat, tracing changes in the functions of critical knowledge system participants, information flows, and research priorities. Most of the knowledge system's key players have been in place for many decades, although their roles have changed in response to exogenous and endogenous shocks and trends (e.g., drought, policy shifts, and price trends). The system has been agile and able to respond to challenges, in part because of the diversity of players (evolving roles of actors spanning research–decision maker boundaries) and also because of the strong and consistent role of innovative farmers. Although the agricultural research agenda in the Valley is primarily controlled from within the agricultural sector, outside voices have become an important influence in broadening development- and production-oriented perspectives to sustainability perspectives. PMID:21606365

Acting discursively: the development of UK organic food and farming policy networks.

PubMed

TOMLINSON, Isobel Jane

2010-01-01

This paper documents the early evolution of UK organic food and farming policy networks and locates this empirical focus in a theoretical context concerned with understanding the contemporary policy-making process. While policy networks have emerged as a widely acknowledged empirical manifestation of governance, debate continues as to the concept's explanatory utility and usefulness in situations of network and policy transformation since, historically, policy networks have been applied to "static" circumstances. Recognizing this criticism, and in drawing on an interpretivist perspective, this paper sees policy networks as enacted by individual actors whose beliefs and actions construct the nature of the network. It seeks to make links between the characteristics of the policy network and the policy outcomes through the identification of discursively constructed "storylines" that form a tool for consensus building in networks. This study analyses the functioning of the organic policy networks through the discursive actions of policy-network actors.

Knowledge and networks – key sources of power in global health

PubMed Central

Hanefeld, Johanna; Walt, Gill

2015-01-01

Shiffman rightly raises questions about who exercises power in global health, suggesting power is a complex concept, and the way it is exercised is often opaque. Power that is not based on financial strength but on knowledge or experience, is difficult to estimate, and yet it may provide the legitimacy to make moral claims on what is, or ought to be, on global health agendas. Twenty years ago power was exercised in a much less complex health environment. The World Health Organization (WHO) was able to exert its authority as world health leader. The landscape today is very different. Financial resources for global health are being competed for by diverse organisations, and power is diffused and somewhat hidden in such a climate, where each organization has to establish and make its own moral claims loudly and publicly. We observe two ways which allow actors to capture moral authority in global health. One, through power based on scientific knowledge and two, through procedures in the policy process, most commonly associated with the notion of broad consultation and participation. We discuss these drawing on one particular framework provided by Bourdieu, who analyses the source of actor power by focusing on different sorts of capital. Different approaches or theories to understanding power will go some way to answering the challenge Shiffman throws to health policy analysts. We need to explore much more fully where power lies in global health, and how it is exercised in order to understand underlying health agendas and claims to legitimacy made by global health actors today. PMID:25674577

Manifestations of integrated public health policy in Dutch municipalities.

PubMed

Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

2016-06-01

Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Disruptive innovation, labor markets, and Big Valley STEM School: network analysis in STEM education

NASA Astrophysics Data System (ADS)

Ellison, Scott; Allen, Ben

2018-03-01

A defining characteristic of contemporary trends in global education policy is the promotion of STEM learning in the primary, secondary, and tertiary sectors of education as a means to generate innovation and prosperity in the economy. Intertwined with common sensical assumptions about future labor markets and the transformative potential of technology in education, STEM has become a hegemonic discourse informing policy formation and educational practice. In Gramscian terms, the struggle over STEM as a discursive practice, between proponents of instrumental learning of marketable economic skills and those of education towards humanistic goals, reveals insights about the ideological characteristics of the push for STEM learning. This article explores the power dynamics behind the push for STEM learning as an ideological discourse propagated by global networks of elite policy actors and enacted by non-elite policy actors at the school level. The findings point toward a disjuncture between the discourse of elite policy actors in the US, the realities of STEM labor markets, and the actualization of this policy discourse into classroom practice. The implications of this study indicate that analyses of vertical power relations in network governance in STEM education should attend to the semiotics, materiality, and mutability of networked spaces.

A user evaluation of a local air ambulance service in North Wales.

PubMed

Gruffudd, Gwilym Siôn

2008-01-01

The purpose of this paper is to examine the current state and utilisation of user evaluation consultation adopted by Wales Air Ambulance (WAA) within the policy context. It is intended to provide a baseline for further evaluative research in the field and to highlight existing practices and resources. Gaps in strategic planning and service delivery are identified, with local recommendations proposed. Semi-structured, in-depth face-to-face interviews were conducted with ten participants drawn from a convenient sample representative of stakeholders including practitioners, fundraisers and operational staff. These groups represent primary actors involved in the delivery of services and policy implementation and also secondary actors involved in the delivery as users. Documentary analysis of WAA dispatch policy and protocols combined with secondary quantitative data of key performance indicators was undertaken. In total, 80 per cent of the sample stated their satisfaction with WAA dispatch policy with no perceived need or benefit to further development of policy or local agreements. About 70 per cent of participants had received direct comments that were 100 per cent positive from primary users/patients. All organisations shared the same concerns regarding lack of appropriate present communication. The research design was driven by practicalities of time-scale and resources. Owing to these constraints, plus the legal and ethical requirements relating to the involvement of patients in research, primary users were not included in this study. Areas for future research are identified. Recommendations being implemented by WAA include further engagement with primary users of the service in order to enhance standards. This paper reports the first empirical research conducted with WAA and users of the service.

Between a rock and a hard place: Economic expansion and social responsibility in UK media discourses on the global alcohol industry

PubMed Central

Hawkins, Benjamin

2017-01-01

Context Transnational alcohol corporations (TACs) employ a range of strategies to achieve their business objectives, including attempts to frame perceptions of their activities in media debates. TACs aim to achieve a favourable regulatory environment by presenting themselves as socially responsible actors. However, the need to secure financial investment means they must also emphasise their potential for growth. This article investigates tensions between these objectives in coverage of the global alcohol industry in the UK print media. Methods This article examines coverage of the world’s four largest TACs in five British daily newspapers and one industry publication between March 2012 and February 2013. 477 articles were identified for analysis through keyword searches of the LexisNexis database. Thematic coding of articles was conducted using Nvivo software. Findings Two conflicting framings of the alcohol industry emerge from our analysis. The first presents TACs as socially responsible actors; key partners to government in reducing alcohol-related harms. This is targeted at policy-makers and the public in an attempt to shape policy debates. The second framing highlights TACs’ potential for economic growth by establishing new markets and identifying new customer bases. This is targeted at an audience of potential investors. Conclusions A fundamental contradiction lies at the heart of these framings, reflecting the tensions that exist between TACs’ political and financial strategies. Alcohol industry involvement in policy-making thus involves a fundamental conflict of interests. Consequently, the UK government should reassess the prominence it currently affords to the industry in the development and delivery of alcohol policy. PMID:28092758

Between a rock and a hard place: Economic expansion and social responsibility in UK media discourses on the global alcohol industry.

PubMed

Thornton, Mary; Hawkins, Benjamin

2017-02-01

Transnational alcohol corporations (TACs) employ a range of strategies to achieve their business objectives, including attempts to frame perceptions of their activities in media debates. TACs aim to achieve a favourable regulatory environment by presenting themselves as socially responsible actors. However, the need to secure financial investment means they must also emphasise their potential for growth. This article investigates tensions between these objectives in coverage of the global alcohol industry in the UK print media. This article examines coverage of the world's four largest TACs in five British daily newspapers and one industry publication between March 2012 and February 2013. 477 articles were identified for analysis through keyword searches of the LexisNexis database. Thematic coding of articles was conducted using Nvivo software. Two conflicting framings of the alcohol industry emerge from our analysis. The first presents TACs as socially responsible actors; key partners to government in reducing alcohol-related harms. This is targeted at policy-makers and the public in an attempt to shape policy debates. The second framing highlights TACs' potential for economic growth by establishing new markets and identifying new customer bases. This is targeted at an audience of potential investors. A fundamental contradiction lies at the heart of these framings, reflecting the tensions that exist between TACs' political and financial strategies. Alcohol industry involvement in policy-making thus involves a fundamental conflict of interests. Consequently, the UK government should reassess the prominence it currently affords to the industry in the development and delivery of alcohol policy. Copyright © 2017 Elsevier Ltd. All rights reserved.

One stop crisis centres: A policy analysis of the Malaysian response to intimate partner violence.

PubMed

Colombini, Manuela; Ali, Siti Hawa; Watts, Charlotte; Mayhew, Susannah H

2011-06-21

This article aims to investigate the processes, actors and other influencing factors behind the development and the national scale-up of the One Stop Crisis Centre (OSCC) policy and the subsequent health model for violence-response. Methods used included policy analysis of legal, policy and regulatory framework documents, and in-depth interviews with key informants from governmental and non-governmental organisations in two States of Malaysia. The findings show that women's NGOs and health professionals were instrumental in the formulation and scaling-up of the OSCC policy. However, the subsequent breakdown of the NGO-health coalition negatively impacted on the long-term implementation of the policy, which lacked financial resources and clear policy guidance from the Ministry of Health. The findings confirm that a clearly-defined partnership between NGOs and health staff can be very powerful for influencing the legal and policy environment in which health care services for intimate partner violence are developed. It is critical to gain high level support from the Ministry of Health in order to institutionalise the violence-response across the entire health care system. Without clear operational details and resources policy implementation cannot be fully ensured and taken to scale.

Government use licenses in Thailand: The power of evidence, civil movement and political leadership

PubMed Central

2011-01-01

This paper attempts to describe and analyse the policy processes that led to the granting and implementation of the government use licenses to enable the import and production of generic versions of medicines patented in Thailand. The decision to grant the series of government use licenses was taken despite much domestic and international controversy. The paper demonstrates that the policy processes leading to the granting of government use licenses are a successful application of the concept of "the triangle that moves the mountain". This is a well-known conceptualisation of a philosophical and strategic approach to public policy advocacy in Thailand, which propounds that the effective bridging of three powers; a.) Knowledge and evidence generated by research and analysis, b.) Civil society movements and public support, and c.) Leadership of policy makers and politicians; in a synergistic "triangle" can move "mountains", meaning the resolution of seemingly insurmountable problems. The paper provides insights into the policy context for the decision and analyses the roles of key actors, their motivations and the policy processes in the country. PMID:21910864

Explaining Large-Scale Policy Change in the Turkish Health Care System: Ideas, Institutions, and Political Actors.

PubMed

Agartan, Tuba I

2015-10-01

Explaining policy change has been one of the major concerns of the health care politics and policy development literature. This article aims to explain the specific dynamics of large-scale reforms introduced within the framework of the Health Transformation Program in Turkey. It argues that confluence of the three streams - problem, policy, and politics - with the exceptional political will of the Justice and Development Party's (JDP) leaders opened up a window of opportunity for a large-scale policy change. The article also underscores the contribution of recent ideational perspectives that help explain "why" political actors in Turkey would focus on health care reform, given that there are a number of issues waiting to be addressed in the policy agenda. Examining how political actors framed problems and policies deepens our understanding of the content of the reform initiatives as well as the construction of the need to reform. The article builds on the insights of both the ideational and institutionalist perspectives when it argues that the interests, aspirations, and fears of the JDP, alongside the peculiar characteristics of the institutional context, have shaped its priorities and determination to carry out this reform initiative. Copyright © 2015 by Duke University Press.

Understanding the complex relationships among actors involved in the implementation of public-private mix (PPM) for TB control in India, using social theory.

PubMed

Salve, Solomon; Harris, Kristine; Sheikh, Kabir; Porter, John D H

2018-06-07

Public Private Partnerships (PPP) are increasingly utilized as a public health strategy for strengthening health systems and have become a core component for the delivery of TB control services in India, as promoted through national policy. However, partnerships are complex systems that rely on relationships between a myriad of different actors with divergent agendas and backgrounds. Relationship is a crucial element of governance, and relationship building an important aspect of partnerships. To understand PPPs a multi-disciplinary perspective that draws on insights from social theory is needed. This paper demonstrates how social theory can aid the understanding of the complex relationships of actors involved in implementation of Public-Private Mix (PPM)-TB policy in India. Ethnographic research was conducted within a district in a Southern state of India over a 14 month period, combining participant observations, informal interactions and in-depth interviews with a wide range of respondents across public, private and non-government organisation (NGO) sectors. Drawing on the theoretical insights from Bourdieu's "theory of practice" this study explores the relationships between the different actors. The study found that programme managers, frontline TB workers, NGOs, and private practitioners all had a crucial role to play in TB partnerships. They were widely regarded as valued contributors with distinct social skills and capabilities within their organizations and professions. However, their potential contributions towards programme implementation tended to be unrecognized both at the top and bottom of the policy implementation chain. These actors constantly struggled for recognition and used different mechanisms to position themselves alongside other actors within the programme that further complicated the relationships between different actors. This paper demonstrates that applying social theory can enable a better understanding of the complex relationship across public, private and NGO sectors. A closer understanding of these processes is a prerequisite for bridging the gap between field-level practices and central policy intentions, facilitating a move towards more effective partnership strategies for strengthening local health systems. The study contributes to our understanding of implementation of PPP for TB control and builds knowledge to help policy makers and programme managers strengthen and effectively implement strategies to enable stronger governance of these partnerships.

Dynamic Sensor Tasking for Space Situational Awareness via Reinforcement Learning

NASA Astrophysics Data System (ADS)

Linares, R.; Furfaro, R.

2016-09-01

This paper studies the Sensor Management (SM) problem for optical Space Object (SO) tracking. The tasking problem is formulated as a Markov Decision Process (MDP) and solved using Reinforcement Learning (RL). The RL problem is solved using the actor-critic policy gradient approach. The actor provides a policy which is random over actions and given by a parametric probability density function (pdf). The critic evaluates the policy by calculating the estimated total reward or the value function for the problem. The parameters of the policy action pdf are optimized using gradients with respect to the reward function. Both the critic and the actor are modeled using deep neural networks (multi-layer neural networks). The policy neural network takes the current state as input and outputs probabilities for each possible action. This policy is random, and can be evaluated by sampling random actions using the probabilities determined by the policy neural network's outputs. The critic approximates the total reward using a neural network. The estimated total reward is used to approximate the gradient of the policy network with respect to the network parameters. This approach is used to find the non-myopic optimal policy for tasking optical sensors to estimate SO orbits. The reward function is based on reducing the uncertainty for the overall catalog to below a user specified uncertainty threshold. This work uses a 30 km total position error for the uncertainty threshold. This work provides the RL method with a negative reward as long as any SO has a total position error above the uncertainty threshold. This penalizes policies that take longer to achieve the desired accuracy. A positive reward is provided when all SOs are below the catalog uncertainty threshold. An optimal policy is sought that takes actions to achieve the desired catalog uncertainty in minimum time. This work trains the policy in simulation by letting it task a single sensor to "learn" from its performance. The proposed approach for the SM problem is tested in simulation and good performance is found using the actor-critic policy gradient method.

Work, family, and managerial attitudes and practices in the European workplace: comparing Dutch, British, and Slovenian financial sector managers.

PubMed

Dulk, Laura Den; Peper, Bram; Sadar, Nevenka Černigoj; Lewis, Suzan; Smithson, Janet; Van Doorne-Huiskes, Anneke

2011-01-01

Managers are key actors shaping employees’ capabilities to utilize work–life policies. However, most research on managers’ implementation of these policies has been conducted in liberal welfare states and ignores the impact of institutional context. In this study, we situate managers within specific workplace and national layers of context. We investigated how managers in financial organizations in the Netherlands, UK, and Slovenia talk about the utilization of work–life policies. Managers’ discourses stressed disruption and dependency considerations in these case studies, as in the US research. However, a further management discourse of the moral case or right thing to do also emerged. The lack of resources for replacing staff on leave creates disruption and reduces managers capability to support the use of work–life policies, even when they are statutory or if managers are inclined be supportive (dependency or moral argument). This is likely to impact on parents' capabilities.

Can rights stop the wrongs? Exploring the connections between framings of sex workers' rights and sexual and reproductive health.

PubMed

Overs, Cheryl; Hawkins, Kate

2011-12-16

There is growing interest in the ways in which legal and human rights issues related to sex work affect sex workers' vulnerability to HIV and abuses including human trafficking and sexual exploitation. International agencies, such as UNAIDS, have called for decriminalisation of sex work because the delivery of sexual and reproductive health services is affected by criminalisation and social exclusion as experienced by sex workers. The paper reflects on the connections in various actors' framings between sex workers sexual and reproductive health and rights (SRHR) and the ways that international law is interpreted in policing and regulatory practices. The literature review that informs this paper was carried out by the authors in the course of their work within the Paulo Longo Research Initiative. The review covered academic and grey literature such as resources generated by sex worker rights activists, UN policy positions and print and online media. The argument in this paper has been developed reflectively through long term involvement with key actors in the field of sex workers' rights. International legislation characterises sex work in various ways which do not always accord with moves toward decriminalisation. Law, policy and regulation at national level and law enforcement vary between settings. The demands of sex worker rights activists do relate to sexual and reproductive health but they place greater emphasis on efforts to remove the structural barriers that limit sex workers' ability to participate in society on an equal footing with other citizens. There is a tension between those who wish to uphold the rights of sex workers in order to reduce vulnerability to ill-health and those who insist that sex work is itself a violation of rights. This is reflected in contemporary narratives about sex workers' rights and the ways in which different actors interpret human rights law. The creation of regulatory frameworks around sex work that support health, safety and freedom from abuse requires a better understanding of the broad scope of laws, policies and enforcement practices in different cultural contexts and economic settings, alongside reviews of UN policies and human rights conventions.

Influencing health policy through public deliberation: Lessons learned from two decades of Citizens'/community juries.

PubMed

Degeling, Chris; Rychetnik, Lucie; Street, Jackie; Thomas, Rae; Carter, Stacy M

2017-04-01

Citizens'/community juries [CJs] engage members of the public in policy decision-making processes. CJs can be employed to develop policy responses to health problems that require the consideration of both community values and scientific evidence. Based on the principles of deliberative democracy, recent reviews indicate that findings from CJs have successfully been used to influence health policy decision-making. Despite this evidence of success, there appears to be a gap between the goals of health researchers who organize CJs and the needs of policy actors and decision makers. Drawing on our experiences working with CJs and recent research on CJ methods, we describe a synopsis of the current state of the art organized around four key questions, and informed by insights from deliberative theory and critical policy studies. Our intention is to stimulate further discussion as to the types of health policy questions that can be usefully addressed through public deliberation, and provide guidance on the methodological and political dimensions that need to be considered in deciding whether a CJ is an appropriate approach for informing a policy decision-making process. Copyright © 2017 Elsevier Ltd. All rights reserved.

Developing lay health worker policy in South Africa: a qualitative study

PubMed Central

2012-01-01

Background Over the past half decade South Africa has been developing, implementing and redeveloping its Lay Health Worker (LHW) policies. Research during this period has highlighted challenges with LHW programme implementation. These challenges have included an increased burden of care for female LHWs. The aim of this study was to explore contemporary LHW policy development processes and the extent to which issues of gender are taken up within this process. Methods The study adopted a qualitative approach to exploring policy development from the perspective of policy actors. Eleven policy actors (policy makers and policy commentators) were interviewed individually. Data from the interviews were analysed thematically. Results Considerations of LHW working conditions drove policy redevelopment. From the interviews it seems that gender as an issue never reached the policy making agenda. Although there was strong recognition that the working conditions of LHWs needed to be improved, poor working conditions were not necessarily seen as a gender concern. Our data suggests that in the process of defining the problem which the redeveloped policy had to address, gender was not included. There was no group or body who brought the issue of gender to the attention of policy developers. As such the issue of gender never entered the policy debates. These debates focused on whether it was appropriate to have LHWs, what LHW programme model should be adopted and whether or not LHWs should be incorporated into the formal health system. Conclusion LHW policy redevelopment focused on resolving issues of LHW working conditions through an active process involving many actors and strong debates. Within this process the issue of gender had no champion and never reached the LHW policy agenda. Future research may consider how to incorporate the voices of ordinary women into the policy making process. PMID:22410185

A Mixed Methods Approach for Identifying Influence on Public Policy

ERIC Educational Resources Information Center

Weaver-Hightower, Marcus B.

2014-01-01

Fields from political science to critical education policy studies have long explored power relations in policy processes, showing who influences policy agendas, policy creation, and policy implementation. Yet showing particular actors' influence on specific points in a policy text remains a methodological challenge. This article presents a…

Policy Prolepsis in Education: Encounters, Becomings, and Phantasms

ERIC Educational Resources Information Center

Webb, P. Taylor; Gulson, Kalervo N.

2012-01-01

We argue that the concept of a "policy prolepsis" is a category of becoming-policy that actualizes educational practices within spaces of desired policy initiatives and implementations. Policy prolepses represent a range of emergent policy ontologies produced through the interface of educational actors' senses of policy and their estimations of…

Health-industry linkages for local health: reframing policies for African health system strengthening

PubMed Central

Mackintosh, Maureen; Mugwagwa, Julius; Banda, Geoffrey; Tibandebage, Paula; Tunguhole, Jires; Wangwe, Samuel; Karimi Njeru, Mercy

2018-01-01

Abstract The benefits of local production of pharmaceuticals in Africa for local access to medicines and to effective treatment remain contested. There is scepticism among health systems experts internationally that production of pharmaceuticals in sub-Saharan Africa (SSA) can provide competitive prices, quality and reliability of supply. Meanwhile low-income African populations continue to suffer poor access to a broad range of medicines, despite major international funding efforts. A current wave of pharmaceutical industry investment in SSA is associated with active African government promotion of pharmaceuticals as a key sector in industrialization strategies. We present evidence from interviews in 2013–15 and 2017 in East Africa that health system actors perceive these investments in local production as an opportunity to improve access to medicines and supplies. We then identify key policies that can ensure that local health systems benefit from the investments. We argue for a ‘local health’ policy perspective, framed by concepts of proximity and positionality, which works with local priorities and distinct policy time scales and identifies scope for incentive alignment to generate mutually beneficial health–industry linkages and strengthening of both sectors. We argue that this local health perspective represents a distinctive shift in policy framing: it is not necessarily in conflict with ‘global health’ frameworks but poses a challenge to some of its underlying assumptions. PMID:29562286

Framework for assessing the capacity of a health ministry to conduct health policy processes--a case study from Tajikistan.

PubMed

Mirzoev, Tolib N; Green, Andrew; Van Kalliecharan, Ricky

2015-01-01

An adequate capacity of ministries of health (MOH) to develop and implement policies is essential. However, no frameworks were found assessing MOH capacity to conduct health policy processes within developing countries. This paper presents a conceptual framework for assessing MOH capacity to conduct policy processes based on a study from Tajikistan, a former Soviet republic where independence highlighted capacity challenges. The data collection for this qualitative study included in-depth interviews, document reviews and observations of policy events. Framework approach for analysis was used. The conceptual framework was informed by existing literature, guided the data collection and analysis, and was subsequently refined following insights from the study. The Tajik MOH capacity, while gradually improving, remains weak. There is poor recognition of wider contextual influences, ineffective leadership and governance as reflected in centralised decision-making, limited use of evidence, inadequate actors' participation and ineffective use of resources to conduct policy processes. However, the question is whether this is a reflection of lack of MOH ability or evidence of constraining environment or both. The conceptual framework identifies five determinants of robust policy processes, each with specific capacity needs: policy context, MOH leadership and governance, involvement of policy actors, the role of evidence and effective resource use for policy processes. Three underlying considerations are important for applying the capacity to policy processes: the need for clear focus, recognition of capacity levels and elements, and both ability and enabling environment. The proposed framework can be used in assessing and strengthening of the capacity of different policy actors. Copyright © 2013 John Wiley & Sons, Ltd.

Global and local networking for HIV/AIDS prevention: the case of the Saathii E-forum.

PubMed

Desouza, Rebecca; Jyoti Dutta, Mohan

2008-06-01

The global spread of HIV/AIDS has sparked the proliferation of civil society groups working on various aspects of the disease such as prevention, treatment, support, and policy. In this article, we explore the role of the Internet in networking civil society organizations working on HIV/AIDS-related issues across local and global spaces. Specifically, we conducted a thematic analysis of an e-forum established by the nongovernmental organization (NGO) Saathii, working on HIV/AIDS issues in India to (a) identify the specific functions served by the e-forum and (b) explore how global and local actors use the e-forum to network with one another. The thematic analysis documented four key functions of the online forum: (a) to provide HIV/AIDS-related news, (b) to serve as an informational resource, (c) to promote political activism, and (d) to express emotions. The discussion elaborates on the how global and local actors network with one another and build solidarity.

The human factor: re-organisations in public health policy.

PubMed

Oliver, Kathryn; Everett, Martin; Verma, Arpana; de Vocht, Frank

2012-06-01

Public health policy-making activities are currently split between local authority and NHS organisations. Despite an increasing body of research on evidence-based policy (EBP), few studies explore the process of policy-making. Little is known about how policies are made in a local context, or how (scientific) evidence is used. Previous research has ignored the 'human element' in EBP. Social network analysis (SNA) techniques are becoming increasingly important in health policy. This paper describes an innovative study giving a fresh perspective on policy-making processes in public health. A social network analysis of public health policy making networks in Greater Manchester based on publicly available data (documents, websites and meeting papers) and an electronic survey, asking actors to nominate those who influenced their own views, those who were powerful, and those who were a source of evidence or information. Policy-making networks are described. Formal executive roles are loosely related to perceived influence and power. Evidence-seeking networks are less coherent, with key organisations not represented. These data indicate the importance of collaboration and good relationships between researchers and policy-makers, but few academic researchers with a direct impact on health policy were identified within the networks. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Alcohol industry influence on UK alcohol policy: A new research agenda for public health

PubMed Central

Hawkins, Benjamin; Holden, Chris; McCambridge, Jim

2012-01-01

The British government has been criticised for according industry interests too much weight in alcohol policy-making. Consequently, it has been argued that alcohol strategy in the UK is built around policies for which the evidence base is weak. This has clear implications for public health. The purpose of this commentary is to map recent developments in UK alcohol policy and related debates within the alcohol policy literature, thus laying the foundations for a systematic examination of the influence of the alcohol industry on alcohol policy. It highlights the changing structure of the industry and summarises what is known about the positions and strategies of industry actors towards alcohol policy. In so doing, it aims to contribute not just to debates about alcohol policy, but to a broader understanding of health policy processes and the relationships between government and other stakeholders. It advances a new research agenda focused on the role of corporate actors in the field of alcohol policy and public health more broadly. PMID:22815594

Implementing Health in All Policies – Time and Ideas Matter Too!

PubMed Central

Clavier, Carole

2016-01-01

Carey and Friel suggest that we turn to knowledge developed in the field of public administration, especially new public governance, to better understand the process of implementing health in all policies (HiAP). In this commentary, I claim that theories from the policy studies bring a broader view of the policy process, complementary to that of new public governance. Drawing on the policy studies, I argue that time and ideas matter to HiAP implementation, alongside with interests and institutions. Implementing HiAP is a complex process considering that it requires the involvement and coordination of several policy sectors, each with their own interests, institutions and ideas about the policy. Understanding who are the actors involved from the various policy sectors concerned, what context they evolve in, but also how they own and frame the policy problem (ideas), and how this has changed over time, is crucial for those involved in HiAP implementation so that they can relate to and work together with actors from other policy sectors. PMID:27694654

Alcohol industry influence on UK alcohol policy: A new research agenda for public health.

PubMed

Hawkins, Benjamin; Holden, Chris; McCambridge, Jim

2012-09-01

The British government has been criticised for according industry interests too much weight in alcohol policy-making. Consequently, it has been argued that alcohol strategy in the UK is built around policies for which the evidence base is weak. This has clear implications for public health. The purpose of this commentary is to map recent developments in UK alcohol policy and related debates within the alcohol policy literature, thus laying the foundations for a systematic examination of the influence of the alcohol industry on alcohol policy. It highlights the changing structure of the industry and summarises what is known about the positions and strategies of industry actors towards alcohol policy. In so doing, it aims to contribute not just to debates about alcohol policy, but to a broader understanding of health policy processes and the relationships between government and other stakeholders. It advances a new research agenda focused on the role of corporate actors in the field of alcohol policy and public health more broadly.

Health financing policies in Sub-Saharan Africa: government ownership or donors' influence? A scoping review of policymaking processes.

PubMed

Gautier, Lara; Ridde, Valéry

2017-01-01

The rise on the international scene of advocacy for universal health coverage (UHC) was accompanied by the promotion of a variety of health financing policies. Major donors presented health insurance, user fee exemption, and results-based financing policies as relevant instruments for achieving UHC in Sub-Saharan Africa. The "donor-driven" push for policies aiming at UHC raises concerns about governments' effective buy-in of such policies. Because the latter has implications on the success of such policies, we searched for evidence of government ownership of the policymaking process. We conducted a scoping review of the English and French literature from January 2001 to December 2015 on government ownership of decision-making on policies aiming at UHC in Sub-Saharan Africa. Thirty-five (35) results were retrieved. We extracted, synthesized and analyzed data in order to provide insights on ownership at five stages of the policymaking process: emergence, formulation, funding, implementation, and evaluation. The majority of articles (24/35) showed mixed results (i.e. ownership was identified at one or more levels of policymaking process but not all) in terms of government ownership. Authors of only five papers provided evidence of ownership at all reviewed policymaking stages. When results demonstrated some lack of government ownership at any of the five stages, we noticed that donors did not necessarily play a role: other actors' involvement was contributing to undermining government-owned decision-making, such as the private sector. We also found evidence that both government ownership and donors' influence can successfully coexist. Future research should look beyond indicators of government ownership, by analyzing historical factors behind the imbalance of power between the different actors during policy negotiations. There is a need to investigate how some national actors become policy champions and thereby influence policy formulation. In order to effectively achieve government ownership of financing policies aiming at UHC, we recommend strengthening the State's coordination and domestic funding mobilization roles, together with securing a higher involvement of governmental (both political and technical) actors by donors.

Scaling the Problem: How Commercial Interests Have Influenced the U.S. Dialogue on Climate Change

NASA Astrophysics Data System (ADS)

Goldman, G. T.; Rogerson, P.

2012-12-01

In recent years, corporations and their affiliates have played an increasing role in the national conversation on climate change, with companies weighing in not only on policy debates but also participating in discussions around climate science. A few of these companies in particular have been tremendously influential in dictating how the public understands, or misunderstands, climate science and how the national discourse on climate policy has progressed, or not progressed. To better understand this corporate involvement, we explored the roles that major corporate actors have played during a key time period in 2009 and 2010 when several important climate change policy proposals were being actively debated in the United States. Analyzing multiple venues in which companies engaged in discussion of climate change with different audiences—including the government, shareholders, and the public—we assess the degree to which commercial interests have helped or hindered a science-based public discourse on climate policy in the past decade. Discussion will focus especially on corporations' use of third party organizations, including industry trade groups, think tanks, and others, to exert influence on climate-related policy without accountability.

Knowledge and networks - key sources of power in global health: Comment on "Knowledge, moral claims and the exercise of power in global health".

PubMed

Hanefeld, Johanna; Walt, Gill

2015-02-01

Shiffman rightly raises questions about who exercises power in global health, suggesting power is a complex concept, and the way it is exercised is often opaque. Power that is not based on financial strength but on knowledge or experience, is difficult to estimate, and yet it may provide the legitimacy to make moral claims on what is, or ought to be, on global health agendas. Twenty years ago power was exercised in a much less complex health environment. The World Health Organization (WHO) was able to exert its authority as world health leader. The landscape today is very different. Financial resources for global health are being competed for by diverse organisations, and power is diffused and somewhat hidden in such a climate, where each organization has to establish and make its own moral claims loudly and publicly. We observe two ways which allow actors to capture moral authority in global health. One, through power based on scientific knowledge and two, through procedures in the policy process, most commonly associated with the notion of broad consultation and participation. We discuss these drawing on one particular framework provided by Bourdieu, who analyses the source of actor power by focusing on different sorts of capital. Different approaches or theories to understanding power will go some way to answering the challenge Shiffman throws to health policy analysts. We need to explore much more fully where power lies in global health, and how it is exercised in order to understand underlying health agendas and claims to legitimacy made by global health actors today.

Stakeholder perspectives on national policy for regulating the school food environment in Mexico.

PubMed

Monterrosa, Eva C; Campirano, Fabricio; Tolentino Mayo, Lizbeth; Frongillo, Edward A; Hernández Cordero, Sonia; Kaufer-Horwitz, Martha; Rivera, Juan A

2015-02-01

In Mexico, the school environment has been promoting sale of unhealthy foods. There is little empirical evidence on multi-stakeholder perspectives around national school food policy to regulate this. We studied stakeholders' perspectives on the proposed regulation for school sale of unhealthy foods. Comments about the regulation were available from an open consultation process held in June 2010 before the approval and implementation of the regulation. To examine perspectives, we coded 597 comments for beliefs, expectations and demands in NVivo. We created matrices by actors: academics, parents, citizens, health professionals and food industry. For academics, citizens and health professionals, the primary issue regarding the regulation was obesity, while for parents it was health of children. Academics, citizens, health professionals and parents believed that government was responsible for health of citizens, expected that this regulation would improve eating habits and health (i.e. less obesity and chronic diseases), and demanded that unhealthy foods be removed from schools. Parents demanded immediate action for school food policy that would protect their children. Citizens and health professionals demanded nutrition education and healthy food environment. Food industry opposed the regulation because it would not solve obesity or improve diet and physical activity behaviours. Instead, industry would lose income and jobs. Food industry demanded policy aimed at families that included nutrition education and physical activity. There was substantial consensus in narratives and perspectives for most actor types, with the primary narrative being the food environment followed by shared responsibility. Food industry rejected both these narratives, espousing instead the narrative of personal responsibility. Consensus among most actor groups supports the potential success of implementation of the regulation in Mexican schools. With regard to addressing childhood obesity, sound government policy is needed to balance different perspectives and desired outcomes among societal actors, particularly in Mexico between food industry and other actors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

The Role of Key Actors in School Governance: An Italian Evidence

ERIC Educational Resources Information Center

Salvioni, Daniela; Gandini, Giuseppina; Franzoni, Simona; Gennari, Francesca

2012-01-01

The greater awareness of the role of key actors in the school governance processes and the need to expect a "new leader" in the increasing school complexity are essential conditions to reform the schools from within, so as to provide them with skills related to globalisation, improvement to the educational quality, strengthening of…

Why do policies change? Institutions, interests, ideas and networks in three cases of policy reform

PubMed Central

Shearer, Jessica C; Abelson, Julia; Kouyaté, Bocar; Lavis, John N; Walt, Gill

2016-01-01

Abstract Policy researchers have used various categories of variables to explain why policies change, including those related to institutions, interests and ideas. Recent research has paid growing attention to the role of policy networks—the actors involved in policy-making, their relationships with each other, and the structure formed by those relationships—in policy reform across settings and issues; however, this literature has largely ignored the theoretical integration of networks with other policy theories, including the ‘3Is’ of institutions, interests and ideas. This article proposes a conceptual framework integrating these variables and tests it on three cases of policy change in Burkina Faso, addressing the need for theoretical integration with networks as well as the broader aim of theory-driven health policy analysis research in low- and middle-income countries. We use historical process tracing, a type of comparative case study, to interpret and compare documents and in-depth interview data within and between cases. We found that while network changes were indeed associated with policy reform, this relationship was mediated by one or more of institutions, interests and ideas. In a context of high donor dependency, new donor rules affected the composition and structure of actors in the networks, which enabled the entry and dissemination of new ideas and shifts in the overall balance of interest power ultimately leading to policy change. The case of strategic networking occurred in only one case, by civil society actors, suggesting that network change is rarely the spark that initiates the process towards policy change. This analysis highlights the important role of changes in institutions and ideas to drive policymaking, but hints that network change is a necessary intermediate step in these processes. PMID:27233927

Using social network analysis to examine the decision-making process on new vaccine introduction in Nigeria.

PubMed

Wonodi, C B; Privor-Dumm, L; Aina, M; Pate, A M; Reis, R; Gadhoke, P; Levine, O S

2012-05-01

The decision-making process to introduce new vaccines into national immunization programmes is often complex, involving many stakeholders who provide technical information, mobilize finance, implement programmes and garner political support. Stakeholders may have different levels of interest, knowledge and motivations to introduce new vaccines. Lack of consensus on the priority, public health value or feasibility of adding a new vaccine can delay policy decisions. Efforts to support country-level decision-making have largely focused on establishing global policies and equipping policy makers with the information to support decision-making on new vaccine introduction (NVI). Less attention has been given to understanding the interactions of policy actors and how the distribution of influence affects the policy process and decision-making. Social network analysis (SNA) is a social science technique concerned with explaining social phenomena using the structural and relational features of the network of actors involved. This approach can be used to identify how information is exchanged and who is included or excluded from the process. For this SNA of vaccine decision-making in Nigeria, we interviewed federal and state-level government officials, officers of bilateral and multilateral partner organizations, and other stakeholders such as health providers and the media. Using data culled from those interviews, we performed an SNA in order to map formal and informal relationships and the distribution of influence among vaccine decision-makers, as well as to explore linkages and pathways to stakeholders who can influence critical decisions in the policy process. Our findings indicate a relatively robust engagement of key stakeholders in Nigeria. We hypothesized that economic stakeholders and implementers would be important to ensure sustainable financing and strengthen programme implementation, but some economic and implementation stakeholders did not appear centrally on the map; this may suggest a need to strengthen the decision-making processes by engaging these stakeholders more centrally and earlier.

Mapping the existing body of health policy implementation research in lower income settings: what is covered and what are the gaps?

PubMed

Erasmus, E; Orgill, M; Schneider, H; Gilson, L

2014-12-01

This article uses 85 peer-reviewed articles published between 1994 and 2009 to characterize and synthesize aspects of the health policy analysis literature focusing on policy implementation in low- and middle-income countries (LMICs). It seeks to contribute, first, to strengthening the field of LMIC health policy analysis by highlighting gaps in the literature and generating ideas for a future research agenda and, second, to thinking about the value and applicability of qualitative synthesis approaches to the health policy analysis field. Overall, the article considers the disciplinary perspectives from which LMIC health policy implementation is studied and the extent to which the focus is on systems or programme issues. It then works with the more specific themes of the key thrusts of the reviewed articles, the implementation outcomes studied, implementation improvement recommendations made and the theories used in the reviewed articles. With respect to these more specific themes, the article includes explorations of patterns within the themes themselves, the contributions of specific disciplinary perspectives and differences between systems and programme articles. It concludes, among other things, that the literature remains small, fragmented, of limited depth and quite diverse, reflecting a wide spectrum of health system dimensions studied and many different suggestions for improving policy implementation. However, a range of issues beyond traditional 'hardware' health system concerns, such as funding and organizational structure, are understood to influence policy implementation, including many 'software' issues such as the understandings of policy actors and the need for better communication and actor relationships. Looking to the future, there is a need, given the fragmentation in the literature, to consolidate the existing body of work where possible and, given the often broad nature of the work and its limited depth, to draw more explicitly on theoretical frames and concepts to deepen work by sharpening and focusing concerns and questions. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Report to Congress on Arctic Operations and the Northwest Passage

DTIC Science & Technology

2011-05-19

interests in the region. Intergovernmental and non -state actors, including the media, and State actors external to the region will seek to play...developing, and implementing Arctic policy on a range of issues. Non -state actors such as oil, gas, shipping, and tourism companies; indigenous...assessment looks at the near- (2010-2020), mid- (2020-2030), and far-term (beyond 2030), and factors in non -material capabilities, such as having a cadre

Education Stakeholders' Translation and Sense-Making of Accountability Policies

ERIC Educational Resources Information Center

Werts, Amanda B.; Della Sala, Matt; Lindle, Jane; Horace, Jennifer M.; Brewer, Curtis; Knoeppel, Robert

2013-01-01

Scholars of education policy have consistently found that the capacity, beliefs, and values of local actors affect the relative success or failure of policy implementation. This article examines stakeholders' perceptions of education policy in South Carolina to consider the relationship between interpretations of education policy and attitudes of…

One stop crisis centres: A policy analysis of the Malaysian response to intimate partner violence

PubMed Central

2011-01-01

Background This article aims to investigate the processes, actors and other influencing factors behind the development and the national scale-up of the One Stop Crisis Centre (OSCC) policy and the subsequent health model for violence-response. Methods Methods used included policy analysis of legal, policy and regulatory framework documents, and in-depth interviews with key informants from governmental and non-governmental organisations in two States of Malaysia. Results The findings show that women's NGOs and health professionals were instrumental in the formulation and scaling-up of the OSCC policy. However, the subsequent breakdown of the NGO-health coalition negatively impacted on the long-term implementation of the policy, which lacked financial resources and clear policy guidance from the Ministry of Health. Conclusion The findings confirm that a clearly-defined partnership between NGOs and health staff can be very powerful for influencing the legal and policy environment in which health care services for intimate partner violence are developed. It is critical to gain high level support from the Ministry of Health in order to institutionalise the violence-response across the entire health care system. Without clear operational details and resources policy implementation cannot be fully ensured and taken to scale. PMID:21693029

Bombing alone: tracing the motivations and antecedent behaviors of lone-actor terrorists,.

PubMed

Gill, Paul; Horgan, John; Deckert, Paige

2014-03-01

This article analyzes the sociodemographic network characteristics and antecedent behaviors of 119 lone-actor terrorists. This marks a departure from existing analyses by largely focusing upon behavioral aspects of each offender. This article also examines whether lone-actor terrorists differ based on their ideologies or network connectivity. The analysis leads to seven conclusions. There was no uniform profile identified. In the time leading up to most lone-actor terrorist events, other people generally knew about the offender's grievance, extremist ideology, views, and/or intent to engage in violence. A wide range of activities and experiences preceded lone actors' plots or events. Many but not all lone-actor terrorists were socially isolated. Lone-actor terrorists regularly engaged in a detectable and observable range of activities with a wider pressure group, social movement, or terrorist organization. Lone-actor terrorist events were rarely sudden and impulsive. There were distinguishable behavioral differences between subgroups. The implications for policy conclude this article. © 2013 American Academy of Forensic Sciences.

Education Policies and Policy Making in Arizona: Report on a Survey of Education Policy Actors

ERIC Educational Resources Information Center

Lawton, Stephen B.

2011-01-01

This study provides an objective look at the education policies adopted by the State of Arizona since 2000, describes participants in the policy-making process, and identifies policy options for the future. The framework of the study uses a typology of educational policies with seven categories: school building and facilities, curriculum…

Adapting public policy theory for public health research: A framework to understand the development of national policies on global health.

PubMed

Jones, Catherine M; Clavier, Carole; Potvin, Louise

2017-03-01

National policies on global health appear as one way that actors from health, development and foreign affairs sectors in a country coordinate state action on global health. Next to a burgeoning literature in which international relations and global governance theories are employed to understand global health policy and global health diplomacy at the international level, little is known about policy processes for global health at the national scale. We propose a framework of the policy process to understand how such policies are developed, and we identify challenges for public health researchers integrating conceptual tools from political science. We developed the framework using a two-step process: 1) reviewing literature to establish criteria for selecting a theoretical framework fit for this purpose, and 2) adapting Real-Dato's synthesis framework to integrate a cognitive approach to public policy within a constructivist perspective. Our framework identifies multiple contexts as part of the policy process, focuses on situations where actors work together to make national policy on global health, considers these interactive situations as spaces for observing external influences on policy change and proposes policy design as the output of the process. We suggest that this framework makes three contributions to the conceptualisation of national policy on global health as a research object. First, it emphasizes collective action over decisions of individual policy actors. Second, it conceptualises the policy process as organised interactive spaces for collaboration rather than as stages of a policy cycle. Third, national decision-making spaces are opportunities for transferring ideas and knowledge from different sectors and settings, and represent opportunities to identify international influences on a country's global health policy. We discuss two sets of challenges for public health researchers using interdisciplinary approaches in policy research. Copyright © 2017 Elsevier Ltd. All rights reserved.

("Un")Doing Standards in Education with Actor-Network Theory

ERIC Educational Resources Information Center

Fenwick, Tara J.

2010-01-01

Recent critiques have drawn important attention to the depoliticized consensus and empty promises embedded in network discourses of educational policy. While acceding this critique, this discussion argues that some forms of network analysis--specifically those adopting actor-network theory (ANT) approaches--actually offer useful theoretical…

Abortion law reforms in Colombia and Nicaragua: issue networks and opportunity contexts.

PubMed

Reuterswärd, Camilla; Zetterberg, Pär; Thapar-Björkert, Suruchi; Molyneux, Maxine

2011-01-01

This article analyses two instances of abortion law reform in Latin America. In 2006, after a decades-long impasse, the highly controversial issue of abortion came to dominate the political agenda when Colombia liberalized its abortion law and Nicaragua adopted a total ban on abortion. The article analyses the central actors in the reform processes, their strategies and the opportunity contexts. Drawing on Htun's (2003) framework, it examines why these processes concluded with opposing legislative outcomes. The authors argue for the need to understand the state as a non-unitary site of politics and policy, and for judicial processes to be seen as a key variable in facilitating gender policy reforms in Latin America. In addition, they argue that ‘windows of opportunity’ such as the timing of elections can be critically important in legislative change processes.

Education as networking: Rethinking the success of the harm reduction policy of Taiwan.

PubMed

Chen, Jia-shin

2015-05-01

The harm reduction policy of Taiwan has been considered a success. However, the HIV incidence among injection drug users declined before the nationwide needle and syringe program and drug substitution treatments were implemented. Thus, other factors in the policy might have contributed to its success. Some authors have suggested that education may have played a pivotal part. In this research, the purported significance of education in the success of the policy is conceptualized by reviewing the studies on harm reduction in Taiwan and reflecting upon my own fieldwork. Moreover, relevant literature is used as reference to reformulate this notion of education. This article shows that harm reduction education may be conducted in numerous forms, most of which are non-formal, improvisational, and contingent. Non-governmental organizations may play a role, but more actors, strategies, infrastructures, and interactions should be considered. This article draws from actor-network theory and refines the current thesis that attributes the policy success to education by utilizing three reflections, namely, appreciating materiality and spatiality, recognizing covert actors in the networking, and treating education as an outcome rather than a means. In conclusion, looking at education as a form of networking offers theoretical insight that increases understanding of its participants, mechanisms, processes, and permutations. © The Author(s) 2014.

Coherence between health policy and human resource strategy: lessons from maternal health in Vietnam, India and China.

PubMed

Martineau, Tim; Mirzoev, Tolib; Pearson, Stephen; Ha, Bui Thi Thu; Xu, Qian; Ramani, K V; Liu, Xiaoyun

2015-02-01

The failure to meet health goals such as the Millennium Development Goals (MDG) is partly due to the lack of appropriate resources for the effective implementation of health policies. The lack of coherence between the health policies and human resource (HR) strategy is one of the major causes. This article explores the relationship and the degree of coherence between health policy--in this case maternal health policy--processes and HR strategy in Vietnam, China and India in the period 2005-09. Four maternal health policy case studies were explored [skilled birth attendance (SBA), adolescent and sexual reproductive health, domestic violence and medical termination of pregnancy] across three countries through interviews with key respondents, document analysis and stakeholder meetings. Analysis for coherence between health policy and HR strategy was informed by a typology covering 'separation', 'fit' and 'dialogue'. Regarding coherence we found examples of complete separation between health policy and HR strategy, a good fit with the SBA policy though modified through 'dialogue' in Vietnam, and in one case a good fit between policy and strategy was developed through successive evaluations. Three key influences on coherence between health policy and HR strategy emerge from our findings: (1) health as the lead sector, (2) the nature of the policy instrument and (3) the presence of 'HR champions'. Finally, we present a simple algorithm to ensure that appropriate HR related actors are involved; HR is considered at the policy development stage with the option of modifying the policy if it cannot be adequately supported by the available health workforce; and ensuring that HR strategies are monitored to ensure continued coherence with the health policy. This approach will ensure that the health workforce contributes more effectively to meeting the MDGs and future health goals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

“Working the System”—British American Tobacco's Influence on the European Union Treaty and Its Implications for Policy: An Analysis of Internal Tobacco Industry Documents

PubMed Central

Smith, Katherine E.; Fooks, Gary; Collin, Jeff; Weishaar, Heide; Mandal, Sema; Gilmore, Anna B.

2010-01-01

Background Impact assessment (IA) of all major European Union (EU) policies is now mandatory. The form of IA used has been criticised for favouring corporate interests by overemphasising economic impacts and failing to adequately assess health impacts. Our study sought to assess how, why, and in what ways corporations, and particularly the tobacco industry, influenced the EU's approach to IA. Methods and Findings In order to identify whether industry played a role in promoting this system of IA within the EU, we analysed internal documents from British American Tobacco (BAT) that were disclosed following a series of litigation cases in the United States. We combined this analysis with one of related literature and interviews with key informants. Our analysis demonstrates that from 1995 onwards BAT actively worked with other corporate actors to successfully promote a business-oriented form of IA that favoured large corporations. It appears that BAT favoured this form of IA because it could advance the company's European interests by establishing ground rules for policymaking that would: (i) provide an economic framework for evaluating all policy decisions, implicitly prioritising costs to businesses; (ii) secure early corporate involvement in policy discussions; (iii) bestow the corporate sector with a long-term advantage over other actors by increasing policymakers' dependence on information they supplied; and (iv) provide businesses with a persuasive means of challenging potential and existing legislation. The data reveal that an ensuing lobbying campaign, largely driven by BAT, helped secure binding changes to the EU Treaty via the Treaty of Amsterdam that required EU policymakers to minimise legislative burdens on businesses. Efforts subsequently focused on ensuring that these Treaty changes were translated into the application of a business orientated form of IA (cost–benefit analysis [CBA]) within EU policymaking procedures. Both the tobacco and chemical industries have since employed IA in apparent attempts to undermine key aspects of European policies designed to protect public health. Conclusions Our findings suggest that BAT and its corporate allies have fundamentally altered the way in which all EU policy is made by making a business-oriented form of IA mandatory. This increases the likelihood that the EU will produce policies that advance the interests of major corporations, including those that produce products damaging to health, rather than in the interests of its citizens. Given that the public health community, focusing on health IA, has largely welcomed the increasing policy interest in IA, this suggests that urgent consideration is required of the ways in which IA can be employed to undermine, as well as support, effective public health policies. Please see later in the article for the Editors' Summary PMID:20084098

"Working the system"--British American tobacco's influence on the European union treaty and its implications for policy: an analysis of internal tobacco industry documents.

PubMed

Smith, Katherine E; Fooks, Gary; Collin, Jeff; Weishaar, Heide; Mandal, Sema; Gilmore, Anna B

2010-01-12

Impact assessment (IA) of all major European Union (EU) policies is now mandatory. The form of IA used has been criticised for favouring corporate interests by overemphasising economic impacts and failing to adequately assess health impacts. Our study sought to assess how, why, and in what ways corporations, and particularly the tobacco industry, influenced the EU's approach to IA. In order to identify whether industry played a role in promoting this system of IA within the EU, we analysed internal documents from British American Tobacco (BAT) that were disclosed following a series of litigation cases in the United States. We combined this analysis with one of related literature and interviews with key informants. Our analysis demonstrates that from 1995 onwards BAT actively worked with other corporate actors to successfully promote a business-oriented form of IA that favoured large corporations. It appears that BAT favoured this form of IA because it could advance the company's European interests by establishing ground rules for policymaking that would: (i) provide an economic framework for evaluating all policy decisions, implicitly prioritising costs to businesses; (ii) secure early corporate involvement in policy discussions; (iii) bestow the corporate sector with a long-term advantage over other actors by increasing policymakers' dependence on information they supplied; and (iv) provide businesses with a persuasive means of challenging potential and existing legislation. The data reveal that an ensuing lobbying campaign, largely driven by BAT, helped secure binding changes to the EU Treaty via the Treaty of Amsterdam that required EU policymakers to minimise legislative burdens on businesses. Efforts subsequently focused on ensuring that these Treaty changes were translated into the application of a business orientated form of IA (cost-benefit analysis [CBA]) within EU policymaking procedures. Both the tobacco and chemical industries have since employed IA in apparent attempts to undermine key aspects of European policies designed to protect public health. Our findings suggest that BAT and its corporate allies have fundamentally altered the way in which all EU policy is made by making a business-oriented form of IA mandatory. This increases the likelihood that the EU will produce policies that advance the interests of major corporations, including those that produce products damaging to health, rather than in the interests of its citizens. Given that the public health community, focusing on health IA, has largely welcomed the increasing policy interest in IA, this suggests that urgent consideration is required of the ways in which IA can be employed to undermine, as well as support, effective public health policies.

The Politics of Evidence Use in Health Policy Making in Germany-the Case of Regulating Hospital Minimum Volumes.

PubMed

Ettelt, Stefanie

2017-06-01

This article examines the role of scientific evidence in informing health policy decisions in Germany, using minimum volumes policy as a case study. It argues that scientific evidence was used strategically at various stages of the policy process both by individual corporatist actors and by the Federal Joint Committee as the regulator. Minimum volumes regulation was inspired by scientific evidence suggesting a positive relationship between service volume and patient outcomes for complex surgical interventions. Federal legislation was introduced in 2002 to delegate the selection of services and the setting of volumes to corporatist decision makers. Yet, despite being represented in the Federal Joint Committee, hospitals affected by its decisions took the Committee to court to seek legal redress and prevent policy implementation. Evidence has been key to support, and challenge, decisions about minimum volumes, including in court. The analysis of the role of scientific evidence in minimum volumes regulation in Germany highlights the dynamic relationship between evidence use and the political and institutional context of health policy making, which in this case is characterized by the legislative nature of policy making, corporatism, and the role of the judiciary in reviewing policy decisions. Copyright © 2017 by Stefanie Ettelt.

The Philippine Department of Education: Challenges of Policy Implementation amidst Corruption

ERIC Educational Resources Information Center

Reyes, Vicente Chua

2010-01-01

This inquiry interrogates the experiences of local implementation actors of the Philippine Department of Education as they navigate through reform efforts within systemic corruption. Departing from dominant analytical paradigms centred on patron-client frameworks, the article introduces the typology of complex linkages where local actors play…

The Policy Object: A Different Perspective on Policy Enactment in Higher Education

ERIC Educational Resources Information Center

Sin, Cristina

2014-01-01

This paper proposes a new perspective for higher education policy research. It introduces the concept of "policy object" to designate the discrete preoccupation(s) of a policy text (e.g. a new governance regime, a quality system, or new degrees) and suggests that actor conceptualisations of the policy object intersect with other elements…

Performativity and Pedagogising Knowledge: Globalising Educational Policy Formation, Dissemination and Enactment

ERIC Educational Resources Information Center

Singh, Parlo

2015-01-01

Critical policy scholars have increasingly turned their attention to: (1) the work of policy actors engaged in globalised and globalising processes of policy formation, (2) the global flows or movements of education policies across multifaceted, hybrid networks of public-private agencies, and (3) the complex politics of global-national policy…

Policy Intensions and the Folds of the Self

ERIC Educational Resources Information Center

Webb, P. Taylor; Gulson, Kalervo N.

2013-01-01

In this essay, P. Taylor Webb and Kalervo N. Gulson argue that educational policy is a spatial process and that implementation processes in particular produce crucial emergent geographies for policy research. Webb and Gulson describe how emergent geographies are produced when policy "folds" actors through senses and enactments of policy. The idea…

Stakeholders' views on maternity care shortcomings in rural Ghana: An ethnographic study among women, providers, public, and quasiprivate policy sector actors.

PubMed

Ayanore, Martin Amogre; Pavlova, Milena; Biesma, Regien; Groot, Wim

2018-01-01

Access to skilled provider and emergency obstetric care is not universal across all districts in Ghana. The lived experiences of 3 stakeholder groups on maternity care shortcomings in 3 rural Ghanaian districts are examined in this study. We applied an ethnographic study approach where field data were collected between March to May 2015 in 3 rural districts of northern Ghana. Data were collected among women with recent births experiences (n = 90), health care providers (n = 16), and policy actors (n = 6). Transcripts were read through to identify similar and divergent stakeholders' views. Significant expressions and experiences of stakeholders on maternity care shortcomings were extracted and evaluated to define key themes. Four themes emerged: social/community factors, payments for health care, facility level factors, and policy level factors. The results show that traditional women's roles divest time for maternity care. Poor transport arrangements, insufficient health workforce, health funding gaps, insurance reimbursements delays, and catastrophic health expenditures on travel and drugs are attested as major barriers across all stakeholder groups in all districts studied. The discussion of the study findings suggests it is important to ascertain the scale of informal payments and their impacts on health access. Investments in health workforce and reliable ambulatory service systems could help address poor referral difficulties in rural areas of the country. Social support for community initiatives that pool funds could provide extra resources and relieve cost access-related challenges for using maternity care in rural settings in Ghana. Copyright © 2017 John Wiley & Sons, Ltd.

A network approach to policy framing: A case study of the National Aboriginal and Torres Strait Islander Health Plan.

PubMed

Browne, Jennifer; de Leeuw, Evelyne; Gleeson, Deborah; Adams, Karen; Atkinson, Petah; Hayes, Rick

2017-01-01

Aboriginal health policy in Australia represents a unique policy subsystem comprising a diverse network of Aboriginal-specific and "mainstream" organisations, often with competing interests. This paper describes the network structure of organisations attempting to influence national Aboriginal health policy and examines how the different subgroups within the network approached the policy discourse. Public submissions made as part of a policy development process for the National Aboriginal and Torres Strait Islander Health Plan were analysed using a novel combination of network analysis and qualitative framing analysis. Other organisational actors in the network in each submission were identified, and relationships between them determined; these were used to generate a network map depicting the ties between actors. A qualitative framing analysis was undertaken, using inductive coding of the policy discourses in the submissions. The frames were overlaid with the network map to identify the relationship between the structure of the network and the way in which organisations framed Aboriginal health problems. Aboriginal organisations were central to the network and strongly connected with each other. The network consisted of several densely connected subgroups, whose central nodes were closely connected to one another. Each subgroup deployed a particular policy frame, with a frame of "system dysfunction" also adopted by all but one subgroup. Analysis of submissions revealed that many of the stakeholders in Aboriginal health policy actors are connected to one another. These connections help to drive the policy discourse. The combination of network and framing analysis illuminates competing interests within a network, and can assist advocacy organisations to identify which network members are most influential. Copyright © 2016 Elsevier Ltd. All rights reserved.

The persistence of cliques in the post-communist state. The case of deniability in drug reimbursement policy in Poland.

PubMed

Ozierański, Piotr; King, Lawrence

2016-06-01

This article explores a key question in political sociology: Can post-communist policy-making be described with classical theories of the Western state or do we need a theory of the specificity of the post-communist state? In so doing, we consider Janine Wedel's clique theory, concerned with informal social actors and processes in post-communist transition. We conducted a case study of drug reimbursement policy in Poland, using 109 stakeholder interviews, official documents and media coverage. Drawing on 'sensitizing concepts' from Wedel's theory, especially the notion of 'deniability', we developed an explanation of why Poland's reimbursement policy combined suboptimal outcomes, procedural irregularities with limited accountability of key stakeholders. We argue that deniability was created through four main mechanisms: (1) blurred boundaries between different types of state authority allowing for the dispersion of blame for controversial policy decisions; (2) bridging different sectors by 'institutional nomads', who often escaped existing conflicts of interest regulations; (3) institutional nomads' 'flexible' methods of influence premised on managing roles and representations; and (4) coordination of resources and influence by elite cliques monopolizing exclusive policy expertise. Overall, the greatest power over drug reimbursement was often associated with lowest accountability. We suggest, therefore, that the clique theory can be generalized from its home domain of explanation in foreign aid and privatizations to more technologically advanced policies in Poland and other post-communist countries. This conclusion is not identical, however, with arguing the uniqueness of the post-communist state. Rather, we show potential for using Wedel's account to analyse policy-making in Western democracies and indicate scope for its possible integration with the classical theories of the state. © London School of Economics and Political Science 2016.

A health app developer's guide to law and policy: a multi-sector policy analysis.

PubMed

Parker, Lisa; Karliychuk, Tanya; Gillies, Donna; Mintzes, Barbara; Raven, Melissa; Grundy, Quinn

2017-10-02

Apps targeted at health and wellbeing sit in a rapidly growing industry associated with widespread optimism about their potential to deliver accessible and cost-effective healthcare. App developers might not be aware of all the regulatory requirements and best practice principles are emergent. Health apps are regulated in order to minimise their potential for harm due to, for example, loss of personal health privacy, financial costs, and health harms from delayed or unnecessary diagnosis, monitoring and treatment. We aimed to produce a comprehensive guide to assist app developers in producing health apps that are legally compliant and in keeping with high professional standards of user protection. We conducted a case study analysis of the Australian and related international policy environment for mental health apps to identify relevant sectors, policy actors, and policy solutions. We identified 29 policies produced by governments and non-government organisations that provide oversight of health apps. In consultation with stakeholders, we developed an interactive tool targeted at app developers, summarising key features of the policy environment and highlighting legislative, industry and professional standards around seven relevant domains: privacy, security, content, promotion and advertising, consumer finances, medical device efficacy and safety, and professional ethics. We annotated this developer guidance tool with information about: the relevance of each domain; existing legislative and non-legislative guidance; critiques of existing policy; recommendations for developers; and suggestions for other key stakeholders. We anticipate that mental health apps developed in accordance with this tool will be more likely to conform to regulatory requirements, protect consumer privacy, protect consumer finances, and deliver health benefit; and less likely to attract regulatory penalties, offend consumers and communities, mislead consumers, or deliver health harms. We encourage government, industry and consumer organisations to use and publicise the tool.

10 best resources on power in health policy and systems in low- and middle-income countries.

PubMed

Sriram, Veena; Topp, Stephanie M; Schaaf, Marta; Mishra, Arima; Flores, Walter; Rajasulochana, Subramania Raju; Scott, Kerry

2018-05-01

Power is a critical concept to understand and transform health policy and systems. Power manifests implicitly or explicitly at multiple levels-local, national and global-and is present at each actor interface, therefore shaping all actions, processes and outcomes. Analysing and engaging with power has important potential for improving our understanding of the underlying causes of inequity, and our ability to promote transparency, accountability and fairness. However, the study and analysis of the role of power in health policy and systems, particularly in the context of low- and middle-income countries, has been lacking. In order to facilitate greater engagement with the concept of power among researchers and practitioners in the health systems and policy realm, we share a broad overview of the concept of power, and list 10 excellent resources on power in health policy and systems in low- and middle-income countries, covering exemplary frameworks, commentaries and empirical work. We undertook a two-stage process to identify these resources. First, we conducted a collaborative exercise involving crowdsourcing and participatory validation, resulting in 24 proposed articles. Second, we conducted a structured literature review in four phases, resulting in 38 articles reviewed. We present the 10 selected resources in the following categories to bring out key facets of the literature on power and health policy and systems-(1) Resources that provide an overarching conceptual exploration into how power shapes health policy and systems, and how to investigate it; and (2) examples of strong empirical work on power and health policy and systems research representing various levels of analyses, geographic regions and conceptual understandings of power. We conclude with a brief discussion of key gaps in the literature, and suggestions for additional methodological approaches to study power.

Actor Diversity and Interactions in the Development of Banana Hybrid Varieties in Uganda: Implications for Technology Uptake

ERIC Educational Resources Information Center

Sanya, Losira Nasirumbi; Sseguya, Haroon; Kyazze, Florence Birungi; Baguma, Yona; Kibwika, Paul

2018-01-01

Purpose: We examine the nature of networks through which new hybrid banana varieties (HBVs) in Uganda are developed, and how different actors engage in the technology development process. Design/methodology/approach: We collected the data through 20 key informant interviews and 5 focus group discussions with actors involved in the process. We…

Climate policy in India: what shapes international, national and state policy?

PubMed

Atteridge, Aaron; Shrivastava, Manish Kumar; Pahuja, Neha; Upadhyay, Himani

2012-01-01

At the international level, India is emerging as a key actor in climate negotiations, while at the national and sub-national levels, the climate policy landscape is becoming more active and more ambitious. It is essential to unravel this complex landscape if we are to understand why policy looks the way it does, and the extent to which India might contribute to a future international framework for tackling climate change as well as how international parties might cooperate with and support India's domestic efforts. Drawing on both primary and secondary data, this paper analyzes the material and ideational drivers that are most strongly influencing policy choices at different levels, from international negotiations down to individual states. We argue that at each level of decision making in India, climate policy is embedded in wider policy concerns. In the international realm, it is being woven into broader foreign policy strategy, while domestically, it is being shaped to serve national and sub-national development interests. While our analysis highlights some common drivers at all levels, it also finds that their influences over policy are not uniform across the different arenas, and in some cases, they work in different ways at different levels of policy. We also indicate what this may mean for the likely acceptability within India of various climate policies being pushed at the international level.

New Lenses for Viewing Educational Policy: Insights through Imaginative Literature.

ERIC Educational Resources Information Center

Fenwick, Tara J.

This paper calls for an alternative view of educational policy, a departure from the macroperspective currently dominating policy analysis. The latter perspective tends to focus on policy development and implementation issues of politics and control, compliance and measurement, and relationship structures and influences among groups and actors.…

Government Accountability Reports and Public Education Policy: Studying Political Actors' Decision-Making

ERIC Educational Resources Information Center

Salazar, Timothy Ross

2013-01-01

This study asks how government accountability reports are used to influence public education policy. Government accountability reports, called "audits" in Utah, prove to be useful tools for examining education policy. Using a collective case study design examining Utah's Class Size Reduction (CSR) policy, government accountability…

Meta-principles for developing smart, sustainable, and healthy cities.

PubMed

Ramaswami, Anu; Russell, Armistead G; Culligan, Patricia J; Sharma, Karnamadakala Rahul; Kumar, Emani

2016-05-20

Policy directives in several nations are focusing on the development of smart cities, linking innovations in the data sciences with the goal of advancing human well-being and sustainability on a highly urbanized planet. To achieve this goal, smart initiatives must move beyond city-level data to a higher-order understanding of cities as transboundary, multisectoral, multiscalar, social-ecological-infrastructural systems with diverse actors, priorities, and solutions. We identify five key dimensions of cities and present eight principles to focus attention on the systems-level decisions that society faces to transition toward a smart, sustainable, and healthy urban future. Copyright © 2016, American Association for the Advancement of Science.

An exploration of the political economy dynamics shaping health worker incentives in three districts in Sierra Leone.

PubMed

Bertone, Maria Paola; Witter, Sophie

2015-09-01

The need for evidence-based practice calls for research focussing not only on the effectiveness of interventions and their translation into policies, but also on implementation processes and the factors influencing them, in particular for complex health system policies. In this paper, we use the lens of one of the health system's 'building blocks', human resources for health (HRH), to examine the implementation of official policies on HRH incentives and the emergence of informal practices in three districts of Sierra Leone. Our mixed-methods research draws mostly from 18 key informant interviews at district level. Data are organised using a political economy framework which focuses on the dynamic interactions between structure (context, historical legacies, institutions) and agency (actors, agendas, power relations) to show how these elements affect the HRH incentive practices in each district. It appears that the official policies are re-shaped both by implementation challenges and by informal practices emerging at local level as the result of the district-level dynamics and negotiations between District Health Management Teams (DHMTs) and nongovernmental organisations (NGOs). Emerging informal practices take the form of selective supervision, salary supplementations and per diems paid to health workers, and aim to ensure a better fit between the actors' agendas and the incentive package. Importantly, the negotiations which shape such practices are characterised by a substantial asymmetry of power between DHMTs and NGOs. In conclusion, our findings reveal the influence of NGOs on the HRH incentive package and highlight the need to empower DHMTs to limit the discrepancy between policies defined at central level and practices in the districts, and to reduce inequalities in health worker remuneration across districts. For Sierra Leone, these findings are now more relevant than ever as new players enter the stage at district level, as part of the Ebola response and post-Ebola reconstruction. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Strengthening the health workforce and rolling out universal health coverage: the need for policy analysis.

PubMed

Koon, Adam D; Mayhew, Susannah H

2013-07-24

This article opens a debate about how to think about moving forward with the emerging twin movements of human resources for health (HRH) and universal health coverage (UHC). There is sufficient evidence to warrant these movements, but actors and the policy process significantly affect which policies are adopted and how they are implemented. How exactly this occurs in low- and middle-income countries (LMICs) is not very well understood. Furthermore, it is not clear whether actors will mobilize for or against the emergent HRH and UHC agendas. Policy analysis should help illuminate potential strategies to account for multiple interests and divergent values in volatile stakeholder environments. We argue that not only should the movement for UHC be paired with current efforts to address the human resources crisis, but also, for both to succeed, we need to know more about how health policy works in LMICs.

[Social marketing and public policies for health: campaign to promote smoke-free spaces in Mexico].

PubMed

Villalobos, Víctor; Ramírez, Olivia Ortiz; Thrasher, James F; Santillán, Edna Arillo; Hernández, Rosaura Pérez; Cedillo, Claudia; González, Wendy

2010-01-01

"Porque todos respiramos lo mismo" is a mass media campaign to promote smoke-free places (SFP). The development stages were: strategic planning; formative research; message development; media plan; and impact evaluation. Development involved formation of a coalition of key actors in various sectors. The target population was smokers and nonsmokers, with the aim of changing social norms around SFP. Nonsmokers were targeted because they comprised the majority and were most likely to appreciate the benefits of SFPs. Campaign materials were aired on television, radio, print and on billboards. One key limitation was the lack of evidence for previous campaigns, which increased the importance of formative research and of including a rigorous evaluation for this one. The campaign evaluation indicates a significant impact, which suggests that future campaigns use similar strategies in their development.

Assessing land degradation and acknowledging adaptive policy options to face with changes: an integrated approach applied to a semiarid agropastoral system

NASA Astrophysics Data System (ADS)

Tarrasón, D.; Ravera, F.; Reed, M.; Dougill, A.

2009-04-01

The complexity of assessing land degradation on semiarid systems deals with challenges that have rarely been addressed. Land degradation is a human-induced and permanent reduction of key ecosystem functions and services at different temporal and spatial scale. Initial attempts to assess land degradation at a broader scale were based on expert opinion, however the empirical bases to sustain these estimations are weak and the ecological data are still scarce. In addition, such approaches are essentially subjective and they reflect the objectives and assumptions of those making the assessment, who are rarely land users themselves. Currently, the concept of "land degradation" is debated, and in the last years have emerged a growing number of efforts to develop land degradation participatory assessment methods that could capture a more complex understanding of human-environment interactions. This study proposes an interdisciplinary and hybrid methodology, combining local and scientific knowledge, to assess land degradation in mixed farming systems. Specifically, i) it describes and analyses the mixed farming system and it explores how historically political, social and institutional local factors have interacted with ecological process, ii) it identifies key ecosystem processes and services needed to support the agropastoral systems that are perceived to be under threat from land degradation; iii) it assesses the status and trends of these key ecosystem services; and iv) it identifies and evaluates potential management alternatives to prevent land degradation and cope with changes (e.g. climate change). We show how to achieve, through a co-construction of hybrid knowledge between scientific and farmers, a more accurate and reliable appraisal of land degradation, since farmer's perception is contextualized, dynamic and complex and involves simultaneously multiple temporal and spatial scales and multiple dimensions of analysis that could help the scientific exploration. The study reveals that the ecosystem services' exploration with local actors is a good method to reveal the multiple and sometimes conflictive local strategies and interests at stake. Ecosystem services assessment has also been used as an entry to discuss with local land users about adaptive management strategies to improve soil functions involved in the maintenance of the provision and regulation processes and land productivity that support local livelihoods face to changes. The integrated methodological framework adopted has a positive impact to empower local users, enlarging the access to adequate information and channels of communication between experts/local users, and improving their capacity to use the co-constructed hybrid knowledge. We argue that engaging the relevant and interested actors in the process is key to understand margin of flexibility for dialogue between local users, scientific and policy makers and it is a base for ownership of local actors in decision making processes that facilitates effective soil-land governance. Finally, we discuss how wide institutional changes at different levels are needed to support agro-environmental policies for communities, small and medium farmers and to undertake new adaptive management strategies to cope with uncertainties of future changes.

Bombing Alone: Tracing the Motivations and Antecedent Behaviors of Lone-Actor Terrorists*,†,‡

PubMed Central

Gill, Paul; Horgan, John; Deckert, Paige

2014-01-01

This article analyzes the sociodemographic network characteristics and antecedent behaviors of 119 lone-actor terrorists. This marks a departure from existing analyses by largely focusing upon behavioral aspects of each offender. This article also examines whether lone-actor terrorists differ based on their ideologies or network connectivity. The analysis leads to seven conclusions. There was no uniform profile identified. In the time leading up to most lone-actor terrorist events, other people generally knew about the offender’s grievance, extremist ideology, views, and/or intent to engage in violence. A wide range of activities and experiences preceded lone actors’ plots or events. Many but not all lone-actor terrorists were socially isolated. Lone-actor terrorists regularly engaged in a detectable and observable range of activities with a wider pressure group, social movement, or terrorist organization. Lone-actor terrorist events were rarely sudden and impulsive. There were distinguishable behavioral differences between subgroups. The implications for policy conclude this article. PMID:24313297

Policy Subjects and Policy Actors in Schools: Some Necessary but Insufficient Analyses

ERIC Educational Resources Information Center

Ball, Stephen J.; Maguire, Meg; Braun, Annette; Hoskins, Kate

2011-01-01

This paper explores two different ontological positions from which policy in schools and teachers can be viewed. On the one hand, it explores the ways in which policies make up and make possible particular sorts of teacher subjects--as producers and consumers of policy, as readers and writers of policy. On the other, it begins to conceptualise the…

A novel approach to locomotion learning: Actor-Critic architecture using central pattern generators and dynamic motor primitives.

PubMed

Li, Cai; Lowe, Robert; Ziemke, Tom

2014-01-01

In this article, we propose an architecture of a bio-inspired controller that addresses the problem of learning different locomotion gaits for different robot morphologies. The modeling objective is split into two: baseline motion modeling and dynamics adaptation. Baseline motion modeling aims to achieve fundamental functions of a certain type of locomotion and dynamics adaptation provides a "reshaping" function for adapting the baseline motion to desired motion. Based on this assumption, a three-layer architecture is developed using central pattern generators (CPGs, a bio-inspired locomotor center for the baseline motion) and dynamic motor primitives (DMPs, a model with universal "reshaping" functions). In this article, we use this architecture with the actor-critic algorithms for finding a good "reshaping" function. In order to demonstrate the learning power of the actor-critic based architecture, we tested it on two experiments: (1) learning to crawl on a humanoid and, (2) learning to gallop on a puppy robot. Two types of actor-critic algorithms (policy search and policy gradient) are compared in order to evaluate the advantages and disadvantages of different actor-critic based learning algorithms for different morphologies. Finally, based on the analysis of the experimental results, a generic view/architecture for locomotion learning is discussed in the conclusion.

A novel approach to locomotion learning: Actor-Critic architecture using central pattern generators and dynamic motor primitives

PubMed Central

Li, Cai; Lowe, Robert; Ziemke, Tom

2014-01-01

In this article, we propose an architecture of a bio-inspired controller that addresses the problem of learning different locomotion gaits for different robot morphologies. The modeling objective is split into two: baseline motion modeling and dynamics adaptation. Baseline motion modeling aims to achieve fundamental functions of a certain type of locomotion and dynamics adaptation provides a “reshaping” function for adapting the baseline motion to desired motion. Based on this assumption, a three-layer architecture is developed using central pattern generators (CPGs, a bio-inspired locomotor center for the baseline motion) and dynamic motor primitives (DMPs, a model with universal “reshaping” functions). In this article, we use this architecture with the actor-critic algorithms for finding a good “reshaping” function. In order to demonstrate the learning power of the actor-critic based architecture, we tested it on two experiments: (1) learning to crawl on a humanoid and, (2) learning to gallop on a puppy robot. Two types of actor-critic algorithms (policy search and policy gradient) are compared in order to evaluate the advantages and disadvantages of different actor-critic based learning algorithms for different morphologies. Finally, based on the analysis of the experimental results, a generic view/architecture for locomotion learning is discussed in the conclusion. PMID:25324773

One Approach to a Pluralist Dilemma: Private School Aid Policy in France, 1959-1985.

ERIC Educational Resources Information Center

Fowler, Frances C.

Information about the French policy of government aid to private schools is presented in this report to promote understanding in the United States of the pluralist dilemma raised by the private school aid issue. An historical longitudinal policy evaluation involved document analysis and interviews with 16 French policy actors. The French policy is…

Affect Theory and Policy Mobility: Challenges and Possibilities for Critical Policy Research

ERIC Educational Resources Information Center

McKenzie, Marcia

2017-01-01

This article contributes to a growing literature on policy mobilities by proposing that affect be considered in analyses of the movements and transformations of policy over time and space. In particular, collective affective conditions, the role of affect in terms of infrastructures and actors of policy apparatuses and the mediating influences of…

Signal and Symbol: How State and Local Policies Address Data-Informed Practice

ERIC Educational Resources Information Center

Jimerson, Jo Beth; Childs, Joshua

2017-01-01

Numerous actors influence how educational policies play out in practice, but this does not mean that policies themselves are without power. Policies are crafted and enacted in part because they serve as signal and symbol: How a policy is formally codified establishes expectations, exerts norming influence, and catalyzes shifts in how issues are…

Using Evaluation Research as a Means for Policy Analysis in a "New" Mission-Oriented Policy Context

ERIC Educational Resources Information Center

Amanatidou, Effie; Cunningham, Paul; Gök, Abdullah; Garefi, Ioanna

2014-01-01

Grand challenges stress the importance of multi-disciplinary research, a multi-actor approach in examining the current state of affairs and exploring possible solutions, multi-level governance and policy coordination across geographical boundaries and policy areas, and a policy environment for enabling change both in science and technology and in…

A Comparative Analysis of Education Policy and Practice: The Case of Institutions in Mumbai and Delhi

ERIC Educational Resources Information Center

Iyengar, Radhika; Surianarain, Sharmi

2010-01-01

There exist many actors within the realm of education policy planning and implementation, namely: the policy makers; the national, local and regional institutions engaged in the dissemination and interpretation of these policies; and the educational institutions that implement these policies at the ground level (schools). While schools are largely…

Centrifugal Schooling: Third Sector Policy Networks and the Reassembling of Curriculum Policy in England

ERIC Educational Resources Information Center

Williamson, Ben

2012-01-01

This article examines changes in curriculum policy in secondary education in England. It is concerned with recent curriculum policy and reform, and the proliferation of non-government actors in curriculum policy creation. It examines the emergence of a loose alliance of third sector organisations and their involvement in a series of alternative…

Policy Enactment, Context and Performativity: Ontological Politics and Researching Australian National Partnership Policies

ERIC Educational Resources Information Center

Singh, Parlo; Heimans, Stephen; Glasswell, Kathryn

2014-01-01

Recently, critical policy scholars have used the concepts of enactment, context and performativity as an analytic toolkit to illuminate the complex processes of the policy cycle, in particular, the ways in which a multitude of official education reform policies are taken up, challenged and/or resisted by actors in local, situation-specific…

Silencing women’s sexuality: global AIDS policies and the case of the female condom

PubMed Central

Peters, Anny JTP; van Driel, Francien TM; Jansen, Willy HM

2013-01-01

Introduction The female condom is the only evidence-based AIDS prevention technology that has been designed for the female body; yet, most women do not have access to it. This is remarkable since women constitute the majority of all HIV-positive people living in sub-Saharan Africa, and gender inequality is seen as a driving force of the AIDS epidemic. In this study, we analyze how major actors in the AIDS prevention field frame the AIDS problem, in particular the female condom in comparison to other prevention technologies, in their discourse and policy formulations. Our aim is to gain insight into the discursive power mechanisms that underlie the thinking about AIDS prevention and women’s sexual agency. Methods We analyze the AIDS policies of 16 agencies that constitute the most influential actors in the global response to AIDS. Our study unravels the discursive power of these global AIDS policy actors, when promoting and making choices between AIDS prevention technologies. We conducted both a quantitative and qualitative analysis of how the global AIDS epidemic is being addressed by them, in framing the AIDS problem, labelling of different categories of people for targeting AIDS prevention programmes and in gender marking of AIDS prevention technologies. Results We found that global AIDS policy actors frame the AIDS problem predominantly in the context of gender and reproductive health, rather than that of sexuality and sexual rights. Men’s sexual agency is treated differently from women’s sexual agency. An example of such differentiation and of gender marking is shown by contrasting the framing and labelling of male circumcision as an intervention aimed at the prevention of HIV with that of the female condom. Conclusions The gender-stereotyped global AIDS policy discourse negates women’s agency in sexuality and their sexual rights. This could be an important factor in limiting the scale-up of female condom programmes and hampering universal access to female condoms. PMID:23838151

Efficient model learning methods for actor-critic control.

PubMed

Grondman, Ivo; Vaandrager, Maarten; Buşoniu, Lucian; Babuska, Robert; Schuitema, Erik

2012-06-01

We propose two new actor-critic algorithms for reinforcement learning. Both algorithms use local linear regression (LLR) to learn approximations of the functions involved. A crucial feature of the algorithms is that they also learn a process model, and this, in combination with LLR, provides an efficient policy update for faster learning. The first algorithm uses a novel model-based update rule for the actor parameters. The second algorithm does not use an explicit actor but learns a reference model which represents a desired behavior, from which desired control actions can be calculated using the inverse of the learned process model. The two novel methods and a standard actor-critic algorithm are applied to the pendulum swing-up problem, in which the novel methods achieve faster learning than the standard algorithm.

Uncovering Influence through Social Network Analysis: The Role of Schools in Education for Sustainable Development

ERIC Educational Resources Information Center

Kolleck, Nina

2016-01-01

This paper examines the implementation of Education for Sustainable Development (ESD) in Germany and explores the possibilities of Social Network Analysis (SNA) for uncovering influential actors in educational policy innovation processes. From the theoretical perspective, an actor's influence is inferred from its relative position within…

Between Argument and Coercion: Social Coordination in Rural Environmental Governance

ERIC Educational Resources Information Center

Taylor, Bruce M.

2010-01-01

Increasingly, partnerships and other cooperative forms of governance are common-place in addressing problems of environmental management in rural landscapes. These forms of governance are multi-dimensional in the policy instruments employed; the make-up of actors; and, the types of rationalities that actors use to debate the problem and proposed…

Approximate N-Player Nonzero-Sum Game Solution for an Uncertain Continuous Nonlinear System.

PubMed

Johnson, Marcus; Kamalapurkar, Rushikesh; Bhasin, Shubhendu; Dixon, Warren E

2015-08-01

An approximate online equilibrium solution is developed for an N -player nonzero-sum game subject to continuous-time nonlinear unknown dynamics and an infinite horizon quadratic cost. A novel actor-critic-identifier structure is used, wherein a robust dynamic neural network is used to asymptotically identify the uncertain system with additive disturbances, and a set of critic and actor NNs are used to approximate the value functions and equilibrium policies, respectively. The weight update laws for the actor neural networks (NNs) are generated using a gradient-descent method, and the critic NNs are generated by least square regression, which are both based on the modified Bellman error that is independent of the system dynamics. A Lyapunov-based stability analysis shows that uniformly ultimately bounded tracking is achieved, and a convergence analysis demonstrates that the approximate control policies converge to a neighborhood of the optimal solutions. The actor, critic, and identifier structures are implemented in real time continuously and simultaneously. Simulations on two and three player games illustrate the performance of the developed method.

From irreversibility to participation: towards a participatory foresight for the governance of collective environmental risks.

PubMed

Faucheux, S; Hue, C

2001-09-14

This paper presents a reflection on the introduction of methods and tools of "participative foresight" for scientific and technology policy as well as environmental policy fields. Future studies have recently made a comeback under the label of foresight. Future technology studies no longer claim to forecast the future, but are presented as a strategic tool for improving interaction between key actors and for anticipatory policy making. They can be defined as a "process by which one comes to a fuller understanding of the forces shaping the long term future which should be taken into account in policy formulation, planning and decision-making" [Foresight in Federal Government Policymaking, Futures Res. Quart. (1985) 29]. We discuss applications of this approach for perspectives on environmental policy and sustainable development. Foresight opens up the possibility of negotiating a new and more fruitful relationship or 'social contract' between science and technology, on the one hand, and society on the other. The focus has moved from merely scientific and industrial insights to social demand, thus emphasizing the importance of both the production and "supply" of innovation, and the "demand" as signaled in the views of citizens.

Camus' Actor as Tom Stoppard's Player; A Key to Interpreting "Rosencrantz and Guildenstern Are Dead."

ERIC Educational Resources Information Center

Zivanovic, Judith

An examination of Albert Camus' definition of the actor in "The Myth on Sisyphus" helps to illuminate the character and role of The Player in Tom Stoppard's play and, hence, to bring light to an understanding of the philosophy of the play itself. The actor, for Camus, reveals our mortality in the face of the absurdity of our mortality,…

Why do policies change? Institutions, interests, ideas and networks in three cases of policy reform.

PubMed

Shearer, Jessica C; Abelson, Julia; Kouyaté, Bocar; Lavis, John N; Walt, Gill

2016-11-01

Policy researchers have used various categories of variables to explain why policies change, including those related to institutions, interests and ideas. Recent research has paid growing attention to the role of policy networks-the actors involved in policy-making, their relationships with each other, and the structure formed by those relationships-in policy reform across settings and issues; however, this literature has largely ignored the theoretical integration of networks with other policy theories, including the '3Is' of institutions, interests and ideas. This article proposes a conceptual framework integrating these variables and tests it on three cases of policy change in Burkina Faso, addressing the need for theoretical integration with networks as well as the broader aim of theory-driven health policy analysis research in low- and middle-income countries. We use historical process tracing, a type of comparative case study, to interpret and compare documents and in-depth interview data within and between cases. We found that while network changes were indeed associated with policy reform, this relationship was mediated by one or more of institutions, interests and ideas. In a context of high donor dependency, new donor rules affected the composition and structure of actors in the networks, which enabled the entry and dissemination of new ideas and shifts in the overall balance of interest power ultimately leading to policy change. The case of strategic networking occurred in only one case, by civil society actors, suggesting that network change is rarely the spark that initiates the process towards policy change. This analysis highlights the important role of changes in institutions and ideas to drive policymaking, but hints that network change is a necessary intermediate step in these processes. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Violence-related deaths in Argentina: two case studies in the cities of Venado Tuerto and San Rafael].

PubMed

Spinelli, Hugo; Alazraqui, Marcio; Galeano, Diego; Calandrón, Sabrina

2012-12-01

This article presents the results of a comparative study of two Argentinian cities, namely Venado Tuerto and San Rafael, which revealed different trends in the rates of firearm-related homicides. The methodology combined two strategies of analysis: semi-structured interviews with key informants (municipal and provincial government agents in different areas of management, as well as members of non-governmental organizations) and focus groups with actors involved in medical care, education, and religious institutions. The results suggest little difference between cities in which rates have increased and those in which rates have decreased. The most significant difference was that in Venado Tuerto a greater fragility of public institutions was observed due to the lack of articulation between such institutions. In San Rafael, the actors interviewed attribute the low level of conflict to a violence prevention network in which provincial and municipal agencies interact. Although neither city is violent at the most critical Latin American levels, the different results shown in Venado Tuerco and San Rafael indicate the possibility of bringing institutions together in a joint framework of conversations, agreements and policies.

The Changing Role of ENGOs in Water Governance: Institutional Entrepreneurs?

NASA Astrophysics Data System (ADS)

Davidson, Seanna L.; de Loë, Rob C.

2016-01-01

The changing role of the state in the last quarter century has been an important contemporary concern for policy makers, scholars, and the public. Equally, there is increasing recognition among governance scholars that nongovernment actors are exerting new kinds of influence over governance systems and contributing in novel ways to governance processes. The role of environmental nongovernmental organizations (ENGOs) is particularly pertinent given the continued involvement of ENGOs within collaborative, adaptive, and co-management governance, across several contexts and regions. This paper uses an analytical framework derived from recent studies on institutional entrepreneurs, to examine the skills ENGOs are applying in order to orchestrate change. An empirical case of governance for water in Canada's Lake Simcoe region provides the foundation for the research. Drawing on a mixed methods approach, the research finds that ENGOs in Lake Simcoe have taken on a role as an institutional entrepreneur, and thereby have altered the relationship between governance actors in this setting. A key outcome of their actions is a more dominant, engaged, and influential role for ENGOs in a critical, regional governance system.

Selling Tech to Teachers: Education Trade Shows as Policy Events

ERIC Educational Resources Information Center

Player-Koro, Catarina; Bergviken Rensfeldt, Annika; Selwyn, Neil

2018-01-01

Digital technology is an expanding area of education policy. There is growing interest, therefore, in how networks of corporate and state policy actors implicit in the formation of (inter)national education technology agendas intersect with local school systems and teachers. In particular, this paper explores the significant policy work that takes…

Responding to Policy Challenges with Research Evidence: Introduction to Special Issue

ERIC Educational Resources Information Center

Aydarova, Elena; Berliner, David C.

2018-01-01

In a policy climate where various actors claim to have solutions for the enduring challenges of teacher education, policy deliberations sideline certain voices and omit important perspectives. This special issue brings together scholars who attend to the voices, perspectives, and issues overlooked by teacher education policy debates dominated by…

Education Policy Influence Efficacy: Teacher Beliefs in Their Ability to Change Education Policy

ERIC Educational Resources Information Center

Hinnant-Crawford, Brandi

2016-01-01

Guided by Social Cognitive Theory (SCT) this study sought to understand how teachers view themselves as educational policy actors and to construct an instrument that measures teacher beliefs about their aptitude to advocate for changes in educational policy. This study employed a sequential explanatory design, characterized by quantitative data…

Coming to Matter "in" Practice: Enacting Education Policy

ERIC Educational Resources Information Center

Heimans, Stephen

2012-01-01

This article is offered as a counterpoint and complement to the symposium on policy enactment in a previous issue of "Discourse" by Stephen Ball, Meg Maguire and colleagues. Although their focus was largely on the discursive, and policy actors and policy subjects, this article is concerned with researching the emergent materiality of…

Ecological Knowledge Among Communities, Managers and Scientists: Bridging Divergent Perspectives to Improve Forest Management Outcomes

NASA Astrophysics Data System (ADS)

Rist, Lucy; Shackleton, Charlie; Gadamus, Lily; Chapin, F. Stuart; Gowda, C. Made; Setty, Siddappa; Kannan, Ramesh; Shaanker, R. Uma

2016-04-01

Multiple actors are typically involved in forest management, namely communities, managers and researchers. In such cases, suboptimal management outcomes may, in addition to other factors, be symptomatic of a divergence in perspectives among these actors driven by fundamental differences in ecological knowledge. We examine the degree of congruence between the understandings of actors surrounding key issues of management concern in three case studies from tropical, subtropical and boreal forests. We identify commonly encountered points of divergence in ecological knowledge relating to key management processes and issues. We use these to formulate seven hypotheses about differences in the bodies of knowledge that frequently underlie communication and learning failures in forest management contexts where multiple actors are involved and outcomes are judged to be suboptimal. Finally, we present a set of propositions to acknowledge and narrow these differences. A more complete recognition of the full triangulation between all actors involved, and of the influence that fundamental differences in ecological knowledge can exert, may help lead to a more fruitful integration between local knowledge and practice, manager knowledge and practice, and contemporary science in forest management.

Innovation or 'Inventions'? The conflict between latent assumptions in marine aquaculture and local fishery.

PubMed

Martínez-Novo, Rodrigo; Lizcano, Emmánuel; Herrera-Racionero, Paloma; Miret-Pastor, Lluís

2018-02-01

Recent European policy highlights the need to promote local fishery and aquaculture by means of innovation and joint participation in fishery management as one of the keys to achieve the sustainability of our seas. However, the implicit assumptions held by the actors in the two main groups involved - innovators (scientists, businessmen and administration managers) and local fishermen - can complicate, perhaps even render impossible, mutual understanding and co-operation. A qualitative analysis of interviews with members of both groups in the Valencian Community (Spain) reveals those latent assumptions and their impact on the respective practices. The analysis shows that the innovation narrative in which one group is based and the inventions narrative used by the other one are rooted in two dramatically different, or even antagonistic, collective worldviews. Any environmental policy that implies these groups should take into account these strong discords.

Analysis of the policymaking process in Burkina Faso's health sector: case studies of the creation of two health system support units.

PubMed

Zida, Andre; Lavis, John N; Sewankambo, Nelson K; Kouyate, Bocar; Moat, Kaelan; Shearer, Jessica

2017-02-13

Burkina Faso has made a number of health system policy decisions to improve performance on health indicators and strengthen responsiveness to health-related challenges. These included the creation of a General Directorate of Health Information and Statistics (DGISS) and a technical unit to coordinate performance-based financing (CT-FBR). We analysed the policymaking processes associated with the establishment of these units, and documented the factors that influenced this process. We used a multiple-case study design based on Kingdon's agenda-setting model to investigate the DGISS and CT-FBR policymaking processes. Data were collected from interviews with key informants (n = 28), published literature, policy documents (including two strategic and 230 action plans), and 55 legal/regulatory texts. Interviews were analysed using thematic qualitative analysis. Data from the documentary analysis were triangulated with the qualitative interview data. Key factors influencing the policymaking processes associated with the two units involved the 'problem' (problem identification), 'policy' (formation of policy proposals), and 'politics' (political climate/change) streams, which came together in a way that resulted in proposals being placed on the decision agenda. A number of problems with Burkina Faso's health information and financing systems were identified. Policy proposals for the DGISS and CT-FBR units were developed in response to these problems, emerging from several sources including development partners. Changes in political and public service administrations (specifically the 2008 appointment of a new Minister of Health and the establishment of a new budget allocation system), with corresponding changes in the actors and interests involved, appeared key in elevating the proposals to the decision agenda. Efforts to improve performance on health indicators and strengthen responsiveness to health-related challenges need focus on the need for a compelling problem, a viable policy, and conducive politics in order to make it to the decision agenda.

Selling Pre-K: Media, Politics, and Policy in the Case of Universal Pre-Kindergarten in New York City

ERIC Educational Resources Information Center

Delaney, Katherine K.; Neuman, Susan B.

2018-01-01

Background/Context: Educational policy is informed by multiple stakeholders and actors. Research has focused on understanding how policy decisions are informed and made, as well as how teachers and school leaders take up these policies in their practice. However, few researchers have examined how educational policy is framed for the larger public…

Implementing Health in All Policies - Time and Ideas Matter Too! Comment on "Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities".

PubMed

Clavier, Carole

2016-06-20

Carey and Friel suggest that we turn to knowledge developed in the field of public administration, especially new public governance, to better understand the process of implementing health in all policies (HiAP). In this commentary, I claim that theories from the policy studies bring a broader view of the policy process, complementary to that of new public governance. Drawing on the policy studies, I argue that time and ideas matter to HiAP implementation, alongside with interests and institutions. Implementing HiAP is a complex process considering that it requires the involvement and coordination of several policy sectors, each with their own interests, institutions and ideas about the policy. Understanding who are the actors involved from the various policy sectors concerned, what context they evolve in, but also how they own and frame the policy problem (ideas), and how this has changed over time, is crucial for those involved in HiAP implementation so that they can relate to and work together with actors from other policy sectors. © 2016 by Kerman University of Medical Sciences.

Identifying Key Actors in Heterogeneous Networks

DTIC Science & Technology

2017-11-29

analysis (SNA) and game theory (GT) to improve accuracy for detecting significant or “powerful” actors within a total actor space when both resource...coalesce in order to achieve a desired outcome. Cooperative game theory (CGT) models of coalition formation are based on two limiting assumptions: that...demonstration of a new approach for synthesizing social network analysis and game theory. The ultimate goal of this research agenda is to generalize

Understanding the Roles of Non-State Actors in Global Governance: Evidence from the Global Partnership for Education

ERIC Educational Resources Information Center

Menashy, Francine

2016-01-01

The study detailed in this paper examines the growing role of non-state actors in the transnational policy-making landscape through a case study of the Global Partnership for Education (GPE)--a partnership of donor and developing country governments, multilateral organizations, civil society, private companies and foundations, dedicated to…

What Can We Learn About the Processes of Regulation of Tuberculosis Medicines From the Experiences of Health Policy and System Actors in India, Tanzania, and Zambia?

PubMed

Sheikh, Kabir; Uplekar, Mukund

2016-03-09

The unregulated availability and irrational use of tuberculosis (TB) medicines is a major issue of public health concern globally. Governments of many low- and middle-income countries (LMICs) have committed to regulating the quality and availability of TB medicines, but with variable success. Regulation of TB medicines remains an intractable challenge in many settings, but the reasons for this are poorly understood. The objective of this paper is to elaborate processes of regulation of quality and availability of TB medicines in three LMICs - India, Tanzania, and Zambia - and to understand the factors that constrain and enable these processes. We adopted the action-centred approach of policy implementation analysis that draws on the experiences of relevant policy and health system actors in order to understand regulatory processes. We drew on data from three case studies commissioned by the World Health Organization (WHO), on the regulation of TB medicines in India, Tanzania, and Zambia. Qualitative research methods were used, including in-depth interviews with 89 policy and health system actors and document review. Data were organized thematically into accounts of regulators' authority and capacity; extent of policy implementation; and efficiency, transparency, and accountability. In India, findings included the absence of a comprehensive policy framework for regulation of TB medicines, constraints of authority and capacity of regulators, and poor implementation of prescribing and dispensing norms in the majority private sector. Tanzania had a policy that restricted import, prescribing and dispensing of TB medicines to government operators. Zambia procured and dispensed TB medicines mainly through government services, albeit in the absence of a single policy for restriction of medicines. Three cross-cutting factors emerged as crucially influencing regulatory processes - political and stakeholder support for regulation, technical and human resource capacity of regulatory bodies, and the manner of private actors' influence on regulatory policy and implementation. Strengthening regulation to ensure the quality and availability of TB medicines in LMIC with emerging private markets may necessitate financial and technical inputs to upgrade regulatory bodies, as well as broader political and ethical actions to reorient and transform their current roles. © 2016 by Kerman University of Medical Sciences

Menu-labeling policy in King County, Washington.

PubMed

Johnson, Donna B; Payne, Elizabeth C; McNeese, Molly A; Allen, Deborah

2012-09-01

Food eaten away from home now accounts for about one third of total calories consumed in the U.S. Policy change could lead to sustainable improvements in restaurant and other nutrition environments. Broadly described, policy development is one of the three core functions of public health, and there is a need to more fully understand and evaluate this function. Policy process research has developed frameworks and models that can be used to understand the policy development process. To describe policy processes associated with the passage of restaurant menu-labeling regulations in order to inform nutrition policy development in other settings. Document reviews and interviews with 12 key players in the policy process were conducted and analyzed between June 2009 and October 2010. Policy process actors primarily belonged to two advocacy coalitions: a public health coalition and an industry coalition. Within the coalitions there were shared values and beliefs about the appropriate role of governmental regulation in protecting the health of the population and the need for environmental change. The process was adversarial at times, but "policy learning" built the trust needed for collaboration to negotiate agreements. Expert technical assistance moved the process forward. Elements that contributed to the success of a menu-labeling policy initiative in a large, urban health department have been identified. The King County case study can inform the work of others who seek to build healthier nutrition environments through policy change. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Shaping drug policy in Poland.

PubMed

Malinowska-Sempruch, Kasia

2016-05-01

Poland, a post-socialist democracy with a high interest in successful integration with the European Union and a strong catholic tradition, currently has some of the most restrictive anti-drug laws in Europe. Structural violence towards drug users has intensified as a result of decades of shifting drug policies and, surprisingly, the more recent process of political and economic liberalization. This commentary considers the contextual and historical dynamics of drug policy-making in Poland. It traces transitions in Poland's drug control policy, throughout Poland's history as a soviet satellite state, under martial law, and in the democracy that it is today. This case study draws on an analysis of interviews with key actors and participant observations in combination with documents and archival records. This paper follows the changes in Poland's drug control policy, throughout Poland's history as a soviet satellite state, under martial law, and in the democracy that it is today. Factors contributing to the enactment of restrictive drug laws have occurred in a highly politicized context during a series of dramatic political transitions. Current drug policies are woefully inadequate for treating those in need of drug treatment and care as well as for preventing HIV and other harms linked to drug injecting. Copyright © 2016 Elsevier B.V. All rights reserved.

International institutions and China's health policy.

PubMed

Huang, Yanzhong

2015-02-01

This article examines the role of international institutional actors in China's health policy process. Particular attention is paid to three major international institutional actors: the World Bank, the World Health Organization, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Through process tracing and comparative case studies, the article looks at how international institutions contribute to policy change in China and seeks to explain different outcomes in the relationship between international institutions and China's health policies. It finds that despite the opaque and exclusive authoritarian structure in China, international institutions play a significant role in the country's domestic health governance. By investing their resources and capabilities selectively and strategically, international institutions can change the preferences of government policy makers, move latent public health issues to the government's agenda, and affect the timing of government action and the content of policy design. Furthermore, the study suggests that different outcomes in the relationship between China's health policies and global health governance can be explained through the seriousness of the externalities China faces. Copyright © 2015 by Duke University Press.

Role of local government in responding to environmental health challenges: a case study of Chungnam.

PubMed

Myung, Hyung-Nam; Lee, Hoo-Young

2017-01-01

The purpose of this study is to introduce the establishment process, policy target, and projects for "Chungnam's master plan on environmental health policy (2017-2020)" as the local government's role in addressing local environmental health challenges. We first analyzed existing studies and social issues on the media related to "Chungnam's master plan" to understand Chungnam's environmental health status and discussed domestic and international policy trends and related plans. An environmental health perception questionnaire survey and a Delphi expert questionnaire survey were conducted among provincial residents to collect various actors' opinions on Chungnam's environmental health issues and policy. An expert advisory panel was launched, and a residents' voice workshop and cities-and-guns-policy-suggestion workshop were held. The vision of Chungnam's environmental health policy is minimizing environmental hazards. We finally selected "Pleasant environment, healthy people, happy Chungnam" to represent the will to shape a pleasant environment and prevent and manage health damages for a happy Chungnam. We selected five strategies based on status analysis and a review of domestic and international policy trends and related plans and identified 2 targets (policy objectives) to accomplish the strategies. The strategies to achieve the first target, "Leader in environmental health policy: Chungnam," include 'Empowering active provincial capabilities,' 'Setting up province-specific systems for environmental health surveys and research,' and 'Preventing and managing newly emerging pollutants.' The strategies for the second target, "Everyone is healthy: Chungnam," include 'Relieving health inequalities among vulnerable regions and residents' and 'Enlarging the resident-friendly environmental health policy.' We developed 29 projects in total, according to these strategies. The establishment of "Chungnam's master plan" is highly valuable; we developed it through discussion involving diverse actors to address environmental health challenges together. It is necessary to continue to strengthen participation, communication, and cooperation among actors to develop an environmental health policy model for the future.

The Power of Folk Linguistic Knowledge in Language Policy

ERIC Educational Resources Information Center

Albury, Nathan John

2017-01-01

Just as an expanded view of language policy now affords agency to many more actors across society than authorities and linguists alone, it also accepts that the dispositions these agents bring to language affairs influence language policy processes and outcomes. However, this paper makes the case that language policy may also be guided, to some…

Governing Methods: Policy Innovation Labs, Design and Data Science in the Digital Governance of Education

ERIC Educational Resources Information Center

Williamson, Ben

2015-01-01

Policy innovation labs are emerging knowledge actors and technical experts in the governing of education. The article offers a historical and conceptual account of the organisational form of the policy innovation lab. Policy innovation labs are characterised by specific methods and techniques of design, data science, and digitisation in public…

Incentives in financing mental health care in Austria.

PubMed

Zechmeister, Ingrid; Oesterle, August; Denk, Peter; Katschnig, Heinz

2002-09-01

In Austria, financing health care -and even more so mental health care- is characterized by a mix of federal and provincial responsibilities, lack of uniformity in service provision and service providers, and diverse funding arrangements. The division between financing structures for health care and social care makes the situation even more complex. This state of affairs results in various, partly counterproductive and sometimes paradoxical financial incentives and disincentives for the providers, recipients and financiers of mental health services. In several provinces of Austria, recent reform plans in mental health care have focused strongly on establishing community-based and patient-oriented mental health care. One of the main challenges in implementing this new policy is the re-allocation of resources. The authors hypothesize that the existing structure of mental health care financing, with its incentives and disincentives, constitutes an obstacle to patient-oriented community-based mental health care. Analyzing the characteristics of the overall mental health care financing system in one Austrian province, Lower Austria, will provide a better understanding of actor-relationships and inherent incentives and highlight implications for the process of deinstitutionalization. The authors used an analytical framework based on the principal-agent theory, empirical evidence, and information on financial, organizational and legal structures to identify the characteristics of actor-relationships and the position of single actors within the system. The article shows how incentives are linked to existing constellations of actors involved in mental health care financing and identifies significant power relations. As a consequence, incentives and disincentives within the financing system result in hospital- centered and supply-oriented mental health care in Lower Austria. The current system of financing mental health care provides an obstacle to the provision of patient-oriented and community-based mental care. This is due to existing constellations and power relations among the actors where, most importantly, patients are the weakest party in the patient-payer-provider triangle. Balancing power relations will be a significant prerequisite for alternative financing systems. IMPLICATIONS FOR HEALTH POLICIES AND FURTHER RESEARCH: If a community and needs-based mental health care system is to be established in Austria, the financing structures have to be changed accordingly. Applying a principal-agent framework is useful for identifying key aspects in mental health care financing in relation to the provision of services. Further research is needed to help develop alternative financing mechanisms that support community-based and patient-oriented mental health care systems.

Five Myths of School Turnaround Policy and Practice

ERIC Educational Resources Information Center

Meyers, Coby V.; Smylie, Mark A.

2017-01-01

Despite the intensity of funding and numerous intervention efforts in recent school turnaround initiatives, many perspectives, practices, and policies specific to school turnaround appear to be at odds with organizational theory. Yet, many actors in research, policy, and practice arenas appear convinced that their steadfastness will eventually be…

Policy Images of Teachers: How Influential Actors Construct Images of Teachers

ERIC Educational Resources Information Center

Bulkley, Katrina E.; Gottlieb, Jessica

2017-01-01

Background/Context: Prior research demonstrates that the policy images of critical target populations, which reflect the ways in which they are socially constructed in the political sphere, have important implications for policy prescriptions and design (Cochran-Smith & Fries, 2001; Jansen, 2001; Schneider & Ingram, 1993). In examining the…

Globalisation and International Higher Education: Contested Positionings

ERIC Educational Resources Information Center

Dixon, Mary

2006-01-01

This article stems from recent policy research involving participants in an international higher education program. Story lines of the program from Thai and Australian policy makers and policy actors are interpreted from a poststructural stance. Through the multiple and shifting positionings of the participants, agency and identity within this…

The Rhetorical Icon: Toward an Iconological Theory of U.S. Foreign Policy.

ERIC Educational Resources Information Center

Hamlett, Ralph A.

American foreign policy must operate within the parameters of public opinion, and governmental and non-governmental actors must educate the characteristically alienated citizenry concerning policy issues. Since rational discourse is of limited benefit in the process, advocates instead use verbal representations or metaphor to instill within the…

Insights into the government's role in food system policy making: improving access to healthy, local food alongside other priorities.

PubMed

Wegener, Jessica; Raine, Kim D; Hanning, Rhona M

2012-11-12

Government actors have an important role to play in creating healthy public policies and supportive environments to facilitate access to safe, affordable, nutritious food. The purpose of this research was to examine Waterloo Region (Ontario, Canada) as a case study for "what works" with respect to facilitating access to healthy, local food through regional food system policy making. Policy and planning approaches were explored through multi-sectoral perspectives of: (a) the development and adoption of food policies as part of the comprehensive planning process; (b) barriers to food system planning; and (c) the role and motivation of the Region's public health and planning departments in food system policy making. Forty-seven in-depth interviews with decision makers, experts in public health and planning, and local food system stakeholders provided rich insight into strategic government actions, as well as the local and historical context within which food system policies were developed. Grounded theory methods were used to identify key overarching themes including: "strategic positioning", "partnerships" and "knowledge transfer" and related sub-themes ("aligned agendas", "issue framing", "visioning" and "legitimacy"). A conceptual framework to illustrate the process and features of food system policy making is presented and can be used as a starting point to  engage multi-sectoral stakeholders in plans and actions to facilitate access to healthy food.

The devil is in the detail: tobacco industry political influence in the Dutch implementation of the 2001 EU Tobacco Products Directive.

PubMed

Lie, Jessamina Lih Yan; Willemsen, Marc C; de Vries, Nanne K; Fooks, Gary

2016-09-01

The Dutch implementation of the black border provision in the 2001 European Union Tobacco Products Directive (TPD) is studied to examine the implications of tobacco industry involvement in the implementation phase of the policy process. A qualitative analysis was conducted of Dutch government documents obtained through Freedom of Information Act requests, triangulated with in-depth interviews with key informants and secondary data sources (publicly available government documents, scientific literature, and news articles). Tobacco manufacturers' associations were given the opportunity to set implementation specifications via a fast-track deal with the government. The offer of early implementation of the labelling section of the TPD was used as political leverage by the industry, and underpinned by threats of litigation and arguments highlighting the risks of additional public costs and the benefits to the government of expediency and speed. Ultimately, the government agreed to the industry's interpretation, against the advice of the European Commission. The findings highlight the policy risks associated with corporate actors' ability to use interactions over technical product specifications to influence the implementation of health policy and illustrate the difficulties in limiting industry interference in accordance with Article 5.3 of the Framework Convention on Tobacco Control (FCTC). The implementation phase is particularly vulnerable to industry influence, where negotiation with industry actors may be unavoidable and the practical implications of relatively technical considerations are not always apparent to policymakers. During the implementation of the new TPD 2014/40/EU, government officials are advised to take a proactive role in stipulating technical specifications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The international dimension of drug policy reform in Uruguay.

PubMed

von Hoffmann, Jonas

2016-08-01

In 2013, Uruguay became the first country in the world to legally regulate cannabis from seed to smoke. A growing body of research addresses drug policy reform in Uruguay. However, existing studies have almost completely elided its international dimension, treating the process as exclusively domestic phenomenon. To consider the international dimension of drug policy reform in Uruguay, the paper draws on primary and secondary sources such as existing studies, media reports, official documents, parliamentary debates and interviews with stakeholders and policy analysts from Uruguay and elsewhere. The paper shows that, when, and, how international factors and actors contributed to Uruguay's drug policy reform process. Two ways in which the international dimension manifested itself are identified. First, as drug policy debate around the world changed, the context for reforms in Uruguay evolved. This resulted in a rather mixed international reaction to Uruguay's reform proposal. Second, international actors became directly involved in the process. Drug policy experts informed and legitimated cannabis reform and transnational advocates supported campaigning and mobilisation in Uruguay. By unearthing the international dimension of Uruguay's drug policy reform, the paper adds a novel perspective to the study of drug policy reform in the Uruguay. Copyright © 2016 Elsevier B.V. All rights reserved.

Science, the public, and social elites: how the general public, scientists, top politicians and managers perceive science.

PubMed

Prpić, Katarina

2011-11-01

This paper finds that the Croatian public's and the social elites' perceptions of science are a mixture of scientific and technological optimism, of the tendency to absolve science of social responsibility, of skepticism about the social effects of science, and of cognitive optimism and skepticism. However, perceptions differ significantly according to the different social roles and the wider value system of the observed groups. The survey data show some key similarities, as well as certain specificities in the configuration of the types of views of the four groups--the public, scientists, politicians and managers. The results suggest that the well-known typology of the four cultures reveals some of the ideologies of the key actors of scientific and technological policy. The greatest social, primarily educational and socio-spatial, differentiation of the perceptions of science was found in the general public.

Weighted Key Player Problem for Social Network Analysis

DTIC Science & Technology

2011-03-01

the degree of the actor, the number of adjacent neighbors, to de - termine its centrality value. Introduced in its current form by Freeman, a node’s...identifying individuals who are key in a number of contexts. This chapter developed the WKPP-Pos measure that allows for the inclusion of actor and...Techniques were de - 44 veloped for using the p-median to find optimal solutions to the WKPP-Pos measure and for using hierarchical clustering as a

The fierce ox becomes tame on strange ground

NASA Astrophysics Data System (ADS)

Ertsen, Maurits

2015-04-01

Obviously, the science of change in hydrology and society requires the humanities and social sciences to be an integrated part of the academic project. With the promise that serious study might actually change the hydrological framework, human-environmental interactions need to be studied. An issue is obviously how to ensure that social action by human agents is well represented. In this paper, I propose to rethink human's role within its own environment: people create environments expecting specific results (even though people have their own agendas). The group of 'people' is not a homogenous category. Bruno Latour, the French sociologist and philosopher, argues that human decision making and development of societal institutions is a local activity, constructed within networks of actors. Networks are continuously created and recreated by human actors engaging with other human actors and non-human intermediaries. The resulting networks build links between short and long term human responses - from individuals to societies - in terms of actions, policies, interventions and the like in relation to the - often stochastic - nature of water flows and systems on different scales. Through Actor Network Theory, I suggest new insights from this approach as well as the pitfalls to understand how networks of people and material conditions shape policy development for and management of water resources. I discuss how a focus on the short-term, small-scale interactions among people, their environments and technology in developing water policies and managing water systems can yield insights relevant for those involved in current water policy. How representatives of society itself can be part of this remains an issue. The paper will suggest some ideas from a project setup in the Netherlands, in which researchers, water managers and heritage agencies collaborate.

Overview of the infant and young child feeding policy environment in Pakistan: Federal, Sindh and Punjab context.

PubMed

Mahmood, Hana; Suleman, Yasmeen; Hazir, Tabish; Akram, Durre Samin; Uddin, Shahadat; Dibley, Michael J; Abassi, Saleem; Shakeel, Amara; Kazmi, Narjis; Thow, Anne Marie

2017-06-13

Appropriate infant and young child feeding (IYCF) practices have been identified as important for appropriate child growth and development. (Ministry of Planning and Development, Ministry of National Health Services, Regulations and Coordination (2012)) Children in Pakistan still experience high rates of malnutrition, indicating a likely need for stronger IYCF policy. The purpose of this study was to identify major stakeholders who shape the IYCF policy environment and analyze which policies protect, promote and support IYCF practices, either directly or indirectly. This study was conducted at the federal level, and in the provinces of Sindh and Punjab. We identified policies relevant to IYCF using a matrix developed by the South Asian Infant Feeding Research Network (SAIFRN), designed to capture policies at a range of levels (strategic policy documents through to implementation guidelines) in sectors relevant to IYCF. We analyzed the content using predetermined themes focused on support for mothers, and used narrative synthesis to present our findings. For the stakeholder analysis, we conducted four Net-Map activities with 49 interviewees using the Net-Map methodology. We analyzed the quantitative data using Organizational Risk Analyzer ORA and used the qualitative data to elucidate further information regarding relationships between stakeholders. We identified 19 policy documents for analysis. Eleven of these were nutrition and/or IYCF focused and eight were broader policies with IYCF as a component. The majority lacked detail relevant to implementation, particularly in terms of: ownership of the policies by a specific government body; sustainability of programs/strategies (most are donor funded), multi-sectoral collaboration; and effective advocacy and behavior change communication. Data collected through four Net-Map activities showed that after devolution of health ministry, provincial health departments were the key actors in the government whereas UNICEF and WHO were the key donors who were also highly influential and supportive of the objective. This analysis identified opportunities to strengthen IYCF policy in Pakistan through increased clarity on roles and responsibilities, improved multisectoral collaboration, and strong and consistent training guidelines and schedules for community health workers. The current policy environment presents opportunities, despite limitations. Our Net-Map analysis indicated several key government and international stakeholders, who differed across Federal and Provincial study sites. The detailed information regarding stakeholder influence can be used to strengthen advocacy.

Das baden-württembergische Innovationssystem im Wandel:. Akteure vor neuen Herausforderungen

NASA Astrophysics Data System (ADS)

Stahlecker, Thomas; Zenker, Andrea

2017-09-01

Recently, new forms of innovation, new actors and actor constellations can be observed, especially in "mature" innovation systems like Baden-Wuerttemberg, that are flanked by new instruments of innovation support. Against the backdrop of an evolved innovation system heuristics, this paper outlines these new developments in Baden-Wuerttemberg. It uses examples to describe characteristic innovation actors, actors from the research landscape, education and the intermediary function of mediators, social actors as well as the aspect of innovation financing and to reveal current tendencies and trends. It becomes clear that the innovation system in Baden-Wuerttemberg has continuously evolved and become more differentiated. Its industries' research efforts and modernization activities as well as innovation-friendly policies contribute to the adaptability of the system and are major influencing factors for the ongoing success of the innovation system. This is supplemented by diverse innovations at the level of actors, institutions and measures. The question concerns the governance and capacity of this complex system given dynamic changing global circumstances.

The Role of the Sheffield Model on the Minimum Unit Pricing of Alcohol Debate: The Importance of a Rhetorical Perspective

ERIC Educational Resources Information Center

Katikireddi, Srinivasa Vittal; Hilton, Shona; Bond, Lyndal

2016-01-01

The minimum unit pricing (MUP) alcohol policy debate has been informed by the Sheffield model, a study which predicts impacts of different alcohol pricing policies. This paper explores the Sheffield model's influences on the policy debate by drawing on 36 semi-structured interviews with policy actors who were involved in the policy debate.…

Actor-specific contributions to the deforestation slowdown in the Brazilian Amazon.

PubMed

Godar, Javier; Gardner, Toby A; Tizado, E Jorge; Pacheco, Pablo

2014-10-28

Annual deforestation rates in the Brazilian Amazon fell by 77% between 2004 and 2011, yet have stabilized since 2009 at 5,000-7,000 km(2). We provide the first submunicipality assessment, to our knowledge, of actor-specific contributions to the deforestation slowdown by linking agricultural census and remote-sensing data on deforestation and forest degradation. Almost half (36,158 km(2)) of the deforestation between 2004 and 2011 occurred in areas dominated by larger properties (>500 ha), whereas only 12% (9,720 km(2)) occurred in areas dominated by smallholder properties (<100 ha). In addition, forests in areas dominated by smallholders tend to be less fragmented and less degraded. However, although annual deforestation rates fell during this period by 68-85% for all actors, the contribution of the largest landholders (>2,500 ha) to annual deforestation decreased over time (63% decrease between 2005 and 2011), whereas that of smallholders went up by a similar amount (69%) during the same period. In addition, the deforestation share attributable to remote areas increased by 88% between 2009 and 2011. These observations are consistent across the Brazilian Amazon, regardless of geographical differences in actor dominance or socioenvironmental context. Our findings suggest that deforestation policies to date, which have been particularly focused on command and control measures on larger properties in deforestation hotspots, may be increasingly limited in their effectiveness and fail to address all actors equally. Further reductions in deforestation are likely to be increasingly costly and require actor-tailored approaches, including better monitoring to detect small-scale deforestation and a shift toward more incentive-based conservation policies.

Exploration of priority actions for strengthening the role of nurses in achieving universal health coverage

PubMed Central

Maaitah, Rowaida Al; AbuAlRub, Raeda Fawzi

2017-01-01

ABSTRACT Objective: to explore priority actions for strengthening the role of Advanced Practice Nurses (APNs) towards the achievement of Universal Health Converge (UHC) as perceived by health key informants in Jordan. Methods: an exploratory qualitative design, using a semi-structured survey, was utilized. A purposive sample of seventeen key informants from various nursing and health care sectors was recruited for the purpose of the study. Content analysis utilizing the five-stage framework approach was used for data analysis. Results: the findings revealed that policy and regulation, nursing education, research, and workforce were identified as the main elements that influence the role of APNs in contributing to the achievement of UHC. Priority actions were identified by the participants for the main four elements. Conclusion: study findings confirm the need to strengthen the role of APNs to achieve UHC through a major transformation in nursing education, practice, research, leadership, and regulatory system. Nurses should unite to come up with solid nursing competencies related to APNs, PHC, UHC, leadership and policy making to strengthen their position as main actors in influencing the health care system and evidence creation. PMID:28146176

'Sustainability does not quite get the attention it deserves': synergies and tensions in the sustainability frames of Australian food policy actors.

PubMed

Trevena, Helen; Kaldor, Jenny Claire; Downs, Shauna M

2015-09-01

The development of food policy is strongly influenced by the understanding and position actors adopt in their 'framing' of sustainability. The Australian Government developed a National Food Plan (2010-2013). In public consultations on the National Food Plan Green Paper, the government sought stakeholders' views on sustainability. The present study examined the way in which the food industry and civil society organizations framed sustainability in their submissions to the Green Paper. Submissions by food industry actors and civil society organizations were analysed using a framing matrix that examined positioning, drivers, underlying principles and policy solutions related to sustainability. Submissions were open coded and subsequently organized based on themes within the framing matrix. Australia. One hundred and twenty-four written submissions (1420 pages). While submissions from industry and civil society organizations often framed sustainability similarly, there were also major differences. Civil society organizations were more likely to make the link between the food supply and population health, while industry was more likely to focus on economic sustainability. Both viewed consumer demand as a driver of sustainability, welcomed the idea of a whole-of-government approach and stressed the need for investment in research and development to improve productivity and sustainable farming practices. The meaning of sustainability shifted throughout the policy process. There are opportunities for creating shared value in food policy, where the health, environment and economic dimensions of sustainability can be compatible. However, despite pockets of optimism there is a need for a shared vision of sustainability if Australia is to have a food policy integrating these dimensions.

A Changed Language of Education with New Actors and Solutions: The Authorization of Promotion and Prevention Programmes in Swedish Schools

ERIC Educational Resources Information Center

Bergh, Andreas; Englund, Tomas

2014-01-01

This article demonstrates how changes in the language of Swedish education policy have opened up a new social perception of education, in which space has been created for new actors, models and solutions in terms of managing activities in schools. Specifically, it seeks to illustrate how various "promotion" and "prevention…

The Danish tax on saturated fat: why it did not survive.

PubMed

Vallgårda, S; Holm, L; Jensen, J D

2015-02-01

Health promoters have repeatedly proposed using economic policy tools, taxes and subsidies, as a means of changing consumer behaviour. As the first country in the world, Denmark introduced a tax on saturated fat in 2011. It was repealed in 2012. In this paper, we present arguments and themes involved in the debates surrounding the introduction and the repeal. An analysis of parliamentary debates, expert reports and media coverage; key informant interviews; and a review of studies about the effects of the tax on consumer behaviour. A tax on saturated fat had been suggested by two expert committees and was introduced with a majority in parliament, as a part of a larger economic reform package. Many actors, including representatives from the food industry and nutrition researchers, opposed the tax both before and after its introduction, claiming that it harmed the economy and had no positive influence on health, rather the contrary. Few policy actors defended the tax. Public health had a prominent role in the politicians' arguments for introducing the tax but was barely mentioned in the debate about the repeal. Shortly after the repeal of the tax, research was published showing that consumption of saturated fat had declined in Denmark. The analysis indicates that the Danish tax on fat was introduced mainly to increase public revenue. As the tax had no strong proponents and many influential adversaries, it was repealed. New research indicates that the tax was effective in changing consumer behaviour.

Introduction of New Vaccines: Decision-making Process in Bangladesh

PubMed Central

Sarma, Haribondhu; Bari, Tajul I.; Koehlmoos, Tracey P.

2013-01-01

The understanding of the decision-making process in the introduction of new vaccines helps establish why vaccines are adopted or not. It also contributes to building a sustainable demand for vaccines in a country. The purpose of the study was to map and analyze the formal decision-making process in relation to the introduction of new vaccines within the context of health policy and health systems and identify the ways of making decisions to introduce new vaccines in Bangladesh. During February-April 2011, a qualitative assessment was made at the national level to evaluate the decision-making process around the adoption of new vaccines in Bangladesh. The study population included: policy-level people, programme heads or associates, and key decision-makers of the Government, private sector, non-governmental organizations, and international agencies at the national level. In total, 13 key informants were purposively selected. Data were collected by interviewing key informants and reviewing documents. Data were analyzed thematically. The findings revealed that the actors from different sectors at the policy level were involved in the decision-making process in the introduction of new vaccines. They included policy-makers from the ministries of health and family welfare, finance, and local government and rural development; academicians; researchers; representatives from professional associations; development partners; and members of different committees on EPI. They contributed to the introduction of new vaccines in their own capacity. The burden of disease, research findings on vaccine-preventable diseases, political issues relating to outbreaks of certain diseases, initiatives of international and local stakeholders, pressure of development partners, the Global Alliance for Vaccines and Immunization (GAVI) support, and financial matters were the key factors in the introduction of new vaccines in Bangladesh. The slow introduction and uptake of new vaccines is a concern in the country. Rapid action on the application of GAVI support and less time taken by the Government in processing the implementation and administrative work may expedite the introduction of new vaccines in future in this country. PMID:23930339

Introduction of new vaccines: decision-making process in Bangladesh.

PubMed

Uddin, Jasim; Sarma, Haribondhu; Bari, Tajul I; Koehlmoos, Tracey P

2013-06-01

The understanding of the decision-making process in the introduction of new vaccines helps establish why vaccines are adopted or not. It also contributes to building a sustainable demand for vaccines in a country. The purpose of the study was to map and analyze the formal decision-making process in relation to the introduction of new vaccines within the context of health policy and health systems and identify the ways of making decisions to introduce new vaccines in Bangladesh. During February-April 2011, a qualitative assessment was made at the national level to evaluate the decision-making process around the adoption of new vaccines in Bangladesh. The study population included: policy-level people, programme heads or associates, and key decision-makers of the Government, private sector, non-governmental organizations, and international agencies at the national level. In total, 13 key informants were purposively selected. Data were collected by interviewing key informants and reviewing documents. Data were analyzed thematically. The findings revealed that the actors from different sectors at the policy level were involved in the decision-making process in the introduction of new vaccines. They included policy-makers from the ministries of health and family welfare, finance, and local government and rural development; academicians; researchers; representatives from professional associations; development partners; and members of different committees on EPI. They contributed to the introduction of new vaccines in their own capacity. The burden of disease, research findings on vaccine-preventable diseases, political issues relating to outbreaks of certain diseases, initiatives of international and local stakeholders, pressure of development partners, the Global Alliance for Vaccines and Immunization (GAVI) support, and financial matters were the key factors in the introduction of new vaccines in Bangladesh. The slow introduction and uptake of new vaccines is a concern in the country. Rapid action on the application of GAVI support and less time taken by the Government in processing the implementation and administrative work may expedite the introduction of new vaccines in future in this country.

Social Network Analysis Identifies Key Participants in Conservation Development.

PubMed

Farr, Cooper M; Reed, Sarah E; Pejchar, Liba

2018-05-01

Understanding patterns of participation in private lands conservation, which is often implemented voluntarily by individual citizens and private organizations, could improve its effectiveness at combating biodiversity loss. We used social network analysis (SNA) to examine participation in conservation development (CD), a private land conservation strategy that clusters houses in a small portion of a property while preserving the remaining land as protected open space. Using data from public records for six counties in Colorado, USA, we compared CD participation patterns among counties and identified actors that most often work with others to implement CDs. We found that social network characteristics differed among counties. The network density, or proportion of connections in the network, varied from fewer than 2 to nearly 15%, and was higher in counties with smaller populations and fewer CDs. Centralization, or the degree to which connections are held disproportionately by a few key actors, was not correlated strongly with any county characteristics. Network characteristics were not correlated with the prevalence of wildlife-friendly design features in CDs. The most highly connected actors were biological and geological consultants, surveyors, and engineers. Our work demonstrates a new application of SNA to land-use planning, in which CD network patterns are examined and key actors are identified. For better conservation outcomes of CD, we recommend using network patterns to guide strategies for outreach and information dissemination, and engaging with highly connected actor types to encourage widespread adoption of best practices for CD design and stewardship.

Vested Interests in Addiction Research and Policy The challenge corporate lobbying poses to reducing society’s alcohol problems: insights from UK evidence on minimum unit pricing

PubMed Central

McCambridge, Jim; Hawkins, Benjamin; Holden, Chris

2014-01-01

Background There has been insufficient research attention to alcohol industry methods of influencing public policies. With the exception of the tobacco industry, there have been few studies of the impact of corporate lobbying on public health policymaking more broadly. Methods We summarize here findings from documentary analyses and interview studies in an integrative review of corporate efforts to influence UK policy on minimum unit pricing (MUP) of alcohol 2007–10. Results Alcohol producers and retailers adopted a long-term, relationship-building approach to policy influence, in which personal contacts with key policymakers were established and nurtured, including when they were not in government. The alcohol industry was successful in achieving access to UK policymakers at the highest levels of government and at all stages of the policy process. Within the United Kingdom, political devolution and the formation for the first time of a Scottish National Party (SNP) government disrupted the existing long-term strategy of alcohol industry actors and created the conditions for evidence-based policy innovations such as MUP. Conclusions Comparisons between policy communities within the United Kingdom and elsewhere are useful to the understanding of how different policy environments are amenable to influence through lobbying. Greater transparency in how policy is made is likely to lead to more effective alcohol and other public policies globally by constraining the influence of vested interests. PMID:24261642

Qualitative analysis of the risks and practices associated with the spread of African swine fever within the smallholder pig value chains in Uganda.

PubMed

Dione, Michel; Ouma, Emily; Opio, Felix; Kawuma, Brian; Pezo, Danilo

2016-12-01

A study was undertaken between September 2014 and December 2014 to assess the perceptions of smallholder pig value chain actors of the risks and practices associated with the spread of African swine fever (ASF) disease within the pig value chains. Data was collected from 136 value chain actors and 36 key informants through 17 group discussions and two key informant interview (KII) sessions respectively using Participatory Rural Appraisal (PRA) tools. Results from this study revealed that according to value chain actors and stakeholders, the transporting, slaughtering, and collecting/bulking nodes represent the highest risk, followed by the inputs and services (feeds and drugs) supply nodes. The processing, whole sale and consumption nodes represented the lowest risk. Value chain actors are aware of the disease and its consequences to the pig industry, however biosecurity measures are poorly implemented at all nodes. As for the causes, value chain actors pointed to several factors, such as inadequate knowledge of mechanisms for the spread of the disease, poor enforcement of regulations on disease control, and low capacities of actors to implement biosecurity measures, amongst others. Although traders, butchers and veterinary practitioners accepted that they played an important role in the spread of the virus, they did not perceive themselves as key actors in the control of the disease; instead, they believed that only farmers should adopt biosecurity measures on their farms because they keep the pigs for a longer period. Most of the recommendations given by the value chain actors for controlling and preventing ASF disease were short term, and targeted mainly pig producers. These recommendations included: the establishment of live pig collection centres so that traders and brokers do not have to directly access pig farms, capacity building of value chain actors on application of biosecurity, enactment and enforcement of by-laws on live pig movements and establishment of operational outbreak reporting mechanism at district level. Long term recommendations included the development of a vaccine, as well as pen-side diagnostic tests. This study suggests that interventions to control ASF disease through application of biosecurity measures should target all value chain nodes, while putting more emphasis on post-farm nodes especially the trading. Copyright © 2016 Elsevier B.V. All rights reserved.

Societal transformation and adaptation necessary to manage dynamics in flood hazard and risk mitigation (TRANS-ADAPT)

NASA Astrophysics Data System (ADS)

Fuchs, Sven; Thaler, Thomas; Bonnefond, Mathieu; Clarke, Darren; Driessen, Peter; Hegger, Dries; Gatien-Tournat, Amandine; Gralepois, Mathilde; Fournier, Marie; Mees, Heleen; Murphy, Conor; Servain-Courant, Sylvie

2015-04-01

Facing the challenges of climate change, this project aims to analyse and to evaluate the multiple use of flood alleviation schemes with respect to social transformation in communities exposed to flood hazards in Europe. The overall goals are: (1) the identification of indicators and parameters necessary for strategies to increase societal resilience, (2) an analysis of the institutional settings needed for societal transformation, and (3) perspectives of changing divisions of responsibilities between public and private actors necessary to arrive at more resilient societies. This proposal assesses societal transformations from the perspective of changing divisions of responsibilities between public and private actors necessary to arrive at more resilient societies. Yet each risk mitigation measure is built on a narrative of exchanges and relations between people and therefore may condition the outputs. As such, governance is done by people interacting and defining risk mitigation measures as well as climate change adaptation are therefore simultaneously both outcomes of, and productive to, public and private responsibilities. Building off current knowledge this project will focus on different dimensions of adaptation and mitigation strategies based on social, economic and institutional incentives and settings, centring on the linkages between these different dimensions and complementing existing flood risk governance arrangements. The policy dimension of adaptation, predominantly decisions on the societal admissible level of vulnerability and risk, will be evaluated by a human-environment interaction approach using multiple methods and the assessment of social capacities of stakeholders across scales. As such, the challenges of adaptation to flood risk will be tackled by converting scientific frameworks into practical assessment and policy advice. In addressing the relationship between these dimensions of adaptation on different temporal and spatial scales, this project is both scientifically innovative and policy relevant, thereby supporting climate policy needs in Europe towards a concept of risk governance. Key words: climate change adaptation; transformation; flood risk management; resilience; vulnerability; innovative bottom-up developments; multifunctional use

Towards a Policy Social Psychology: Teacher Engagement with Policy Enactment and the Core Concept of Affective Disruption

ERIC Educational Resources Information Center

Sheikh, Irfan; Bagley, Carl

2018-01-01

The article uncovers the complex process of educational policy enactment and the impact this process has on teachers as policy actors as they undertake the task of introducing a new mathematics curriculum in a Canadian secondary school. The three year study based on in-depth qualitative interviews adopts a classic grounded theory approach of…

Co-Construction of Agency and Environmental Management. The Case of Agri-Environmental Policy Implementation at Finnish Farms

ERIC Educational Resources Information Center

Kaljonen, Minna

2006-01-01

One of the main challenges of European environmental policies is to recruit local-level actors to fulfill set targets. This article explores how targets of European agri-environmental policy have been achieved in Finland. It also analyses how implementation practices produce conditions for agri-environmental management and how policy success-or…

Understanding Public Policy Making through the Work of Committees: Utilizing a Student-Led Congressional Hearing Simulation

ERIC Educational Resources Information Center

Rinfret, Sara R.; Pautz, Michelle C.

2015-01-01

In an effort to help students better understand the complexity of making environmental policy and the role of policy actors in this process, we developed a mock congressional hearing simulation. In this congressional hearing, students in two environmental policy courses take on the roles of members of Congress and various interest groups to…

Adaptive optimal control of unknown constrained-input systems using policy iteration and neural networks.

PubMed

Modares, Hamidreza; Lewis, Frank L; Naghibi-Sistani, Mohammad-Bagher

2013-10-01

This paper presents an online policy iteration (PI) algorithm to learn the continuous-time optimal control solution for unknown constrained-input systems. The proposed PI algorithm is implemented on an actor-critic structure where two neural networks (NNs) are tuned online and simultaneously to generate the optimal bounded control policy. The requirement of complete knowledge of the system dynamics is obviated by employing a novel NN identifier in conjunction with the actor and critic NNs. It is shown how the identifier weights estimation error affects the convergence of the critic NN. A novel learning rule is developed to guarantee that the identifier weights converge to small neighborhoods of their ideal values exponentially fast. To provide an easy-to-check persistence of excitation condition, the experience replay technique is used. That is, recorded past experiences are used simultaneously with current data for the adaptation of the identifier weights. Stability of the whole system consisting of the actor, critic, system state, and system identifier is guaranteed while all three networks undergo adaptation. Convergence to a near-optimal control law is also shown. The effectiveness of the proposed method is illustrated with a simulation example.

Using Bibliometric and Social Media Analyses to Explore the "Echo Chamber" Hypothesis

ERIC Educational Resources Information Center

Goldie, David; Linick, Matthew; Jabbar, Huriya; Lubienski, Christopher

2014-01-01

Educational policy debates are no longer occurring exclusively in academic or governmental settings. Intermediary actors are promoting research using a variety of traditional and non-traditional media to advance and oppose policy agendas. Given the current policy arena, it is useful to re-examine the research underlying current reforms, and to…

The Higher Learning and High Technology: Dynamics of Higher Education Policy Formation.

ERIC Educational Resources Information Center

Slaughter, Sheila

An examination of national higher education policy formation focuses on the shift in relationships of the central actors in the policy formation process. It is argued that whereas the federal government, together with the scientific community and foundations, previously had the dominant voice, the corporate community, in partnership with leaders…

Students as Policy Actors: The TDSB Equity Foundation Statement and Commitments to Equity Policy

ERIC Educational Resources Information Center

Ferfolja, Tania

2013-01-01

Discrimination on the basis of homophobia/transphobia in many schools is an internationally recognised problem. The Toronto District School Board's (TDSB) Equity Foundation Statement and Commitments to Equity Policy (EFS) provides an explicit mandate to schools in its jurisdiction to address such discrimination and educate about sexual and…

Language Policy, In-Migration and Discursive Debates in Wales

ERIC Educational Resources Information Center

Edwards, Catrin Wyn

2017-01-01

Drawing on theory from critical language policy literature, this article explores the impact of discourses on in-migration on Welsh language policy. By focussing on discursive debates surrounding the subject of in-migration, the article analyses how a range of actors produce and reproduce discourses on in-migration in Wales and how these…

Vanuatu Education Policy Post-2015: "Alternative", Decolonising Processes for "Development"

ERIC Educational Resources Information Center

McCormick, Alexandra

2016-01-01

This article is based on ongoing research in Vanuatu and the wider Pacific. It maps multilevel roles that education and development policy actors, and civil societies in particular, have increasingly been playing in official education and development policy activities. Most recently this has been in relation to the "post-2015" agendas…

Analyzing Variability in Ebola-Related Controls Applied to Returned Travelers in the United States

PubMed Central

Siedner, Mark J.; Stoto, Michael A.

2015-01-01

Public health authorities have adopted entry screening and subsequent restrictions on travelers from Ebola-affected West African countries as a strategy to prevent importation of Ebola virus disease (EVD) cases. We analyzed international, federal, and state policies—principally based on the policy documents themselves and media reports—to evaluate policy variability. We employed means-ends fit analysis to elucidate policy objectives. We found substantial variation in the specific approaches favored by WHO, CDC, and various American states. Several US states impose compulsory quarantine on a broader range of travelers or require more extensive monitoring than recommended by CDC or WHO. Observed differences likely partially resulted from different actors having different policy goals—particularly the federal government having to balance foreign policy objectives less salient to states. Further, some state-level variation appears to be motivated by short-term political goals. We propose recommendations to improve future policies, which include the following: (1) actors should explicitly clarify their objectives, (2) legal authority should be modernized and clarified, and (3) the federal government should consider preempting state approaches that imperil its goals. PMID:26348222

Safety or efficiency?: strategies and conflicting interests in Belgian road-safety policy, 1920-1940.

PubMed

Weber, Donald

2015-04-01

After World War I, automobile ownership became a mass phenomenon in Belgium, as in most other industrialized countries. Unfortunately, road-casualty figures soon followed. By the mid-1930s, traffic accidents had become the main cause of accidental deaths. There was clearly a need for a renewed road-safety policy. Public authorities in Belgium, however, were suspiciously reluctant to take new measures. While there was a public outcry for more severe regulation of motorized traffic and several MPs backed bills to this effect, motoring associations lobbied against traffic legislation reforms. In order to understand the Belgian government's hesitation, this article looks at the key strategies of the actors involved in the decision-making process concerning traffic policy. Such strategies included, among others: the creation of detailed traffic-accident statistics, revision of traffic legislation, and support for mass traffic-education campaigns. Eventually, public officials stepped in and created a new technocratic traffic regime in the 1930s, yet their prime concern was not road-user safety, but the efficiency of traffic streams.

The emergence, growth and decline of political priority for newborn survival in Bolivia.

PubMed

Smith, Stephanie L

2014-12-01

Bolivia is expected to achieve United Nations Millennium Development Goal Four, reducing under-five child mortality by two-thirds between 2021 and 2025. However, progress on child mortality reduction masks a disproportionately slow decline in newborn deaths during the 2000s. Bolivia's neonatal mortality problem emerged on the policy agenda in the mid-1990s and grew through 2004 in relationship to political commitments to international development goals and the support of a strong policy network. Network status declined later in the decade. This study draws upon a framework for analysing determinants of political priority for global health initiatives to understand the trajectory of newborn survival policy in Bolivia from the early 1990s. A process-tracing case study methodology is used, informed by interviews with 26 individuals with close knowledge of newborn survival policy in the country and extensive document analysis. The case of newborn survival in Bolivia highlights the significance of political commitments to international development goals, health policy network characteristics (cohesion, composition, status and key actor support) and political transitions and instability in shaping agenda status, especially decline-an understudied phenomenon considering the transitory nature of policy priorities. The study suggests that the sustainability of issue attention therefore become a focal point for health policy networks and analyses. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Global health governance as shared health governance.

PubMed

Ruger, Jennifer Prah

2012-07-01

With the exception of key 'proven successes' in global health, the current regime of global health governance can be understood as transnational and national actors pursuing their own interests under a rational actor model of international cooperation, which fails to provide sufficient justification for an obligation to assist in meeting the health needs of others. An ethical commitment to providing all with the ability to be healthy is required. This article develops select components of an alternative model of shared health governance (SHG), which aims to provide a 'road map,' 'focal points' and 'the glue' among various global health actors to better effectuate cooperation on universal ethical principles for an alternative global health equilibrium. Key features of SHG include public moral norms as shared authoritative standards; ethical commitments, shared goals and role allocation; shared sovereignty and constitutional commitments; legitimacy and accountability; country-level attention to international health relations. A framework of social agreement based on 'overlapping consensus' is contrasted against one based on self-interested political bargaining. A global health constitution delineating duties and obligations of global health actors and a global institute of health and medicine for holding actors responsible are proposed. Indicators for empirical assessment of select SHG principles are described. Global health actors, including states, must work together to correct and avert global health injustices through a framework of SHG based on shared ethical commitments.

The path dependence of district manager decision-space in Ghana

PubMed Central

Kwamie, Aku; van Dijk, Han; Ansah, Evelyn K; Agyepong, Irene Akua

2016-01-01

The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970–85); (2) Strengthening District Health Systems Initiative (1986–93); (3) health sector reform planning and creation of the Ghana Health Service (1994–96) and (4) health sector reform implementation (1997–2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of power has remained at national level, with strong vertical accountabilities and dependence of the district on national level. This study demonstrates that the rhetoric of decentralization does not always mirror actual implementation, nor always result in empowered local actors. PMID:26318537

Political economy of tobacco control in low-income and middle-income countries: lessons from Thailand and Zimbabwe. Global Analysis Project Team.

PubMed Central

Chantornvong, S.; Collin, J.; Dodgson, R.; Lee, K.; McCargo, D.; Seddon, D.; Vaughan, P.; Woelk, G.

2000-01-01

Crucial to the success of the proposed Framework Convention on Tobacco Control will be an understanding of the political and economic context for tobacco control policies, particularly in low-income and middle-income countries. Policy studies in Thailand and Zimbabwe employed the analytical perspective of political economy and a research strategy that used political mapping, a technique for characterizing and evaluating the political environment surrounding a policy issue, and stakeholder analysis, which seeks to identify key actors and to determine their capacity to shape policy outcomes. These policy studies clearly revealed how tobacco control in low-income and middle-income countries is also being shaped by developments in the global and regional political economy. Hence efforts to strengthen national control policies need to be set within the context of globalization and the international context. Besides the transnational tobacco companies, international tobacco groups and foreign governments, international agencies and nongovernmental organizations are also playing influential roles. It cannot be assumed, therefore, that the tobacco control strategies being implemented in industrialized countries will be just as effective and appropriate when implemented in developing countries. There is an urgent need to expand the number of such tobacco policy studies, particularly in low-income and middle-income countries. Comprehensive guidelines for tobacco policy analysis and research are required to support this process, as is a broader international strategy to coordinate further tobacco policy research studies at country, regional and global levels. PMID:10994265

Public engagement with information on renewable energy developments: The case of single, semi-urban wind turbines.

PubMed

Parks, J M; Theobald, K S

2013-01-01

This paper explores perceptions of public engagement with information on renewable energy developments. It draws on a case study of proposals by a major supermarket chain to construct single wind turbines in two semi-urban locations in the UK, analysing data from interviews with key actors in the planning process and focus groups with local residents. The paper concludes that key actors often had high expectations of how local people should engage with information, and sometimes implied that members of the public who were incapable of filtering or processing information in an organised or targeted fashion had no productive role to play in the planning process. It shows how the specific nature of the proposals (single wind turbines in semi-urban locations proposed by a commercial private sector developer) shaped local residents' information needs and concerns in a way that challenged key actors' expectations of how the public should engage with information.

Resistances to Global Educational Prescriptions in the Global South: Theoretical Considerations through Michel Foucault's Lenses

ERIC Educational Resources Information Center

Charlier, Jean-Émile; Panait, Oana Marina

2018-01-01

This article proposes an inquiry into Foucault's approach of subjectivation, extending it to the institutional actors and individual subjects in the educational field in the Global South. The article takes Senegal as a case study and examines the reactions of these categories of actors to the Education for All global policy and to the national…

Contesting authority: China and the new landscape of power sector governance in the developing world

NASA Astrophysics Data System (ADS)

Hannam, Phillip Matthew

Two co-constructed trends threaten to complicate global efforts to manage climate change. Electric power in developing countries is becoming more coal-intensive, while the international institutions capable of assisting lower-carbon growth paths are having their authority challenged by an emergent set of institutions under China's leadership. In the last decade Chinese firms and state banks have become central players in power sector development across the developing world; China has been involved in over sixty percent of Africa's hydropower capacity and is the single largest exporter of coal power plants globally. Statistical and qualitative evidence suggests that China's growing role in these power markets has contributed to re-prioritization of the power sector in U.S. bilateral development assistance, complicated negotiation and implementation of coal power finance rules among OECD export credit agencies, and influenced where the World Bank chooses to build hydropower projects. The thesis establishes a framework for understanding responses to discord in development governance by drawing inductively on these contemporary cases. Competition between established and emerging actors increases with two variables: 1) conflicting ideological, commercial and diplomatic goals (difference in interests); and 2) the degree to which the emerging actor challenges rules and norms upheld by the established actor (contested authority). Competitive policy adjustment - one actor seeking to undermine or diminish the other's pursuit of its objectives - has been historically commonplace when an emerging actor challenged an established actor in the regime for development assistance. China's growing authority in global power sector assistance has prompted competitive policy adjustment among established donors while also enabling recipient countries to leverage donors and better direct their own development pathways. The thesis shows that although contested authority increases development sovereignty among recipients, it can cause backsliding on safeguards and rules among established donors with consequences for power sector outcomes, making fragile movement away from carbon-intensive development even more tenuous. By characterizing this new and uncertain landscape of power sector governance, the thesis contributes to theorization on discord in international governance and to policy development for mitigating climate change.

Cleavages and co-operation in the UK alcohol industry: a qualitative study.

PubMed

Holden, Chris; Hawkins, Benjamin; McCambridge, Jim

2012-06-26

It is widely believed that corporate actors exert substantial influence on the making of public health policy, including in the alcohol field. However, the industry is far from being monolithic, comprising a range of producers and retailers with varying and diverse interests. With a focus on contemporary debates concerning the minimum pricing of alcohol in the UK, this study examined the differing interests of actors within the alcohol industry, the cleavages which emerged between them on this issue and how this impacted on their ability to organise themselves collectively to influence the policy process. We conducted 35 semi-structured interviews between June and November 2010 with respondents from all sectors of the industry as well as a range of non-industry actors who had knowledge of the alcohol policy process, including former Ministers, Members of the UK Parliament and the Scottish Parliament, civil servants, members of civil society organisations and professionals. The paper draws on an analysis of publicly available documents and 35 semi-structured interviews with respondents from the alcohol industry (on- and off-trade including retailers, producers of wines, spirits and beers and trade associations) and a range of non-industry actors with knowledge of the alcohol policy process (including former Ministers, Members of Parliament and of the Scottish Parliament, civil servants, members of civil society organisations and professional groups). Interviews were recorded, transcribed and analysed using Nvivo qualitative analysis software. Processes of triangulation between data sources and different types of respondent sought to ensure we gained as accurate a picture as possible of industry participation in the policy process. Divergences of interest were evident between producers and retailers and within the retail sector between the on and off trade. Divisions within the alcohol industry, however, existed not only between these sectors, but within them. Cleavages were evident within the producer sector between different product categories and within the retail sector between different types of off-trade retailers. However, trade associations were particularly important in providing a means by which the entire industry, or broad sectors within it, could speak with a single voice, despite the limitations on this. There was also evidence of ad-hoc cooperation on specific issues, which resulted from both formal and informal contacts between industry actors. Alcohol industry corporations and trade associations collaborate with one another effectively where there are shared interests, allowing the best placed bodies to lead on a given issue. Thus, whilst industry actors may be deeply divided on certain issues they are able to coordinate their positions on occasions where there are clear advantages in so doing. Health policymakers may benefit from an awareness of the multiplicity of interests within the industry and the ways that these may shape collective lobbying positions.

Cleavages and co-operation in the UK alcohol industry: A qualitative study

PubMed Central

2012-01-01

Background It is widely believed that corporate actors exert substantial influence on the making of public health policy, including in the alcohol field. However, the industry is far from being monolithic, comprising a range of producers and retailers with varying and diverse interests. With a focus on contemporary debates concerning the minimum pricing of alcohol in the UK, this study examined the differing interests of actors within the alcohol industry, the cleavages which emerged between them on this issue and how this impacted on their ability to organise themselves collectively to influence the policy process. We conducted 35 semi-structured interviews between June and November 2010 with respondents from all sectors of the industry as well as a range of non-industry actors who had knowledge of the alcohol policy process, including former Ministers, Members of the UK Parliament and the Scottish Parliament, civil servants, members of civil society organisations and professionals. Methods The paper draws on an analysis of publicly available documents and 35 semi-structured interviews with respondents from the alcohol industry (on- and off-trade including retailers, producers of wines, spirits and beers and trade associations) and a range of non-industry actors with knowledge of the alcohol policy process (including former Ministers, Members of Parliament and of the Scottish Parliament, civil servants, members of civil society organisations and professional groups). Interviews were recorded, transcribed and analysed using Nvivo qualitative analysis software. Processes of triangulation between data sources and different types of respondent sought to ensure we gained as accurate a picture as possible of industry participation in the policy process. Results Divergences of interest were evident between producers and retailers and within the retail sector between the on and off trade. Divisions within the alcohol industry, however, existed not only between these sectors, but within them. Cleavages were evident within the producer sector between different product categories and within the retail sector between different types of off-trade retailers. However, trade associations were particularly important in providing a means by which the entire industry, or broad sectors within it, could speak with a single voice, despite the limitations on this. There was also evidence of ad-hoc cooperation on specific issues, which resulted from both formal and informal contacts between industry actors. Conclusions Alcohol industry corporations and trade associations collaborate with one another effectively where there are shared interests, allowing the best placed bodies to lead on a given issue. Thus, whilst industry actors may be deeply divided on certain issues they are able to coordinate their positions on occasions where there are clear advantages in so doing. Health policymakers may benefit from an awareness of the multiplicity of interests within the industry and the ways that these may shape collective lobbying positions. PMID:22734630

The key actor: a qualitative study of patient participation in the handover process in Europe

PubMed Central

Flink, Maria; Hesselink, Gijs; Pijnenborg, Loes; Wollersheim, Hub; Vernooij-Dassen, Myrra; Dudzik-Urbaniak, Ewa; Orrego, Carola; Toccafondi, Giulio; Schoonhoven, Lisette; Gademan, Petra J; Johnson, Julie K; Öhlén, Gunnar; Hansagi, Helen; Olsson, Mariann; Barach, Paul

2012-01-01

Background Patient safety experts have postulated that increasing patient participation in communications during patient handovers will improve the quality of patient transitions, and that this may reduce hospital readmissions. Choosing strategies that enhance patient safety through improved handovers requires better understanding of patient experiences and preferences for participation. Objective The aim of this paper is to explore the patients’ experiences and perspectives related to the handovers between their primary care providers and the inpatient hospital. Methods A qualitative secondary analysis was performed, based on individual and focus group patient interviews with 90 patients in five European countries. Results The analysis revealed three themes: patient positioning in the handover process; prerequisites for patient participation and patient preferences for the handover process. Patients’ participation ranged from being the key actor, to sharing the responsibility with healthcare professional(s), to being passive participants. For active participation patients required both personal and social resources as well as prerequisites such as information and respect. Some patients preferred to be the key actor in charge; others preferred their healthcare professionals to be the key actors in the handover. Conclusions Patients’ participation is related to the healthcare system, the activity of healthcare professionals’ and patients’ capacity for participation. Patients prefer a handover process where the responsibility is clear and unambiguous. Healthcare organisations need a clear and well-considered system of responsibility for handover processes, that takes into account the individual patient's need of clarity, and support in relation to his/hers own recourses. PMID:23112290

Actor-network theory: a tool to support ethical analysis of commercial genetic testing.

PubMed

Williams-Jones, Bryn; Graham, Janice E

2003-12-01

Social, ethical and policy analysis of the issues arising from gene patenting and commercial genetic testing is enhanced by the application of science and technology studies, and Actor-Network Theory (ANT) in particular. We suggest the potential for transferring ANT's flexible nature to an applied heuristic methodology for gathering empirical information and for analysing the complex networks involved in the development of genetic technologies. Three concepts are explored in this paper--actor-networks, translation, and drift--and applied to the case of Myriad Genetics and their commercial BRACAnalysis genetic susceptibility test for hereditary breast cancer. Treating this test as an active participant in socio-technical networks clarifies the extent to which it interacts with, shapes and is shaped by people, other technologies, and institutions. Such an understanding enables more sophisticated and nuanced technology assessment, academic analysis, as well as public debate about the social, ethical and policy implications of the commercialization of new genetic technologies.

Actor-specific contributions to the deforestation slowdown in the Brazilian Amazon

PubMed Central

Godar, Javier; Gardner, Toby A.; Tizado, E. Jorge

2014-01-01

Annual deforestation rates in the Brazilian Amazon fell by 77% between 2004 and 2011, yet have stabilized since 2009 at 5,000–7,000 km2. We provide the first submunicipality assessment, to our knowledge, of actor-specific contributions to the deforestation slowdown by linking agricultural census and remote-sensing data on deforestation and forest degradation. Almost half (36,158 km2) of the deforestation between 2004 and 2011 occurred in areas dominated by larger properties (>500 ha), whereas only 12% (9,720 km2) occurred in areas dominated by smallholder properties (<100 ha). In addition, forests in areas dominated by smallholders tend to be less fragmented and less degraded. However, although annual deforestation rates fell during this period by 68–85% for all actors, the contribution of the largest landholders (>2,500 ha) to annual deforestation decreased over time (63% decrease between 2005 and 2011), whereas that of smallholders went up by a similar amount (69%) during the same period. In addition, the deforestation share attributable to remote areas increased by 88% between 2009 and 2011. These observations are consistent across the Brazilian Amazon, regardless of geographical differences in actor dominance or socioenvironmental context. Our findings suggest that deforestation policies to date, which have been particularly focused on command and control measures on larger properties in deforestation hotspots, may be increasingly limited in their effectiveness and fail to address all actors equally. Further reductions in deforestation are likely to be increasingly costly and require actor-tailored approaches, including better monitoring to detect small-scale deforestation and a shift toward more incentive-based conservation policies. PMID:25313087

A Note on Georisk, Sustainable Development and Law

NASA Astrophysics Data System (ADS)

Paterson, John

2006-03-01

Whatever science has to say about risk and sustainable development, ultimately relevant decisions will be taken by political actors. The means they will most often use in order to implement those decisions, however, will be legal (for example, regulations). While law may, therefore, be the point of contact, as it were, between scientific expertise and policy decisions, on the one hand, and the individual or corporate actor, on the other, it can equally appear to be no more than a tool in the hands of more powerful forces and thus low in the list of priorities to be examined in this complex field. Within law, however, there has been increasing discussion in recent years about whether it is actually able to produce the sort of social change that policy actors (and perhaps also scientists) believe that it can. It is, therefore, important to know whether law as it is traditionally understood can deliver what is expected of it and, if not, what sort of adaptations may be required in order to increase the likelihood of success. This paper will begin by briefly reviewing some of the key literature on regulatory failure and consider the ways in which such a problem could serve to exacerbate the risk from seismic events. The paper will then move on to consider a concrete example: the Chernobyl nuclear accident. Although this clearly belongs to the domain of technological rather than seismic risk, it is instructive for present purposes for at least two reasons. Firstly, this was an incident with an impact on a scale comparable to a major seismic event: while it certainly presented a severe challenge in the emergency phase, it has equally stretched scientists, policy makers and regulators in the ongoing rehabilitation phase and exposed many of the shortcomings of traditional regulatory approaches. Secondly, the common political and legal history of the countries affected by this event and many of those in the Black Sea to Caspian region — as former Soviet, transition economies — renders the example particularly pertinent. The people and authorities affected by the Chernobyl nuclear accident have had almost 20 years to consider the shortcomings of traditional approaches. The past decade in particular has seen the emergence of a number of innovations. The final part of this paper will examine these new approaches and consider the extent to which they may offer lessons to scientists, policy makers and regulators concerned with seismic risk.

Policy Making Processes with Respect to Teacher Education in Finland and Norway

ERIC Educational Resources Information Center

Afdal, Hilde Wagsas

2013-01-01

This article examines policy making processes in the area of teacher education (TE) in Finland and Norway. Particular attention is given to the roles different actors play in these processes and the potential effects of their involvement on the TE programs in the two countries. Contemporary policy processes are analyzed through a set of interviews…

Newer Researchers in Higher Education: Policy Actors or Policy Subjects?

ERIC Educational Resources Information Center

Ashwin, Paul; Deem, Rosemary; McAlpine, Lynn

2016-01-01

In this article, we explore the extent to which 42 newer researchers, in the academic sub-field of higher education, were aware of, responded to and negotiated their careers in relation to higher education policies. Participants, who were mainly from European countries, tended to divide into two similarly sized groups: one that engaged with and…

Detecting the Use of Evidence in a Meta-Policy

ERIC Educational Resources Information Center

Castellani, Tommaso; Valente, Adriana; Cori, Liliana; Bianchi, Fabrizio

2016-01-01

In this work a meta-policy on health promotion is analysed, through content analysis of documents and interviews to stakeholders, with the aim of understanding the use of evidence and the knowledge conversion process in a multi-actor policy trajectory. We study the different sources of evidence and their interaction. Among our results, we describe…

Networks in Action: New Actors and Practices in Education Policy in Brazil

ERIC Educational Resources Information Center

Shiroma, Eneida Oto

2014-01-01

This paper focuses on the role of networks in the policy-making process in education and discusses the potential of network analysis as an analytical tool for education policy research. Drawing on publically available data from personal or institutional websites, this paper reports the findings from research carried out between 2005 and 2011.…

Counselors as Policy Actors: Challenges to Systemic Involvement in College and Career Readiness Policy in Secondary Schools

ERIC Educational Resources Information Center

Stone-Johnson, Corrie

2015-01-01

Enacting college and career readiness policy in secondary schools requires systemic involvement of all school professionals, but identifying the specific roles that should be played by teachers and counselors remains a challenge. The study reported in this article used qualitative interviews with counselors and teachers to describe this challenge…

Representations of a High-Quality System of Undergraduate Education in English Higher Education Policy Documents

ERIC Educational Resources Information Center

Ashwin, Paul; Abbas, Andrea; McLean, Monica

2015-01-01

This article examines the ways in which a high-quality system of undergraduate education is represented in recent policy documents from a range of actors interested in higher education. Drawing on Basil Bernstein's ideas, the authors conceptualise the policy documents as reflecting a struggle over competing views of quality that are expressed…

Power structure among the actors of financial support to the poor to access health services: Social network analysis approach.

PubMed

Etemadi, Manal; Gorji, Hasan Abolghasem; Kangarani, Hannaneh Mohammadi; Ashtarian, Kioomars

2017-12-01

The extent of universal health coverage in terms of financial protection is worrisome in Iran. There are challenges in health policies to guarantee financial accessibility to health services, especially for poor people. Various institutions offer support to ensure that the poor have financial access to health services. The aim of this study is to investigate the relationship network among the institutions active in this field. This study is a policy document analysis. It evaluates the country's legal documents in the field of financial support to the poor for healthcare after the Islamic Revolution in Iran. The researchers looked for the documents on the related websites and referred to the related organizations. The social network analysis approach was chosen for the analysis of the documents. Block-modelling and multi-dimensional scaling (MDS) was used to determine the network structures. The UCINET software was employed to analyse the data. Most the main actors of this network are chosen from the government budget. There is no legal communication and cooperation among some of the actors because of their improper position in the network. Seven blocks have been clustered by CONCOR in terms of the actor's degree of similarity. The social distance among the actors of the seven blocks is very short. Power distribution in the field of financial support to the poor has a fragmented structure; however, it is mainly run by a dominant block consisting of The Supreme Council of Welfare and Social Security, Health Insurance Organization, and the Ministry of Health and Medical Education. The financial support for the poor network involves multiple actors. This variety has created a series of confusions in terms of the type, level, and scope of responsibilities among the actors. The weak presence legislative and regulatory institutions and also non-governmental institutions are the main weak points of this network. Copyright © 2017 Elsevier Ltd. All rights reserved.

The politics of federal environmental education policy

NASA Astrophysics Data System (ADS)

Crouch, Richard Craig

Both environmental governance1 and education governance 2 occupy contested territory in contemporary US political discourse. Environmental education (EE) policy has emerged at this intersection and taken on aspects of both controversies. Central to debates surrounding environmental education are still unresolved issues concerning the role of the federal government in education, the role of education in citizen-making, and the role of the public in environmental governance. As a case study of the politics of environmental education policy, I explore these issues as they relate to the National Environmental Education Act of 1990,3 attempts at its reauthorization, its continued appropriations, and its current state of policy stasis. The political controversy over the federal role in environmental education is an appropriate case study of environmental education politics insofar as it reflects the different positions held by actor groups with regard to the definition, efficacy, and legitimacy of environmental education. At the core of these debates, as we will see, is a definitional crisis---that is, there is no common understanding across the relevant actor groups as to what environmental education is, or should be. I suggest here that this definitional issue can be best understood as having technical, ideological, and structural components4---all of which are mutually reinforcing and thus perpetuate the stasis in federal environmental education policy. 1I rely on Durant, Fiorino and O'leary's definition of environmental governance in Environmental Governance Reconsidered ; "In the term environmental governance, we refer to the increasingly collaborative nature of [environmental and natural resource] policy formulation and implementation. In this vein, a wide array of third parties (for example, actors in the profit sector, the nonprofit sector, and civic society), in addition to government agencies, comprise non hierarchical networks of actors wielding a variety of policy tools (for example, rules and regulations, subsidies, and information) to address diverse, complex and evolving [environmental and natural resource] problems." p. 22-23. 2In this case, I adapt Durant, Fiorino and O'leary's definition of environmental governance to education leadership. 3See Appendix 1 for text of the Environmental Education Act of 1990. 4I am indebted to David Rejeski of the Woodrow Wilson Institute for helping me think through environmental education politics from a definitional perspective.

Systematic examination of publicly-available information reveals the diverse and extensive corporate political activity of the food industry in Australia.

PubMed

Mialon, Melissa; Swinburn, Boyd; Allender, Steven; Sacks, Gary

2016-03-22

The political influence of the food industry, referred to as corporate political activity (CPA), represents a potential barrier to the development and implementation of effective public health policies for non-communicable diseases prevention. This paper reports on the feasibility and limitations of using publicly-available information to identify and monitor the CPA of the food industry in Australia. A systematic search was conducted for information from food industry, government and other publicly-available data sources in Australia. Data was collected in relation to five key food industry actors: the Australian Food and Grocery Council; Coca Cola; McDonald's; Nestle; and Woolworths, for the period January 2012 to February 2015. Data analysis was guided by an existing framework for classifying CPA strategies of the food industry. The selected food industry actors used multiple CPA strategies, with 'information and messaging' and 'constituency building' strategies most prominent. The systematic analysis of publicly-available information over a limited period was able to identify diverse and extensive CPA strategies of the food industry in Australia. This approach can contribute to accountability mechanisms for NCD prevention.

The role of education and training in absorptive capacity of international technology transfer in the aerospace sector

NASA Astrophysics Data System (ADS)

van der Heiden, Patrick; Pohl, Christine; Bin Mansor, Shuhaimi; van Genderen, John

2015-07-01

The role of education and training in the aerospace sector for establishing sufficient levels of absorptive capacity in newly industrialized countries is substantial and forms a fundamental part of a nation's ability to establish and cultivate absorptive capacity on a national or organization-specific level. Successful international technology transfer as well as absorption of aerospace technology and knowledge into recipient organizations, depends prodigiously on the types of policy adopted in education and training of all groups and individuals specifically outlined in this paper. The conducted literature review revealed surprisingly few papers that translate these vital issues from theoretical scrutiny into representations that have practical policy value. Through exploration of the seven key aspects of education and training, this paper provides a practical template for policy-makers and practitioners in Asian newly industrialized countries, which may be utilized as a prototype to coordinate relevant policy aspects of education and training in international technology transfer projects across a wide variety of actors and stakeholders in the aerospace realm. A pragmatic approach through tailored practical training for the identified groups and individuals identified in this paper may lead to an enhanced ability to establish and strengthen absorptive capacity in newly industrialized countries through the development of appropriate policy guidelines. The actual coordination between education and training efforts deserves increased research and subsequent translation into policies with practical content in the aerospace sector.

Insights into the Government’s Role in Food System Policy Making: Improving Access to Healthy, Local Food Alongside Other Priorities

PubMed Central

Wegener, Jessica; Raine, Kim D.; Hanning, Rhona M.

2012-01-01

Government actors have an important role to play in creating healthy public policies and supportive environments to facilitate access to safe, affordable, nutritious food. The purpose of this research was to examine Waterloo Region (Ontario, Canada) as a case study for “what works” with respect to facilitating access to healthy, local food through regional food system policy making. Policy and planning approaches were explored through multi-sectoral perspectives of: (a) the development and adoption of food policies as part of the comprehensive planning process; (b) barriers to food system planning; and (c) the role and motivation of the Region’s public health and planning departments in food system policy making. Forty-seven in-depth interviews with decision makers, experts in public health and planning, and local food system stakeholders provided rich insight into strategic government actions, as well as the local and historical context within which food system policies were developed. Grounded theory methods were used to identify key overarching themes including: “strategic positioning”, “partnerships” and “knowledge transfer” and related sub-themes (“aligned agendas”, “issue framing”, “visioning” and “legitimacy”). A conceptual framework to illustrate the process and features of food system policy making is presented and can be used as a starting point to engage multi-sectoral stakeholders in plans and actions to facilitate access to healthy food. PMID:23202834

Contributions of knowledge products to health policy: a case study on the Public Health Status and Forecasts Report 2010

PubMed Central

Kok, Maarten O.; Janssen, Susan W.J.; Schuit, Albertine J.; van Oers, Hans A.M.

2016-01-01

Background: The Dutch Public Health Status and Forecasts report (PHSF Report) integrates research data and identifies future trends affecting public health in the Netherlands. To investigate how PHSF contributions to health policy can be enhanced, we analysed the development process whereby the PHSF Report for 2010 was produced (PHSF-2010). Method: To collect data, a case study approach was used along the lines of Contribution Mapping including analysis of documents from the PHSF-2010 process and interviews with actors involved. All interviews were recorded and transcribed ad verbatim and coded using an inductive code list. Results: The PHSF-2010 process included activities aimed at alignment between researchers and policy-makers, such as informal meetings. However, we identified three issues that are easily overlooked in knowledge development, but provide suggestions for enhancing contributions: awareness of divergent; continuously changing actor scenarios; vertical alignment within organizations involved and careful timing of draft products to create early adopters. Conclusion: To enhance the contributions made by an established public health report, such as the PHSF Report, it is insufficient to raise the awareness of potential users. The knowledge product must be geared to policy-makers’ needs and must be introduced into the scenarios of actors who may be less familiar. The demand for knowledge product adaptations has to be considered. This requires continuous alignment efforts in all directions: horizontal and vertical, external and internal. The findings of this study may be useful to researchers who aim to enhance the contributions of their knowledge products to health policy. PMID:27452890

A policy iteration approach to online optimal control of continuous-time constrained-input systems.

PubMed

Modares, Hamidreza; Naghibi Sistani, Mohammad-Bagher; Lewis, Frank L

2013-09-01

This paper is an effort towards developing an online learning algorithm to find the optimal control solution for continuous-time (CT) systems subject to input constraints. The proposed method is based on the policy iteration (PI) technique which has recently evolved as a major technique for solving optimal control problems. Although a number of online PI algorithms have been developed for CT systems, none of them take into account the input constraints caused by actuator saturation. In practice, however, ignoring these constraints leads to performance degradation or even system instability. In this paper, to deal with the input constraints, a suitable nonquadratic functional is employed to encode the constraints into the optimization formulation. Then, the proposed PI algorithm is implemented on an actor-critic structure to solve the Hamilton-Jacobi-Bellman (HJB) equation associated with this nonquadratic cost functional in an online fashion. That is, two coupled neural network (NN) approximators, namely an actor and a critic are tuned online and simultaneously for approximating the associated HJB solution and computing the optimal control policy. The critic is used to evaluate the cost associated with the current policy, while the actor is used to find an improved policy based on information provided by the critic. Convergence to a close approximation of the HJB solution as well as stability of the proposed feedback control law are shown. Simulation results of the proposed method on a nonlinear CT system illustrate the effectiveness of the proposed approach. Copyright © 2013 ISA. All rights reserved.

What is driving rates of social policy preliminary references to the CJEU? Evidence from the United Kingdom and France

PubMed Central

Sigafoos, Jennifer

2013-01-01

Preliminary references to the Court of Justice for the European Union are unevenly distributed across the EU, creating differing access to justice for European citizens. This study presents case studies of the UK and France, exploring factors affecting rates of social policy preliminary references from 1996–2009. The UK had a rate twice that of France. What accounts for this difference? Analysis of documentary evidence and 25 expert interviews help to explain the differing rates. Themes were related to policy, structural factors and the agency of actors. In the UK, policy themes are the free movement of persons and the ‘Right to Reside’ test. Legal aid and legal NGOs help individuals access the Court and drive test case strategies. In France, a high degree of dualisation in the welfare state creates an insider/outsider dynamic. Coupled with the resistance of courts and a lack of comparable actors to drive preliminary references, this contributes to a lower rate of references. PMID:23565042

Medium of Instruction Policies and Language Practices, Ideologies and Institutional Divides: Voices of Teachers and Students in a Private University in Bangladesh

ERIC Educational Resources Information Center

Hamid, M. Obaidul; Jahan, Iffat; Islam, M. Monjurul

2013-01-01

The use of English as a medium of instruction (MOI) in polities across the world has drawn attention of language policy and planning scholars and researchers. Increasingly, research on MOI policy and practice focuses on how macro-level policies are translated into action by "actors" including teachers and students in the micro-context.…

The Policy Impact of PISA: An Exploration of the Normative Effects of International Benchmarking in School System Performance. OECD Education Working Papers, No. 71

ERIC Educational Resources Information Center

Breakspear, Simon

2012-01-01

Little research has been done into how the results of the Programme for International Student Assessment (PISA) affect national educational reform and policy-making. This paper examines the normative impact of PISA by investigating how, and the extent to which , national policy actors use PISA in policies and practices, to evaluate and improve…

The Legitimation of Novel Technologies: The Case of Nanotechnology

NASA Astrophysics Data System (ADS)

Thyroff, Anastasia E.

Nanotechnology is the control, manipulation, and application of matter on an atomic and molecular level. The technology is complex and confusing to consumers, and its long-term safety and effect on the human body, as well as the environment, are unknown. However, for the past decade, nanotechnology has been used to develop consumer products and food with novel and attractive attributes. Since nanotechnology is still not well known, it is not legitimized; that is, it has not been deemed safe and accepted by society. However, the market for nanotechnology is in the legitimation process. It will take an entire network of key stakeholders playing a specific roles for nanotechnology to legitimize. Specifically, each key stakeholder will align with a certain cultural discourse to frame nanotechnology in a particular way that complements their values. In Essay 1, I follow previous market system dynamic's literature and combine Actor Network Theory (ANT), Foucault's Discourse on Power and Goffman's Frame analysis to theoretically explore what the actor network for nanotechnology looks like. Four dominate frames are identified: 1) Advancement (i.e., government), 2) Management (i.e., industry), 3) Development (i.e., academia/scientists), and 4) Informant (i.e., NGO). Essay 2 empirically explores each actor's perspective on the nanotechnology network through a total of 24 interviews. A hermeneutic approach is used to analyze the 208 page text and themes describing each actor's role from a self and other's perspective are discussed. Additionally, three overarching themes (i.e., contradiction, constance, and cutoff) emerge; these themes describe the degree of similarity in how actors view their role in the nanotechnology network compared to how other actor's view that actor's role. In Essay 3, I bring critical theory into market system's research to better contextualize market formation theories. Specifically, I discuss how critical theory can be used to supplement ANT. I suggest that ANT can be combined with critical theory to better understand the process of translation through exploring conflicts and contradictions among key stakeholders. To show this process, I explore the juxtaposition of economic benefits vs. cultural concerns that has emerged in the nanotechnology marketplace. It is determined that this exploration process can determine why mobilization has not occurred.

International organizations and migrant health in Europe.

PubMed

Kentikelenis, Alexander E; Shriwise, Amanda

International organizations have defined and managed different aspects of migrant health issues for decades, yet we lack a systematic understanding of how they reach decisions and what they do on the ground. The present article seeks to clarify the state of knowledge on the relationship between international organizations and migrant health in Europe. To do so, we review the operations of six organizations widely recognized as key actors in the field of migrant health: the European Commission, the Regional Office for Europe of the World Health Organization, the International Organization on Migration, Médecins du Monde, Médecins Sans Frontières, and the Open Society Foundation. We find that international organizations operate in a complementary fashion, with each taking on a unique role in migrant health provision. States often rely on international organizations as policy advisors or sub-contractors for interventions, especially in the case of emergencies. These linkages yield a complex web of relationships, which can vary depending on the country under consideration or the health policy issue in question.

Health system's barriers hindering implementation of public-private partnership at the district level: a case study of partnership for improved reproductive and child health services provision in Tanzania.

PubMed

Kamugumya, Denice; Olivier, Jill

2016-10-21

Public-private partnership (PPP) has been suggested as a tool to assist governments in lower to middle income countries fulfil their responsibilities in the efficient delivery of health services. In Tanzania, although the idea of PPP has existed for many years in the health sector, there has been limited coordination, especially at a district level - which has contributed to limited health gains or systems strengthening obviously seen as a result of PPP. This case study was conducted in the Bagamoyo district of Tanzania, and employed in-depth interviews, document reviews, and observations methods. A stakeholder analysis was conducted to understand power distribution and the interests of local actors to engage non-state actors. In total 30 in-depth interviews were conducted with key informants that were identified from a stakeholder mapping activity. The initial data analysis guided further data collection in an iterative process. The provision of Reproductive and Child Health Services was used as a context. This study draws on the decision-space framework. Study findings reveal several forms of informal partnerships, and the untapped potential of non-state actors. Lack of formal contractual agreements with private providers including facilities that receive subsidies from the government is argued to contribute to inappropriate distribution of risk and reward leading to moral hazards. Furthermore, findings highlight weak capacity of governing bodies to exercise oversight and sanctions, which is acerbated by weak accountability linkages and power differences. Disempowered Council Health Services Board, in relation to engaging non-state actors, is shown to impede PPP initiatives. Effective PPP policy implementation at a local level depends on the capacity of local government officials to make choices that would embrace relational elements dynamics in strategic plans. Orientation towards collaborative efforts that create value and enable its distribution is argued to facilitate healthy partnership, and in return, strengthen a district health system. This study highlights a need for new social contracts that will support integrative collaboration at the local level and bring all non-state actors to the centre of the district health system.

Vested interests in addiction research and policy. The challenge corporate lobbying poses to reducing society's alcohol problems: insights from UK evidence on minimum unit pricing.

PubMed

McCambridge, Jim; Hawkins, Benjamin; Holden, Chris

2014-02-01

There has been insufficient research attention to alcohol industry methods of influencing public policies. With the exception of the tobacco industry, there have been few studies of the impact of corporate lobbying on public health policymaking more broadly. We summarize here findings from documentary analyses and interview studies in an integrative review of corporate efforts to influence UK policy on minimum unit pricing (MUP) of alcohol 2007-10. Alcohol producers and retailers adopted a long-term, relationship-building approach to policy influence, in which personal contacts with key policymakers were established and nurtured, including when they were not in government. The alcohol industry was successful in achieving access to UK policymakers at the highest levels of government and at all stages of the policy process. Within the United Kingdom, political devolution and the formation for the first time of a Scottish National Party (SNP) government disrupted the existing long-term strategy of alcohol industry actors and created the conditions for evidence-based policy innovations such as MUP. Comparisons between policy communities within the United Kingdom and elsewhere are useful to the understanding of how different policy environments are amenable to influence through lobbying. Greater transparency in how policy is made is likely to lead to more effective alcohol and other public policies globally by constraining the influence of vested interests. ©2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of The Society for the Study of Addiction.

Fifteen Years Looking at the Mirror: On the Presence of PISA in Education Policy Processes (Portugal, 2000-2016)

ERIC Educational Resources Information Center

Carvalho, Luís Miguel; Costa, Estela; Gonçalves, Catarina

2017-01-01

This article describes and discusses what happens when knowledge for policy generated within PISA is received by its target audience: what have the Portuguese policy actors been doing with PISA data and analysis when they consider, express and justify their choices? Drawing on previous and current studies, using interview materials and formal and…

National Renewable Energy Policy in a Global World

NASA Astrophysics Data System (ADS)

Jeong, Minji

Increasing trade of renewable energy products has significantly contributed to reducing the costs of renewable energy sources, but at the same time, it has generated protectionist policies, which may negatively affect the trend of the cost reduction. Although a few recent studies examined the rise of renewable energy protectionism and trade disputes, they are limited in addressing the conflict between the original goal of traditional renewable energy policies and the new protectionist policies under the globalized renewable energy industry. To fill this gap, this dissertation explores how the globalized renewable energy industry has changed national renewable energy policies. Through three analyses, three aspects of the globalized renewable energy industry are examined: the rise of multinational corporations, international interactions among actors, and the changes of the global and domestic market conditions. First analysis investigates how multinational renewable energy corporations have affected national policies. A content analysis of the annual reports of 15 solar photovoltaic multinational corporation shows that solar multinationals have been influenced by national policies and have adapted to the changes rather than having attempted to change national policies. Second analysis examines how diverse actors have framed renewable energy trade issues through a network analysis of the Chinese solar panel issue in the United States. The result shows that the Chinese solar panel issue was framed differently from the traditional environmental frame of renewable energy, being dominated by multinational corporations headquartered in other countries. Third analysis explores what has caused the increasing diversity in national renewable energy policies through the case studies of the U.S. and South Korea. The result reveals that the globalization of solar industry has affected the diversification of solar policies in two countries by generating both challenges, which needed to be addressed by new and additional policies, and opportunities, which strengthened the political power of domestic solar industries. The three analyses show that the globalized renewable energy industry has led to the diversification of national renewable energy policies by increasing international interactions between actors and by introducing both challenges and opportunities to domestic renewable energy industries. This research contributes to the literature on trade and the environment by analyzing a new pattern of the conflicts between traditional environmental policies and "green" protectionist policies. It also contributes to the literature on protectionism by adding an empirical case of green protectionism, one of the forms of "murky" protectionism that has risen after the global financial crisis.

How Choice Changes the Education System: A Michigan Case Study

NASA Astrophysics Data System (ADS)

Plank, David; Sykes, Gary

1999-11-01

In countries around the world policy makers propose that parents should exercise more control over the choice of schools that their children attend. This paper considers the ways in which the introduction of new opportunities for school choice changes the education system. It argues that choice affects the education system as a whole by introducing new actors into the system, by changing the terms of relationships among existing actors, and by creating new pressures within the system that require new responses. The nature, magnitude, and consequences of these effects cannot be predicted in advance, as they depend on a number of factors including the social and economic context. The empirical basis for this paper derives from a case study of the implementation of choice policies in the state of Michigan in the US, but the conceptual issues raised have important implications for the study of school choice wherever such policies are adopted.

The changing role of health-oriented international organizations and nongovernmental organizations.

PubMed

Okma, Kieke G H; Kay, Adrian; Hockenberry, Shelby; Liu, Joanne; Watkins, Susan

2016-10-01

Apart from governments, there are many other actors active in the health policy arena, including a wide array of international organizations (IOs), public-private partnerships and non-governmental organizations (NGOs) that state as their main mission to improve the health of (low-income) populations of low-income countries. Despite the steady rise in numbers and prominence of NGOs, however, there is lack of empirical knowledge about their functioning in the international policy arena, and most studies focus on the larger organizations. This has also caused a somewhat narrow focus of theoretical studies. Some scholars applied the 'principal-agent' theory to study the origins of IOs, for example, other focus on changing power relations. Most of those studies implicitly assume that IOs, public-private partnerships and large NGOs act as unified and rational actors, ignoring internal fragmentation and external pressure to change directions. We assert that the classic analytical instruments for understanding the shaping and outcome of public policy: ideas, interests and institutions apply well to the study of IOs. As we will show, changing ideas about the proper role of state and non-state actors, changing positions and activities of major stakeholders in the (international) health policy arena, and shifts in political institutions that channel the voice of diverging interests resulted in (and reflected) the changing positions of the health-oriented organizations-and also affect their future outlook. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

The moral sense of humanitarian actors: an empirical exploration.

PubMed

Rességuier, Anaïs

2018-01-01

This paper examines humanitarianism's moral positioning above private and political interests to save lives and alleviate suffering. It does not aim to assess the legitimacy of this stance, but rather to probe the way in which humanitarian actors relate to this moral dimension in their everyday work. It investigates empirically humanitarian ethics from the perspective of humanitarian actors, drawing on interviews conducted in Beirut, Lebanon, in 2014. As it is exploratory, three key conceptual innovations were required. The first of these is the introduction of the tools developed to consider a neglected reality: humanitarian actors' 'moral sense' vis-à-vis the humanitarian sector's 'moral culture'. Second, the study shows how the sector's moral culture is structured around the notion of 'concern for persons in need'. Third, it analyses the way in which the sector and its actors handle the asymmetrical relationships encountered daily. Ultimately this paper seeks to valorise humanitarian actors' creativity in their common practices and explore potential challenges to it. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Civil Wars Hijacked: A Case Study of the Lebanese Civil War

DTIC Science & Technology

2016-06-01

will focus on in-depth case studies of external state actors and their sponsored NSAs and outcomes. The state strategies of... case study because they did not employ NSA relationships on the scale of the three other state actors, and U.S. policy often complimented rather than...HIJACKED: A CASE STUDY OF THE LEBANESE CIVIL WAR by Kyle L. Greenheck June 2016 Thesis Advisor: Sean Everton Co-Advisor: Doowan Lee THIS PAGE

Unpacking the concept of land degradation neutrality and addressing its operation through the Rio Conventions.

PubMed

Akhtar-Schuster, Mariam; Stringer, Lindsay C; Erlewein, Alexander; Metternicht, Graciela; Minelli, Sara; Safriel, Uriel; Sommer, Stefan

2017-06-15

The world's commitment towards land degradation neutrality (LDN) became enshrined in various international agreements and decisions throughout the year 2015. The challenge now becomes one of addressing its operation, in order to achieve these new policy goals and targets by the year 2030. Advancing LDN demands attention to what the concept seeks to achieve, as well as unravelling the perspectives of the key multi-lateral environmental agreements through which progress can be made. The three Rio Conventions (the UN Convention to Combat Desertification (UNCCD), the UN Framework Convention on Climate Change (UNFCCC) and the Convention on Biological Diversity (CBD)) all play key roles in shaping the international LDN governance and implementation context. Their different but related foci create a number of challenges and opportunities for advancing LDN. In this paper we critically analyze the literature to elucidate potential challenges and opportunities in moving LDN towards implementation, considering the mandates and objectives of all three Rio Conventions. We first unpack the concept of LDN's aspirations. We highlight the importance of the definitions and terminology used, and the relationships between those definitions, terms and the actors using them, as well as their implications in framing the range of policy actions and synergies that could benefit progress towards multiple Sustainable Development Goals. We then examine the LDN pilot project spearheaded by the UNCCD to identify key lessons for LDN implementation. Synthesizing these lessons, we present a portfolio of blended interventions that seeks to address the aspirations of the UNCCD, UNFCCC and CBD in the LDN space, identifying synergistic options for national actions to move towards LDN. Overall, our analysis provides insights in advancing LDN from its current position as a policy target, towards synergetic action. Copyright © 2016 Elsevier Ltd. All rights reserved.

Start-stop funding, its causes and consequences: a case study of the delivery exemptions policy in Ghana.

PubMed

Witter, Sophie; Adjei, Sam

2007-01-01

This article looks at the issue of sustaining funding for a public programme through the case study of the delivery exemptions policy in Ghana. The Government of Ghana introduced the policy of exempting users from delivery fees in September 2003 in the four most deprived regions of the country, and in April 2005 it was extended to the remaining six regions in Ghana. The aim of the policy of free delivery care was to reduce financial barriers to using maternity services. Using materials from key informant interviews at national and local levels in 2005, the article examines how the policy has been implemented and what the main constraints have been, as perceived by different actors in the health system. The interviews show that despite being a high-profile public policy and achieving positive results, the delivery exemptions policy quickly ran into implementation problems caused by inadequate funding. They suggest that facility and district managers bear the brunt of the damage that is caused when benefits that have been promised to the public cannot be delivered. There can be knock-on effects on other public programmes too. Despite these problems, start-stop funding and under-funding of public programmes is more the norm than the exception. Some of the factors causing erratic funding--such as party politics and intersectoral haggling over resources--are unavoidable, but others, such as communication and management failures can and should be addressed. Copyright (c) 2007 John Wiley & Sons, Ltd.

Can legality verification enhace local rights to forest resources? Piloting the policy learning protocol in the Peruvian forest context

Treesearch

B. Cashore; I. Visseren-Hamakers; P. Caro Torres; W. de Jong; A. Denvir; D. Humphreys; Kathleen McGinley; G. Auld; S. Lupberger; C. McDermott; S. Sax; D. Yin

2016-01-01

This report, “Can Legality Verification Enhance Local Rights to Forest Resources? Piloting the policy learning protocol in the Peruvian forest context,” reports on the testing of the application of the 11-step Policy Learning Protocol in Peru in 2015-16. The Protocol (Cashore et al. 2014) enables actors to draw from international policy initiatives in order to improve...

Interrogating Social Sustainability in the Biofuels Sector in Latin America: Tensions Between Global Standards and Local Experiences in Mexico, Brazil, and Colombia.

PubMed

Selfa, Theresa; Bain, Carmen; Moreno, Renata; Eastmond, Amarella; Sweitz, Sam; Bailey, Conner; Pereira, Gustavo Simas; Souza, Tatiana; Medeiros, Rodrigo

2015-12-01

Across the Americas, biofuels production systems are diverse due to geographic conditions, historical patterns of land tenure, different land use patterns, government policy frameworks, and relations between the national state and civil society, all of which shape the role that biofuels play in individual nations. Although many national governments throughout the Americas continue to incentivize growth of the biofuels industry, one key challenge for biofuels sustainability has been concern about its social impacts. In this article, we discuss some of the key social issues and tensions related to the recent expansion of biofuels production in Mexico, Colombia, and Brazil. We argue that a process of "simplification" of ecological and cultural diversity has aided the expansion of the biofuels frontier in these countries, but is also undermining their viability. We consider the ability of governments and non-state actors in multi-stakeholder initiatives (MSI) to address social and environmental concerns that affect rural livelihoods as a result of biofuels expansion. We analyze the tensions between global sustainability standards, national level policies for biofuels development, and local level impacts and visions of sustainability. We find that both government and MSI efforts to address sustainability concerns have limited impact, and recommend greater incorporation of local needs and expertise to improve governance.

Interrogating Social Sustainability in the Biofuels Sector in Latin America: Tensions Between Global Standards and Local Experiences in Mexico, Brazil, and Colombia

NASA Astrophysics Data System (ADS)

Selfa, Theresa; Bain, Carmen; Moreno, Renata; Eastmond, Amarella; Sweitz, Sam; Bailey, Conner; Pereira, Gustavo Simas; Souza, Tatiana; Medeiros, Rodrigo

2015-12-01

Across the Americas, biofuels production systems are diverse due to geographic conditions, historical patterns of land tenure, different land use patterns, government policy frameworks, and relations between the national state and civil society, all of which shape the role that biofuels play in individual nations. Although many national governments throughout the Americas continue to incentivize growth of the biofuels industry, one key challenge for biofuels sustainability has been concern about its social impacts. In this article, we discuss some of the key social issues and tensions related to the recent expansion of biofuels production in Mexico, Colombia, and Brazil. We argue that a process of "simplification" of ecological and cultural diversity has aided the expansion of the biofuels frontier in these countries, but is also undermining their viability. We consider the ability of governments and non-state actors in multi-stakeholder initiatives (MSI) to address social and environmental concerns that affect rural livelihoods as a result of biofuels expansion. We analyze the tensions between global sustainability standards, national level policies for biofuels development, and local level impacts and visions of sustainability. We find that both government and MSI efforts to address sustainability concerns have limited impact, and recommend greater incorporation of local needs and expertise to improve governance.

iSAW: Integrating Structure, Actors, and Water to study socio-hydro-ecological systems

NASA Astrophysics Data System (ADS)

Hale, Rebecca L.; Armstrong, Andrea; Baker, Michelle A.; Bedingfield, Sean; Betts, David; Buahin, Caleb; Buchert, Martin; Crowl, Todd; Dupont, R. Ryan; Ehleringer, James R.; Endter-Wada, Joanna; Flint, Courtney; Grant, Jacqualine; Hinners, Sarah; Horsburgh, Jeffery S.; Jackson-Smith, Douglas; Jones, Amber S.; Licon, Carlos; Null, Sarah E.; Odame, Augustina; Pataki, Diane E.; Rosenberg, David; Runburg, Madlyn; Stoker, Philip; Strong, Courtenay

2015-03-01

Urbanization, climate, and ecosystem change represent major challenges for managing water resources. Although water systems are complex, a need exists for a generalized representation of these systems to identify important components and linkages to guide scientific inquiry and aid water management. We developed an integrated Structure-Actor-Water framework (iSAW) to facilitate the understanding of and transitions to sustainable water systems. Our goal was to produce an interdisciplinary framework for water resources research that could address management challenges across scales (e.g., plot to region) and domains (e.g., water supply and quality, transitioning, and urban landscapes). The framework was designed to be generalizable across all human-environment systems, yet with sufficient detail and flexibility to be customized to specific cases. iSAW includes three major components: structure (natural, built, and social), actors (individual and organizational), and water (quality and quantity). Key linkages among these components include: (1) ecological/hydrologic processes, (2) ecosystem/geomorphic feedbacks, (3) planning, design, and policy, (4) perceptions, information, and experience, (5) resource access and risk, and (6) operational water use and management. We illustrate the flexibility and utility of the iSAW framework by applying it to two research and management problems: understanding urban water supply and demand in a changing climate and expanding use of green storm water infrastructure in a semi-arid environment. The applications demonstrate that a generalized conceptual model can identify important components and linkages in complex and diverse water systems and facilitate communication about those systems among researchers from diverse disciplines.

Understanding key factors affecting electronic medical record implementation: a sociotechnical approach.

PubMed

Cucciniello, Maria; Lapsley, Irvine; Nasi, Greta; Pagliari, Claudia

2015-07-17

Recent health care policies have supported the adoption of Information and Communication Technologies (ICT) but examples of failed ICT projects in this sector have highlighted the need for a greater understanding of the processes used to implement such innovations in complex organizations. This study examined the interaction of sociological and technological factors in the implementation of an Electronic Medical Record (EMR) system by a major national hospital. It aimed to obtain insights for managers planning such projects in the future and to examine the usefulness of Actor Network Theory (ANT) as a research tool in this context. Case study using documentary analysis, interviews and observations. Qualitative thematic analysis drawing on ANT. Qualitative analyses revealed a complex network of interactions between organizational stakeholders and technology that helped to shape the system and influence its acceptance and adoption. The EMR clearly emerged as a central 'actor' within this network. The results illustrate how important it is to plan innovative and complex information systems with reference to (i) the expressed needs and involvement of different actors, starting from the initial introductory phase; (ii) promoting commitment to the system and adopting a participative approach; (iii) defining and resourcing new roles within the organization capable of supporting and sustaining the change and (iv) assessing system impacts in order to mobilize the network around a common goal. The paper highlights the organizational, cultural, technological, and financial considerations that should be taken into account when planning strategies for the implementation of EMR systems in hospital settings. It also demonstrates how ANT may be usefully deployed in evaluating such projects.

Performing Internationalization of Higher Education in Canadian National Policy

ERIC Educational Resources Information Center

Viczko, Melody; Tascón, Clara I.

2016-01-01

Internationalization processes are at the fore of university strategic plans on a global scale. However, the work of internationalization is being performed through the connections between many actors at different policy levels. Our purpose here is to ask, what is happening with internationalization of higher education at the Canadian national…

Actors and Agency in Academic Language Policy and Planning

ERIC Educational Resources Information Center

Fenton-Smith, Ben; Gurney, Laura

2016-01-01

Nearly two decades have passed since Kaplan and Baldauf [1997. "Language planning from practice to theory." Clevedon: Multilingual Matters] drew attention to the dearth of language policy and planning (LPP) in higher education. Despite the continuing inflow of English as an additional language students into Anglophone universities, and a…

From Policy to Pedagogy: Prudence and Precariousness; Actors and Artefacts

ERIC Educational Resources Information Center

Penney, Dawn

2013-01-01

This paper draws on concepts from contemporary education policy sociology to explore the prospective interpretation, contextualisation and enactment of Health and Physical Education in the Australian Curriculum. Analysis examines the dynamic between characteristics of official texts and the contexts in which responses will be made. The paper…

National Innovation Policy and Public Science in Australia

ERIC Educational Resources Information Center

Carter, Lyn

2017-01-01

In this paper, I have positioned myself with Kean Birch and explored some of the political-economic actors/actants of policy suites implicated in the biotechnologies and bioeconomy. In particular, I have considered Australia's recent National Innovation and Science Agenda and allied documents and entities (that is, Innovation and Science…

"Parent Unions" Join Policy Debates

ERIC Educational Resources Information Center

Cavanagh, Sean

2012-01-01

Whether they're organizing events, buttonholing legislators, or simply trading ideas and information, a growing number of "parent unions" are attempting to stake out a place in policy debates over education in states and districts, amid a crowded field of actors and advocates. As the term implies, some of these organizations see…

US Military Presence in Latin America: Making the Manta Forward Operating Location work

DTIC Science & Technology

2003-09-01

actors in the decision making process and the actors’ policy preferences and determine how they group themselves in this policy area and interact......between Peru’s growing areas and Colombia’s processing plants.22 The riverine efforts responded to concerns that drug traffickers would shift smuggling

A window of opportunity for reform in post-conflict settings? The case of Human Resources for Health policies in Sierra Leone, 2002-2012.

PubMed

Bertone, Maria Paola; Samai, Mohamed; Edem-Hotah, Joseph; Witter, Sophie

2014-01-01

It is recognized that decisions taken in the early recovery period may affect the development of health systems. Additionally, some suggest that the immediate post-conflict period may allow for the opening of a political 'window of opportunity' for reform. For these reasons, it is useful to reflect on the policy space that exists in this period, by what it is shaped, how decisions are made, and what are their long-term implications. Examining the policy trajectory and its determinants can be helpful to explore the specific features of the post-conflict policy-making environment. With this aim, the study looks at the development of policies on human resources for health (HRH) in Sierra Leone over the decade after the conflict (2002-2012). Multiple sources were used to collect qualitative data on the period between 2002 and 2012: a stakeholder mapping workshop, a document review and a series of key informant interviews. The analysis draws from political economy and policy analysis tools, focusing on the drivers of reform, the processes, the contextual features, and the actors and agendas. Our findings identify three stages of policy-making. At first characterized by political uncertainty, incremental policies and stop-gap measures, the context substantially changed in 2009. The launch of the Free Health Care Initiative provided to be an instrumental event and catalyst for health system, and HRH, reform. However, after the launch of the initiative, the pace of HRH decision-making again slowed down. OUR STUDY IDENTIFIES THE KEY DRIVERS OF HRH POLICY TRAJECTORY IN SIERRA LEONE: (i) the political situation, at first uncertain and later on more defined; (ii) the availability of funding and the stances of agencies providing such funds; (iii) the sense of need for radical change - which is perhaps the only element related to the post-conflict setting. It also emerges that a 'windows of opportunity' for reform did not open in the immediate post-conflict, but rather 8 years later when the Free Health Care Initiative was announced, thus making it difficult to link it directly to the features of the post-conflict policy-making environment.

Opportunities and challenges in developing a whole-of-government national food and nutrition policy: lessons from Australia's National Food Plan.

PubMed

Carey, Rachel; Caraher, Martin; Lawrence, Mark; Friel, Sharon

2016-01-01

The present article tracks the development of the Australian National Food Plan as a 'whole of government' food policy that aimed to integrate elements of nutrition and sustainability alongside economic objectives. The article uses policy analysis to explore the processes of consultation and stakeholder involvement in the development of the National Food Plan, focusing on actors from the sectors of industry, civil society and government. Existing documentation and submissions to the Plan were used as data sources. Models of health policy analysis and policy streams were employed to analyse policy development processes. Australia. Australian food policy stakeholders. The development of the Plan was influenced by powerful industry groups and stakeholder engagement by the lead ministry favoured the involvement of actors representing the food and agriculture industries. Public health nutrition and civil society relied on traditional methods of policy influence, and the public health nutrition movement failed to develop a unified cross-sector alliance, while the private sector engaged in different ways and presented a united front. The National Food Plan failed to deliver an integrated food policy for Australia. Nutrition and sustainability were effectively sidelined due to the focus on global food production and positioning Australia as a food 'superpower' that could take advantage of the anticipated 'dining boom' as incomes rose in the Asia-Pacific region. New forms of industry influence are emerging in the food policy arena and public health nutrition will need to adopt new approaches to influencing public policy.

Adjusting policy to institutional, cultural and biophysical context conditions: The case of conservation banking in California

Treesearch

Carsten Mann; James D. Absher

2013-01-01

This paper examines the political construction of a policy instrument for matching particular institutional, biophysical and cultural context conditions in a social–ecological system, using the case of conservation banking in California as an example. The guiding research question is: How is policy design negotiated between various actors on its way from early...

Implementation Of Conservation Policy Through The Protection Of Life Support System In The Karimunjawa National Park

NASA Astrophysics Data System (ADS)

Ariyani, Nur Anisa Eka; Kismartini

2018-02-01

The Karimunjawa National Park as the only one marine protected area in Central Java, managed by zonation system has decreased natural resources in the form of decreasing mangrove forest area, coral cover, sea biota population such as clams and sea cucumbers. Conservation has been done by Karimunjawa National Park Authority through protection of life support system activities in order to protect the area from degradation. The objective of the research is to know the implementation of protection and security activities of Karimunjawa National Park Authority for the period of 2012 - 2016. The research was conducted by qualitative method, processing secondary data from Karimunjawa National Park Authority and interview with key informants. The results showed that protection and security activities in The Karimunjawa National Park were held with three activities: pre-emptive activities, preventive activities and repressive activities. Implementation of conservation policy through protection of life support system is influenced by factors of policy characteristic, resource factor and environmental policy factor. Implementation of conservation policy need support from various parties, not only Karimunjawa National Park Authority as the manager of the area, but also need participation of Jepara Regency, Central Java Provinces, communities, NGOs, researchers, developers and tourism actors to maintain and preserve existing biodiversity. Improving the quality of implementors through education and training activities, the availability of the state budget annually and the support of stakeholders is essential for conservation.

A multi-level, multi-jurisdictional strategy: Transnational tobacco companies' attempts to obstruct tobacco packaging restrictions.

PubMed

Hawkins, Benjamin; Holden, Chris; Mackinder, Sophie

2018-03-09

Despite the extensive literature on the tobacco industry, there has been little attempt to study how transnational tobacco companies (TTCs) coordinate their political activities globally, or to theorise TTC strategies within the context of global governance structures and policy processes. This article draws on three concepts from political science - policy transfer, multi-level governance and venue shifting - to analyse TTCs' integrated, global strategies to oppose augmented packaging requirements across multiple jurisdictions. Following Uruguay's introduction of extended labelling requirements, Australia became the first country in the world to require tobacco products to be sold in standardised ('plain') packaging in 2012. Governments in the European Union, including in the United Kingdom and Ireland, adopted similar laws, with other member states due to follow. TTCs vehemently opposed these measures and developed coordinated, global strategies to oppose their implementation, exploiting the complexity of contemporary global governance arrangements. These included a series of legal challenges in various jurisdictions, alongside political lobbying and public relations campaigns. This article draws on analysis of public documents and 32 semi-structured interviews with key policy actors. It finds that TTCs developed coordinated and highly integrated strategies to oppose packaging restrictions across multiple jurisdictions and levels of governance.

Analysing policy delivery in the United Kingdom: the case of street crime and anti-social behaviour.

PubMed

Smith, Martin; Richards, David; Geddes, Andrew; Mathers, Helen

2011-01-01

For all governments, the principle of how and whether policies are implemented as intended is fundamental. The aim of this paper is to examine the difficulties for governments in delivering policy goals when they do not directly control the processes of implementation. This paper examines two case studies – anti-social behaviour and street crime – and demonstrates the difficulties faced by policy-makers in translating policy into practice when the policy problems are complex and implementation involves many actors.

Accelerating learning for pro-poor health markets.

PubMed

Bennett, Sara; Lagomarsino, Gina; Knezovich, Jeffrey; Lucas, Henry

2014-06-24

Given the rapid evolution of health markets, learning is key to promoting the identification and uptake of health market policies and practices that better serve the needs of the poor. However there are significant challenges to learning about health markets. We discuss the different forms that learning takes, from the development of codified scientific knowledge, through to experience-based learning, all in relationship to health markets. Notable challenges to learning in health markets include the difficulty of acquiring data from private health care providers, designing evaluations that capture the complex dynamics present within health markets and developing communities of practice that encompass the diverse actors present within health markets, and building trust and mutual understanding across these groups. The paper proposes experimentation with country-specific market data platforms that can integrate relevant evidence from different data sources, and simultaneously exploring strategies to secure better information on private providers and health markets. Possible approaches to adapting evaluation designs so that they are better able to take account of different and changing contexts as well as producing real time findings are discussed. Finally capturing informal knowledge about health markets is key. Communities of practice that bridge different health market actors can help to share such experience-based knowledge and in so doing, may help to formalize it. More geographically-focused communities of practice are needed, and such communities may be supported by innovation brokers and/or be built around member-based organizations. Strategic investments in and support to learning about health markets can address some of the challenges experienced to-date, and accelerate learning that supports health markets that serve the poor.

Universal Batch Steganalysis

DTIC Science & Technology

2014-06-01

in large-scale datasets such as might be obtained by monitoring a corporate network or social network. Identifying guilty actors, rather than payload...by monitoring a corporate network or social network. Identifying guilty actors, rather than payload-carrying objects, is entirely novel in steganalysis...implementation using Compute Unified Device Architecture (CUDA) on NVIDIA graphics cards. The key to good performance is to combine computations so that

Student Teachers' Team Teaching: How Do Learners in the Classroom Experience Team-Taught Lessons by Student Teachers?

ERIC Educational Resources Information Center

Baeten, Marlies; Simons, Mathea

2016-01-01

This study focuses on student teachers' team teaching. Two team teaching models (sequential and parallel teaching) were applied by 14 student teachers in a quasi-experimental design. When implementing new teaching models, it is important to take into account the perspectives of all actors involved. Although learners are key actors in the teaching…

Brain systems for visual perspective taking and action perception.

PubMed

Mazzarella, Elisabetta; Ramsey, Richard; Conson, Massimiliano; Hamilton, Antonia

2013-01-01

Taking another person's viewpoint and making sense of their actions are key processes that guide social behavior. Previous neuroimaging investigations have largely studied these processes separately. The current study used functional magnetic resonance imaging to examine how the brain incorporates another person's viewpoint and actions into visual perspective judgments. Participants made a left-right judgment about the location of a target object from their own (egocentric) or an actor's visual perspective (altercentric). Actor location varied around a table and the actor was either reaching or not reaching for the target object. Analyses examined brain regions engaged in the egocentric and altercentric tasks, brain regions where response magnitude tracked the orientation of the actor in the scene and brain regions sensitive to the action performed by the actor. The blood oxygen level-dependent (BOLD) response in dorsomedial prefrontal cortex (dmPFC) was sensitive to actor orientation in the altercentric task, whereas the response in right inferior frontal gyrus (IFG) was sensitive to actor orientation in the egocentric task. Thus, dmPFC and right IFG may play distinct but complementary roles in visual perspective taking (VPT). Observation of a reaching actor compared to a non-reaching actor yielded activation in lateral occipitotemporal cortex, regardless of task, showing that these regions are sensitive to body posture independent of social context. By considering how an observed actor's location and action influence the neural bases of visual perspective judgments, the current study supports the view that multiple neurocognitive "routes" operate during VPT.

Crossing institutional boundaries: mapping the policy process for improved control of endemic and neglected zoonoses in sub-Saharan Africa.

PubMed

Okello, Anna; Welburn, Susan; Smith, James

2015-07-01

The recent adoption of the World Health Assembly Resolution 66.12 for neglected tropical diseases (NTDs) in May 2013 is an important turning point for advocacy regarding a number of endemic zoonotic infections, defined by the World Health Organization as the neglected zoonotic diseases (NZDs). In addition to NTD-listed zoonoses such as rabies, echinococcosis (hydatid disease), leishmaniasis, Human African trypanosomiasis (sleeping sickness) and Taenia solium cysticercosis, the NZDs also include important bacterial zoonoses such as anthrax, bovine tuberculosis and brucellosis. To date, analysis of the processes that prioritize, develop and deliver zoonoses control programmes in many low- and middle-income countries is lacking, despite its potential to highlight significant evidence gaps and institutional constraints to the intersectoral approach required for their control. Policy process analysis was conducted via a series of semi-structured interviews with key policy actors within various ministries and institutes in Uganda and Nigeria. The study concluded that despite the rhetoric around 'linear' models of health policy development promoting consultation with a wide range of national stakeholders, the decision-making process for zoonotic disease control appears instead overtly influenced by the external political economy of trending pandemic threats, often overlooking national and regional zoonoses priorities. The inclusion of political systems remains a key factor in the zoonoses analysis matrix, enhancing our understanding of the intersectoral and transdisciplinary approaches required for their control. The authors consider policy process analysis to be a fundamental first step of any attempt to holistically strengthen human and animal health systems in a development context, particularly regarding the promotion of integrated control policies for regionally important zoonoses under the growing One Health movement. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Locating regional health policy: Institutions, politics, and practices.

PubMed

Riggirozzi, Pia; Yeates, Nicola

2015-12-01

Poverty reduction and health became central in the agendas of Southern regional organisations in the last two decades. Yet, little is known about how these organisations address poverty, inclusion and social inequality, and how Southern regional formations are engaging in power constellations, institutions, processes, interests and ideological positions within different spheres of governance. This article reviews academic literatures spanning global social policy, regional studies and diplomacy studies, and the state of knowledge and understanding of the 'place' of regional actors in health governance as a global political practice therein. It identifies theoretical and thematic points of connection between disparate literatures and how these can be bridged through research focusing on the social policies of regional organisations and regional integration processes. This framework hence locates the contributions of each of the research articles of this Special Issue of Global Social Policy on the regional dimension of health policy and diplomacy in relation to Southern Africa and South America. It also highlights the ways in which the articles bring new evidence about how social relations of welfare are being (re)made over larger scales and how regional actors may initiate new norms to improve health rights in international arenas engaging in new forms of 'regional' diplomacy.

Europeanization in VET Policy as a Process of Reshaping the Educational Space

ERIC Educational Resources Information Center

Loogma, Krista

2016-01-01

The EU represents a transforming educational space, where national and supranational boundaries in educational governance are becoming blurred. The EU has become an important actor in educational governance and an important arena for policy learning and transfer. This paper explores how the process of reshaping the educational space manifests…

European Higher Education Policy and the Formation of Entrepreneurial Students as Future European Citizens

ERIC Educational Resources Information Center

Papatsiba, Vassiliki

2009-01-01

In this article, the author argues that European education policies and rhetoric are imbued with orthodoxy of agency and models of empowered, entrepreneurial actors, striving to surpass the limits of national boundaries. Free circulation of citizens has progressively underpinned a new construction of "the European", who is…

Tacit Rejection of Policy and Teacher Ambivalence: Insights into English Language Teaching in Bahrain through Actors' Perceptions

ERIC Educational Resources Information Center

Hayes, Aneta

2018-01-01

This article develops Phillips and Ochs's (2003) framework for policy borrowing, particularly their theorisations about indigenisation of international programmes. It uses the example of communicative language teaching (CLT) in Bahrain, exploring teacher perspectives regarding the effects of CLT on the preexisting arrangements in the national…

Stability and Change of Mentoring Practices in a Capricious Policy Environment: Opening the "Black Box of Institutionalization"

ERIC Educational Resources Information Center

März, Virginie; Kelchtermans, Geert; Dumay, Xavier

2016-01-01

This article addresses how institutional logics are translated, maintained, or disrupted by actors and their (inter)actions within schools. The changing policy environment for mentoring beginning teachers in Flanders (Belgium) provides a fertile context for answering this question. Combining neoinstitutional and sensemaking lenses and analyzing…

The Politics of International League Tables: PISA in Japan's Achievement Crisis Debate

ERIC Educational Resources Information Center

Takayama, Keita

2008-01-01

Using the political-economic analysis of globalisation and education as well as a culturalist approach to education policy borrowing, the paper analyses the role of local actors, specifically, national newspapers and the Ministry of Education, in mediating the potentially homogenising curricular policy pressure of globalisation exerted through the…

Protecting girls and women from harmful practices affecting their health: Are we making progress?

PubMed

Cottingham, Jane; Kismodi, Eszter

2009-08-01

Since female genital mutilation (FGM) was first recognized internationally in 1958, it has now become widely accepted and anchored in international law that FGM is a violation of girls' and women's human rights. Declines in the practice, however, are slow overall, and continued work for its elimination requires action and investment at many levels. Where the practice has diminished, community action has been widespread and sustained. Governments, who are ultimately responsible for the eradication of FGM, must take many measures to outlaw the practice and protect girls' and women's rights, through legislation, policy, education, and resource allocation. Among the other key actors, health care professionals have a particularly important role in treating women and in preventing FGM by actively opposing any medicalization of the practice.

Crisis and Change: The Making of a French FDA.

PubMed

Nathanson, Constance A; Bergeron, Henri

2017-09-01

Policy Points: Introducing a recent special issue of The Lancet on the health system in France, Horton and Ceschia observe that "the dominance of English as the language of science and, increasingly, global health too often closes the door on the history and experiences of others." 1 In that spirit, this manuscript presents a detailed case study of public health policy transformation in France in the early 1990s. It casts light on processes of policy change in a political and cultural environment very different from that of the United States, showing how the public health policy process is shaped by multiple contingencies of history, ideology, and politics. More specifically, we describe the transformation of a disease catastrophe into a political crisis and the deployment of that crisis to precipitate reform of the French public health system. Until the last decade of the 20th century, France had no equivalent to the US Food and Drug Administration. In this paper we describe and interpret the complex series of events that led to the passage by the French Parliament in December 1992 of a law incorporating such an agency, the Agence du Médicament (literally, "medicines agency"). The broad aim of this project was to learn how public health policy change comes about by detailed analysis of a specific instance. More specifically, we aimed to better understand the circumstances under which public health crisis leads to significant public health policy reform. This paper is based on detailed analysis of primary documents (eg, archived French health ministry papers, recorded parliamentary debates, government reports, newspaper articles) and oral history interviews covering a period from 1988 to 1993. Thematic analysis of these materials was initially grounded in theories of organizational change, moving to constructs that emerged from the data themselves. Policy entrepreneurs positioned to frame adverse events and seize opportunities are key to public health policy reform. However, whether these entrepreneurs will have the requisite institutional power is contingent both on political structure and on the power of competing institutional actors. Health crises may catalyze institutional reform, but our analysis suggests that whether reform occurs, or even whether adverse episodes are labeled as crises, is highly contingent on circumstances of history, political structure, and political ideology and is extremely difficult to predict or control. Actors positioned to shape public health policy need to have a detailed understanding of the circumstances that facilitate or impede policy reform. Health crises are now more often global than not. Comparative, theoretically grounded, cross-national research that looks in detail at how different countries respond to similar health crises would be extremely valuable in informing both policymakers and researchers. © 2017 Milbank Memorial Fund.

Can rights stop the wrongs? Exploring the connections between framings of sex workers’ rights and sexual and reproductive health

PubMed Central

2011-01-01

Background There is growing interest in the ways in which legal and human rights issues related to sex work affect sex workers’ vulnerability to HIV and abuses including human trafficking and sexual exploitation. International agencies, such as UNAIDS, have called for decriminalisation of sex work because the delivery of sexual and reproductive health services is affected by criminalisation and social exclusion as experienced by sex workers. The paper reflects on the connections in various actors’ framings between sex workers sexual and reproductive health and rights (SRHR) and the ways that international law is interpreted in policing and regulatory practices. Methods The literature review that informs this paper was carried out by the authors in the course of their work within the Paulo Longo Research Initiative. The review covered academic and grey literature such as resources generated by sex worker rights activists, UN policy positions and print and online media. The argument in this paper has been developed reflectively through long term involvement with key actors in the field of sex workers’ rights. Results International legislation characterises sex work in various ways which do not always accord with moves toward decriminalisation. Law, policy and regulation at national level and law enforcement vary between settings. The demands of sex worker rights activists do relate to sexual and reproductive health but they place greater emphasis on efforts to remove the structural barriers that limit sex workers’ ability to participate in society on an equal footing with other citizens. Discussion and conclusion There is a tension between those who wish to uphold the rights of sex workers in order to reduce vulnerability to ill-health and those who insist that sex work is itself a violation of rights. This is reflected in contemporary narratives about sex workers’ rights and the ways in which different actors interpret human rights law. The creation of regulatory frameworks around sex work that support health, safety and freedom from abuse requires a better understanding of the broad scope of laws, policies and enforcement practices in different cultural contexts and economic settings, alongside reviews of UN policies and human rights conventions. PMID:22376152

Urban revitalization and displacement: types, causes, and public policy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Feagin, J.R.

1981-05-01

The policy research report reviews the scholarly and print media literatures on urban revitalization. The extent of revitalization; the incumbent or occupant upgrading; gentrification (displacement of low- and moderate-income households by better-off households); gentrification and displacement from all causes; and the role of powerful actors in revitalization are discussed. Public policy dealing with land use and development in urban areas is discussed. Future research needs are indicated.

Understanding Agenda Setting in State Educational Policy: An Application of Kingdon's Multiple Streams Model to the Formation of State Reading Policy

ERIC Educational Resources Information Center

Young, Tamara V.; Shepley, Thomas V.; Song, Mengli

2010-01-01

Drawing on interview data from reading policy actors in California, Michigan, and Texas, this study applied Kingdon's (1984, 1995) multiple streams model to explain how the issue of reading became prominent on the agenda of state governments during the latter half of the 1990s. A combination of factors influenced the status of a state's reading…

Promoting universal financial protection: a policy analysis of universal health coverage in Costa Rica (1940-2000).

PubMed

Vargas, Juan Rafael; Muiser, Jorine

2013-08-21

This paper explores the implementation and sustenance of universal health coverage (UHC) in Costa Rica, discussing the development of a social security scheme that covered 5% of the population in 1940, to one that finances and provides comprehensive healthcare to the whole population today. The scheme is financed by mandatory, tri-partite social insurance contributions complemented by tax funding to cover the poor. The analysis takes a historical perspective and explores the policy process including the key actors and their relative influence in decision-making. Data were collected using qualitative research instruments, including a review of literature, institutional and other documents, and in-depth interviews with key informants. Key lessons to be learned are: i) population health was high on the political agenda in Costa Rica, in particular before the 1980s when UHC was enacted and the transfer of hospitals to the social security institution took place. Opposition to UHC could therefore be contained through negotiation and implemented incrementally despite the absence of real consensus among the policy elite; ii) since the 1960s, the social security institution has been responsible for UHC in Costa Rica. This institution enjoys financial and managerial autonomy relative to the general government, which has also facilitated the UHC policy implementation process; iii) UHC was simultaneously constructed on three pillars that reciprocally strengthened each other: increasing population coverage, increasing availability of financial resources based on solidarity financing mechanisms, and increasing service coverage, ultimately offering comprehensive health services and the same benefits to every resident in the country; iv) particularly before the 1980s, the fruits of economic growth were structurally invested in health and other universal social policies, in particular education and sanitation. The social security institution became a flagship of Costa Rica's national development strategy which reinforced its political importance and contributed to its longer-term sustainability and that of UHC. UHC has been achieved in Costa Rica because it was supported at the highest political level within a favourable socio-economic and political context. Once achieved, UHC became an entitlement for the population and now enjoys broad public support.

Promoting universal financial protection: a policy analysis of universal health coverage in Costa Rica (1940–2000)

PubMed Central

2013-01-01

Background This paper explores the implementation and sustenance of universal health coverage (UHC) in Costa Rica, discussing the development of a social security scheme that covered 5% of the population in 1940, to one that finances and provides comprehensive healthcare to the whole population today. The scheme is financed by mandatory, tri-partite social insurance contributions complemented by tax funding to cover the poor. Methods The analysis takes a historical perspective and explores the policy process including the key actors and their relative influence in decision-making. Data were collected using qualitative research instruments, including a review of literature, institutional and other documents, and in-depth interviews with key informants. Results Key lessons to be learned are: i) population health was high on the political agenda in Costa Rica, in particular before the 1980s when UHC was enacted and the transfer of hospitals to the social security institution took place. Opposition to UHC could therefore be contained through negotiation and implemented incrementally despite the absence of real consensus among the policy elite; ii) since the 1960s, the social security institution has been responsible for UHC in Costa Rica. This institution enjoys financial and managerial autonomy relative to the general government, which has also facilitated the UHC policy implementation process; iii) UHC was simultaneously constructed on three pillars that reciprocally strengthened each other: increasing population coverage, increasing availability of financial resources based on solidarity financing mechanisms, and increasing service coverage, ultimately offering comprehensive health services and the same benefits to every resident in the country; iv) particularly before the 1980s, the fruits of economic growth were structurally invested in health and other universal social policies, in particular education and sanitation. The social security institution became a flagship of Costa Rica’s national development strategy which reinforced its political importance and contributed to its longer-term sustainability and that of UHC. Conclusions UHC has been achieved in Costa Rica because it was supported at the highest political level within a favourable socio-economic and political context. Once achieved, UHC became an entitlement for the population and now enjoys broad public support. PMID:24107407

Are Commercial Complementary Food Distributions to Refugees and Migrants in Europe Conforming to International Policies and Guidelines on Infant and Young Child Feeding in Emergencies?

PubMed

Theurich, Melissa Ann; Grote, Veit

2017-08-01

In 2015, more than one million migrants and refugees arrived in Europe. Commercial complementary foods, processed foods marketed for infants and young children 6-23 months of age, were distributed by various humanitarian actors along migrant routes and in European refugee camps. Unsolicited donations and distributions of commercial complementary food products were problematic and divergent from international policies on infant and young child feeding during humanitarian emergencies. Interim guidance regarding commercial complementary foods was published during the peak of the emergency but implemented differently by various humanitarian actors. Clearer and more technical specifications on commercial complementary foods are needed in order to objectively determine their suitability for operational contexts in Europe and emergency nutrition assistance in the future.

Whole-of-society approach for public health policymaking: a case study of polycentric governance from Quebec, Canada.

PubMed

Addy, Nii A; Poirier, Alain; Blouin, Chantal; Drager, Nick; Dubé, Laurette

2014-12-01

In adopting a whole-of-society (WoS) approach that engages multiple stakeholders in public health policies across contexts, the authors propose that effective governance presents a challenge. The purpose of this paper is to highlight a case for how polycentric governance underlying the WoS approach is already functioning, while outlining an agenda to enable adaptive learning for improving such governance processes. Drawing upon a case study from Quebec, Canada, we employ empirically developed concepts from extensive, decades-long work of the 2009 Nobel laureate Elinor Ostrom in the governance of policy in nonhealth domains to analyze early efforts at polycentric governance in policies around overnutrition, highlighting interactions between international, domestic, state and nonstate actors and processes. Using information from primary and secondary sources, we analyze the emergence of the broader policy context of Quebec's public health system in the 20th century. We present a microsituational analysis of the WoS approach for Quebec's 21st century policies on healthy lifestyles, emphasizing the role of governance at the community level. We argue for rethinking prescriptive policy analysis of the 20th century, proposing an agenda for diagnostic policy analysis, which explicates the multiple sets of actors and interacting variables shaping polycentric governance for operationalizing the WoS approach to policymaking in specific contexts. © 2014 New York Academy of Sciences.

The Kenyan national response to internationally agreed sexual and reproductive health and rights goals: a case study of three policies.

PubMed

Oronje, Rose N

2013-11-01

While priorities for, and decision-making processes on, sexual and reproductive health and rights have been determined and led mainly at the international level, conflicting power dynamics and responses at the national level in some countries have continued to pose challenges for operationalising international agreements. This paper demonstrates how these conflicts have played out in Kenya through an analysis of three policy-making processes, which led to the Adolescent Reproductive Health and Development Policy (2003), the Sexual Offences Act (2006), and the National Reproductive Health Policy (2007). The paper is based on data from a broader study on the drivers and inhibitors of sexual and reproductive health policy reform in Kenya, using a qualitative, case study design. Information was gathered through 54 semi-structured, in-depth interviews with governmental and civil society policy actors and an extensive review of policy documents and media reports. The paper shows that the transformative human rights framing of access to sexual and reproductive health, supported by both a strong global women's rights movement and progressive governmental and inter-governmental actors to defeat opposition to sexual and reproductive health and rights at the international level, has not been as influential or successful at the national level in Kenya, and has made comprehensive national reforms difficult to achieve. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Controlling disasters: Local emergency management perceptions about Federal Emergency Management and Homeland Security actions after September 11, 2001.

PubMed

Hildebrand, Sean

This article examines local emergency manager's beliefs regarding control over tasks during various stages of the hazard cycle since federal policies went into effect following the September 11 attacks. The study considers whether a disparity exists between the actions of local officials during each phase of the "hazard cycle" and the policy expectations of the federal government, which call for greater federal control over activities in emergency management and homeland security. To do so, hypothesis testing investigates the jurisdiction's use of comprehensive emergency management (CEM) practices, the perceived "clarity" of the federal policy demands, and if the local actors feel coerced to comply with federal policy demands so that grant funding is not compromised. Using a model developed from "third-generation" policy implementation research, the results show that the odds of local officials citing federal control over these actions have very limited statistical significance. This signals that the perceived lack of local input into the development of these federal policies and the policies' limited use of traditional CEM measures may not be in concert with what local actors perform in the field. Simply put, the respondents claim to understand the federal policy demands, support the concept of federal control as the policies describe, yet follow their own plans or traditional CEM principles, even if such actions do not support the federal policy demands. These results align with pre-existing research in the emergency management field that show issues with efforts to centralize policies under the Department of Homeland Security and Federal Emergency Management Agency.

Operational research in malawi: making a difference with cotrimoxazole preventive therapy in patients with tuberculosis and HIV

PubMed Central

2011-01-01

Background In Malawi, high case fatality rates in patients with tuberculosis, who were also co-infected with HIV, and high early death rates in people living with HIV during the initiation of antiretroviral treatment (ART) adversely impacted on treatment outcomes for the national tuberculosis and ART programmes respectively. This article i) discusses the operational research that was conducted in the country on cotrimoxazole preventive therapy, ii) outlines the steps that were taken to translate these findings into national policy and practice, iii) shows how the implementation of cotrimoxazole preventive therapy for both TB patients and HIV-infected patients starting ART was associated with reduced death rates, and iv) highlights lessons that can be learnt for other settings and interventions. Discussion District and facility-based operational research was undertaken between 1999 and 2005 to assess the effectiveness of cotrimoxazole preventive therapy in reducing death rates in TB patients and subsequently in patients starting ART under routine programme conditions. Studies demonstrated significant reductions in case fatality in HIV-infected TB patients receiving cotrimoxazole and in HIV-infected patients about to start ART. Following the completion of research, the findings were rapidly disseminated nationally at stakeholder meetings convened by the Ministry of Health and internationally through conferences and peer-reviewed scientific publications. The Ministry of Health made policy changes based on the available evidence, following which there was countrywide distribution of the updated policy and guidelines. Policy was rapidly moved to practice with the development of monitoring tools, drug procurement and training packages. National programme performance improved which showed a significant decrease in case fatality rates in TB patients as well as a reduction in early death in people with HIV starting ART. Summary Key lessons for moving this research endeavour through to policy and practice were the importance of placing operational research within the programme, defining relevant questions, obtaining "buy-in" from national programme staff at the beginning of projects and having key actors or "policy entrepreneurs" to push forward the policy-making process. Ultimately, any change in policy and practice has to benefit patients, and the ultimate judge of success is whether treatment outcomes improve or not. PMID:21794154

Construction of a policy arena: the case of public health in France.

PubMed

Bergeron, Henri; Nathanson, Constance A

2012-02-01

In this article we examine the transformation over the past two decades of public health as a policy arena in France from a backwater of little interest to politicians, bureaucrats, the media, and the public into a central preoccupation of the state. Recent dramatic health crises (the scandal over HIV-contaminated blood, mad cow disease, etc.) have substantially raised the political profile of (and corresponding state investment in) public health in France, offering opportunities and incentives for political actors not traditionally associated with public health to enter the field and challenging more traditional actors to galvanize themselves and compete for this newly attractive policy terrain. We use the occasion of the passage of a public health law in 2004, labeled by its proponents as the "first" public health law in one hundred years, to show how, in a context of national struggle to contain both risks and costs, "public health" -- chameleonlike -- has taken on various meanings and forms to serve highly conflicting political interests.

The role of the Sheffield model on the minimum unit pricing of alcohol debate: the importance of a rhetorical perspective.

PubMed

Katikireddi, Srinivasa Vittal; Hilton, Shona; Bond, Lyndal

2016-11-01

The minimum unit pricing (MUP) alcohol policy debate has been informed by the Sheffield model, a study which predicts impacts of different alcohol pricing policies. This paper explores the Sheffield model's influences on the policy debate by drawing on 36 semi-structured interviews with policy actors who were involved in the policy debate. Although commissioned by policy makers, the model's influence has been far broader than suggested by views of 'rational' policy making. While findings from the Sheffield model have been used in instrumental ways, they have arguably been more important in helping debate competing values underpinning policy goals.

Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland.

PubMed

Jones, Catherine M; Clavier, Carole; Potvin, Louise

2017-01-01

Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making.

Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland

PubMed Central

Clavier, Carole; Potvin, Louise

2017-01-01

Background Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Methods Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Results Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Conclusion Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making. PMID:28589007

[Governance in Guatemalan municipal development councils: an analysis of actors and power relationships].

PubMed

Flores, Walter; Gómez-Sánchez, Ismael

2010-01-01

Decentralisation and other public policies have created public spaces for participation in most Latin-American countries where community representatives, together with municipal authorities and other public functionaries, decide on social investment plans, including health services and infrastructure. The municipal development council system constitutes such public space in Guatemala. This study analysed such system's governance in a sample of 6 rural municipalities. A descriptive design was used, applying qualitative and quantitative techniques to study three central categories: the strategic actors, the rules of the game and power asymmetry levels amongst actors. The findings revealed inconsistencies amongst the actors who had to participate according to the legal framework and those actors who actually did so in practice. Divergent interests were also identified for participating which affected the possibility of reaching consensus during decision-making. Analysing the rules of the game led to identifying formal and non-formal mechanisms favouring some actors' ability to influence decisions. Analysing power asymmetry levels led to identifying that community representatives had fewer power resources than institutional representatives (local government and other government organisations). Community representatives also face different barriers blocking their participation and perceive a lesser capacity to influence decision-making. Existing barriers and fewer power resources experienced by community representatives reduce their abilities to influence decision-making in municipal development councils.

Advancing the application of systems thinking in health: managing rural China health system development in complex and dynamic contexts.

PubMed

Zhang, Xiulan; Bloom, Gerald; Xu, Xiaoxin; Chen, Lin; Liang, Xiaoyun; Wolcott, Sara J

2014-08-26

This paper explores the evolution of schemes for rural finance in China as a case study of the long and complex process of health system development. It argues that the evolution of these schemes has been the outcome of the response of a large number of agents to a rapidly changing context and of efforts by the government to influence this adaptation process and achieve public health goals. The study draws on several sources of data including a review of official policy documents and academic papers and in-depth interviews with key policy actors at national level and at a sample of localities. The study identifies three major transition points associated with changes in broad development strategy and demonstrates how the adaptation of large numbers of actors to these contextual changes had a major impact on the performance of the health system. Further, it documents how the Ministry of Health viewed its role as both an advocate for the interests of health facilities and health workers and as the agency responsible for ensuring that government health system objectives were met. It is argued that a major reason for the resilience of the health system and its ability to adapt to rapid economic and institutional change was the ability of the Ministry to provide overall strategy leadership. Additionally, it postulates that a number of interest groups have emerged, which now also seek to influence the pathway of health system development. This history illustrates the complex and political nature of the management of health system development and reform. The paper concludes that governments will need to increase their capacity to analyze the health sector as a complex system and to manage change processes.

Using qualitative methods to understand non-technological aspects of domestic energy efficiency

NASA Astrophysics Data System (ADS)

Ambrose, Aimee Rebecca

The overall aim of the collected published works is to investigate how different policy interventions in the field of energy efficiency (including zero carbon homes, low carbon heat networks, and domestic energy efficiency schemes) are experienced and made sense of by a range of key actors. A further aim is to understand these interventions in the context of existing theories within the field of domestic energy efficiency including socio-technical theory and Actor Network Theory. More specifically, this research advances existing knowledge in the following areas: The nature of the socio-technical challenges encountered in the introduction of more energy efficient buildings, and the importance of achieving a balance between socially acceptable and technically optimal environments. (Papers 2, 3, 4, 6 and 8). The value of qualitative research in gaining a more nuanced understanding of our relationship with the home and the implications of this for domestic energy efficiency interventions and the design of low energy buildings (all papers). The influence of tenure as determinant of access to a more energy efficient home and in particular, the stubborn and complex barriers to achieving higher standards of energy performance within the private rented sector. (Papers 1, 2, 3 and 4). The significance of identity, setting and notions of home in the context of domestic energy efficiency interventions. (Papers 1 and 4). As these themes suggest, this PhD is not just concerned with carbon reduction and energy saving as technical objects, but as a way of life. More specifically, it considers the interactions between the two and contends that technical or policy instruments, no matter how sophisticated, cannot succeed if they are not compatible with our ways of life (and ways of doing businesss) or if our ways of life cannot be reasonably adapted to acoomodate them.

Think Tanks, Education and Elite Policy Actors

ERIC Educational Resources Information Center

Savage, Glenn C.

2016-01-01

The past decade has seen think tanks operate in sophisticated ways to influence the development of education policies. In this paper, I reflect upon the influence of think tanks in the formation of national reform, using the Common Core State Standards initiative in the USA as an illustrative case. In doing so, I explore how certain think tanks,…

Post-Cold War American Foreign Policy: What, When, and Why

DTIC Science & Technology

2011-06-01

issues than international concerns. Something Condoleezza Rice firmly advocated for in a Foreign Affairs opinion piece written for the 2000 Republican... issues . Rice also called for establishing acceptable international 16 Max Boot, ―The...the future. Legitimate policies typically are ones not challenged either legally or morally by significant numbers of actors throughout the

The Significance of Charter Schools and the Privatization of Standards: Holding the Wolf by the Ears

ERIC Educational Resources Information Center

Ford, Brian

2005-01-01

The dynamics of educational policy discourse in the USA are illustrated by the highly contested positions on charter schools in three arenas: media debates, national policy and local school reform. In media debates, civil society actors--including teachers' unions, think tanks and print media--engage in polarized exchanges notable for their…

Choice as a Global Language in Local Practice: A Mixed Model of School Choice in Taiwan

ERIC Educational Resources Information Center

Mao, Chin-Ju

2015-01-01

This paper uses school choice policy as an example to demonstrate how local actors adopt, mediate, translate, and reformulate "choice" as neo-liberal rhetoric informing education reform. Complex processes exist between global policy about school choice and the local practice of school choice. Based on the theoretical sensibility of…

The Common Core's Promises and Pitfalls from the Perspectives of Policy Entrepreneurs and Ground-Level Actors

ERIC Educational Resources Information Center

Kornhaber, Mindy L.; Barkauskas, Nikolaus J.; Griffith, Kelly M.; Sausner, Erica; Mahfouz, Julia

2017-01-01

The Common Core State Standards Initiative (Common Core) was spearheaded by policy entrepreneurs, unveiled nationally in 2010, and initially received strong support from leaders in state and federal government, philanthropic foundations, the business sector, and teacher unions. However, the reform came into the crosshairs of an ideologically wide…

"The Only Answer Is Innovation ...": Europe, Policy, and the Big Society

ERIC Educational Resources Information Center

Hodgson, Naomi

2012-01-01

Recent European and member state policy shows innovation to be a current guiding logic of government. This article offers an analysis of how innovation, seen partly in terms of learning but more significantly in terms of research, forms part of the discourses and practices of government today. Research is now something that all actors must engage…

Forging Consensus for Implementing Youth Socialization Policy in Northwest China

ERIC Educational Resources Information Center

Fairbrother, Gregory P.

2011-01-01

The goal of this article is to examine how the provincial education media in China play a role of forging consensus among local actors responsible for the implementation of new centrally-promulgated youth socialization policy. In doing so, it also explores the tension among three of the Chinese state's claims to legitimacy: economic development,…

Educators Have Little Voice in the Texas Inclusion Policy for Children with Disabilities.

ERIC Educational Resources Information Center

Baxt, Virginia P.

This paper explores the education policy adoption process in the Texas legislature and role of professional educators in influencing critical decisions relating to the inclusion of students with disabilities in general education classes. This case study traced the wielders of power, power interactions, the actors and sources of their power, and…

Interviewing the Education Policy Elite in Scotland: A Changing Picture?

ERIC Educational Resources Information Center

Grek, Sotiria

2011-01-01

In Scotland, access to the "policy community" is relatively easy and relations are very relaxed, but this may be interpreted as a different means of managing and co-opting researchers. However, the relationships of the different actors, and the kinds of knowledge they draw on, are in a process of change. Since parliamentary devolution…

Only a Matter of Education Policy Ideals? German Professors' Perception of the Bologna Process

ERIC Educational Resources Information Center

Brändle, Tobias

2016-01-01

Recently, it has been discussed how actors at universities perceive the Bologna Process. However, there is a lack of understanding about the determinants influencing attitudes towards the reform. In particular, the relation between education policy ideals and perceptions of the Bologna Process has gone unobserved. Based on a survey at three…

The Role of Postsecondary Remediation for African American Students: A Review of Research

ERIC Educational Resources Information Center

Davis, Ryan J.; Palmer, Robert T.

2010-01-01

The role of remediation in higher education has generated much debate over the last two decades. While states have enacted policies that reduced or eliminated postsecondary remediation, many policy actors and analysts have not completely acknowledged the ways in which remediation affects college access and success for African American students.…

The joint Simon effect depends on perceived agency, but not intentionality, of the alternative action

PubMed Central

Stenzel, Anna; Dolk, Thomas; Colzato, Lorenza S.; Sellaro, Roberta; Hommel, Bernhard; Liepelt, Roman

2014-01-01

A co-actor's intentionality has been suggested to be a key modulating factor for joint action effects like the joint Simon effect (JSE). However, in previous studies intentionality has often been confounded with agency defined as perceiving the initiator of an action as being the causal source of the action. The aim of the present study was to disentangle the role of agency and intentionality as modulating factors of the JSE. In Experiment 1, participants performed a joint go/nogo Simon task next to a co-actor who either intentionally controlled a response button with own finger movements (agency+/intentionality+) or who passively placed the hand on a response button that moved up and down on its own as triggered by computer signals (agency−/intentionality−). In Experiment 2, we included a condition in which participants believed that the co-actor intentionally controlled the response button with a Brain-Computer Interface (BCI) while placing the response finger clearly besides the response button, so that the causal relationship between agent and action effect was perceptually disrupted (agency−/intentionality+). As a control condition, the response button was computer controlled while the co-actor placed the response finger besides the response button (agency−/intentionality−). Experiment 1 showed that the JSE is present with an intentional co-actor and causality between co-actor and action effect, but absent with an unintentional co-actor and a lack of causality between co-actor and action effect. Experiment 2 showed that the JSE is absent with an intentional co-actor, but no causality between co-actor and action effect. Our findings indicate an important role of the co-actor's agency for the JSE. They also suggest that the attribution of agency has a strong perceptual basis. PMID:25140144

The joint Simon effect depends on perceived agency, but not intentionality, of the alternative action.

PubMed

Stenzel, Anna; Dolk, Thomas; Colzato, Lorenza S; Sellaro, Roberta; Hommel, Bernhard; Liepelt, Roman

2014-01-01

A co-actor's intentionality has been suggested to be a key modulating factor for joint action effects like the joint Simon effect (JSE). However, in previous studies intentionality has often been confounded with agency defined as perceiving the initiator of an action as being the causal source of the action. The aim of the present study was to disentangle the role of agency and intentionality as modulating factors of the JSE. In Experiment 1, participants performed a joint go/nogo Simon task next to a co-actor who either intentionally controlled a response button with own finger movements (agency+/intentionality+) or who passively placed the hand on a response button that moved up and down on its own as triggered by computer signals (agency-/intentionality-). In Experiment 2, we included a condition in which participants believed that the co-actor intentionally controlled the response button with a Brain-Computer Interface (BCI) while placing the response finger clearly besides the response button, so that the causal relationship between agent and action effect was perceptually disrupted (agency-/intentionality+). As a control condition, the response button was computer controlled while the co-actor placed the response finger besides the response button (agency-/intentionality-). Experiment 1 showed that the JSE is present with an intentional co-actor and causality between co-actor and action effect, but absent with an unintentional co-actor and a lack of causality between co-actor and action effect. Experiment 2 showed that the JSE is absent with an intentional co-actor, but no causality between co-actor and action effect. Our findings indicate an important role of the co-actor's agency for the JSE. They also suggest that the attribution of agency has a strong perceptual basis.

Structural social capital and local-level forest governance: Do they inter-relate? A mushroom permit case in Catalonia.

PubMed

Gorriz-Mifsud, Elena; Secco, Laura; Da Re, Riccardo; Pisani, Elena; Bonet, José Antonio

2017-03-01

In diffuse forest uses, like non-timber forest products' harvesting, the behavioural alignment of pickers is crucial for avoiding a "tragedy of the commons". Moreover, the introduction of policy tools such as a harvest permit system may help in keeping the activity under control. Besides the official enforcement, pickers' engagement may also derive from the perceived legitimate decision of forest managers and the community pressure to behave according to the shared values. Framed within the social capital theory, this paper examines three types of relations of rural communities in a protected area in Catalonia (Spain) where a system of mushroom picking permits was recently introduced. Through social network analysis, we explore structural changes in relations within the policy network across the policy conception, design and implementation phases. We then test whether social links of the pickers' community relate to influential members of the policy network. Lastly, we assess whether pickers' bonding and bridging structures affect the rate of permit uptake. Our results show that the high degree of acceptance could be explained by an adequate consideration of pickers' preferences within the decision-making group: local pickers show proximity to members of the policy network with medium-high influence during the three policy phases. The policy network also evolves, with some members emerging as key actors during certain phases. Significant differences are found in pickers' relations among and across the involved municipalities following an urban-rural gradient. A preliminary relation is found between social structures and differential pickers' engagement. These results illustrate a case of positive social capital backing policy design and, probably, also implementation. This calls for a meticulous design of forest policy networks with respect to communities of affected forest users. Copyright © 2016 Elsevier Ltd. All rights reserved.

Prospects for progress on health inequalities in England in the post-primary care trust era: professional views on challenges, risks and opportunities.

PubMed

Turner, Daniel; Salway, Sarah; Mir, Ghazala; Ellison, George T H; Skinner, John; Carter, Lynne; Bostan, Bushara

2013-03-26

Addressing health inequalities remains a prominent policy objective of the current UK government, but current NHS reforms involve a significant shift in roles and responsibilities. Clinicians are now placed at the heart of healthcare commissioning through which significant inequalities in access, uptake and impact of healthcare services must be addressed. Questions arise as to whether these new arrangements will help or hinder progress on health inequalities. This paper explores the perspectives of experienced healthcare professionals working within the commissioning arena; many of whom are likely to remain key actors in this unfolding scenario. Semi-structured interviews were conducted with 42 professionals involved with health and social care commissioning at national and local levels. These included representatives from the Department of Health, Primary Care Trusts, Strategic Health Authorities, Local Authorities, and third sector organisations. In general, respondents lamented the lack of progress on health inequalities during the PCT commissioning era, where strong policy had not resulted in measurable improvements. However, there was concern that GP-led commissioning will fare little better, particularly in a time of reduced spending. Specific concerns centred on: reduced commitment to a health inequalities agenda; inadequate skills and loss of expertise; and weakened partnership working and engagement. There were more mixed opinions as to whether GP commissioners would be better able than their predecessors to challenge large provider trusts and shift spend towards prevention and early intervention, and whether GPs' clinical experience would support commissioning action on inequalities. Though largely pessimistic, respondents highlighted some opportunities, including the potential for greater accountability of healthcare commissioners to the public and more influential needs assessments via emergent Health & Wellbeing Boards. There is doubt about the ability of GP commissioners to take clearer action on health inequalities than PCTs have historically achieved. Key actors expect the contribution from commissioning to address health inequalities to become even more piecemeal in the new arrangements, as it will be dependent upon the interest and agency of particular individuals within the new commissioning groups to engage and influence a wider range of stakeholders.

The path dependence of district manager decision-space in Ghana.

PubMed

Kwamie, Aku; van Dijk, Han; Ansah, Evelyn K; Agyepong, Irene Akua

2016-04-01

The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970-85); (2) Strengthening District Health Systems Initiative (1986-93); (3) health sector reform planning and creation of the Ghana Health Service (1994-96) and (4) health sector reform implementation (1997-2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of power has remained at national level, with strong vertical accountabilities and dependence of the district on national level. This study demonstrates that the rhetoric of decentralization does not always mirror actual implementation, nor always result in empowered local actors. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Role and use of evidence in policymaking: an analysis of case studies from the health sector in Nigeria.

PubMed

Onwujekwe, Obinna; Uguru, Nkoli; Russo, Giuliano; Etiaba, Enyi; Mbachu, Chinyere; Mirzoev, Tolib; Uzochukwu, Benjamin

2015-10-24

Health policymaking is a complex process and analysing the role of evidence is still an evolving area in many low- and middle-income countries. Where evidence is used, it is greatly affected by cognitive and institutional features of the policy process. This paper examines the role of different types of evidence in health policy development in Nigeria. The role of evidence was compared between three case studies representing different health policies, namely the (1) integrated maternal neonatal and child health strategy (IMNCH); (2) oral health (OH) policy; and (3) human resource for health (HRH) policy. The data was collected using document reviews and 31 in-depth interviews with key policy actors. Framework Approach was used to analyse the data, aided by NVivo 10 software. Most respondents perceived evidence to be factual and concrete to support a decision. Evidence was used more if it was perceived to be context-specific, accessible and timely. Low-cost high-impact evidence, such as the Lancet series, was reported to have been used in drafting the IMNCH policy. In the OH and HRH policies, informal evidence such as experts' experiences and opinions, were reported to have been useful in the policy drafting stage. Both formal and informal evidence were mentioned in the HRH and OH policies, while the development of the IMNCH was revealed to have been informed mainly by more formal evidence. Overall, respondents suggested that formal evidence, such as survey reports and research publications, were most useful in the agenda-setting stage to identify the need for the policy and thus initiating the policy development process. International and local evidence were used to establish the need for a policy and develop policy, and less to develop policy implementation options. Recognition of the value of different evidence types, combined with structures for generating and using evidence, are likely to enhance evidence-informed health policy development in Nigeria and other similar contexts.

Smokeless Tobacco Supply Chain in South Asia: A Comparative Analysis Using the WHO Framework Convention on Tobacco Control.

PubMed

Siddiqi, Kamran; Scammell, Katy; Huque, Rumana; Khan, Amina; Baral, Sushil; Ali, Shehzad; Watt, Ian

2016-04-01

Most South Asian countries are signatories to the WHO Framework Convention for Tobacco Control (FCTC). However, there is little information on the extent to which FCTC standards are effectively implemented for controlling smokeless tobacco (SLT)-used by over 250 million people in the region. We assessed the feasibility of a novel approach based on interviewing the key actors of SLT supply chain and analyzing its findings using standards set by FCTC. Using a snowball-sampling technique, we interviewed point-of-sale vendors, wholesale retailers, manufacturers, raw-tobacco retailers, and farmers involved in the supply chain of SLT in Bangladesh, Nepal, and Pakistan. Using a structured-questionnaire, participants were asked about their customer profiles; product types; marketing practices; suppliers; profit margins, awareness and adherence to legislation. We recruited 72% (130/180) of all supply chain actors approached. Findings indicate several loopholes in the existing taxation, regulatory, and inspection systems. A significant proportion of smuggled and counterfeit SLT products are available in the market. Most SLT products are sold without recommended warnings, information on their ingredients, and manufacturers' details. There appear to be no restrictions on sale of SLT products to minors. On the other hand, there are also several incentives built-in the supply chain that makes tobacco farming, SLT manufacturing, and its sale a profitable business. Our novel approach to study SLT control was successful in identifying and interviewing actors involved in its supply chain. The analysis using FCTC could provide valuable information to policy makers and enable them to effectively regulate SLT products. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Strengthening decentralized primary healthcare planning in Nigeria using a quality improvement model: how contexts and actors affect implementation.

PubMed

Eboreime, Ejemai Amaize; Nxumalo, Nonhlanhla; Ramaswamy, Rohit; Eyles, John

2018-05-08

Quality improvement models have been applied across various levels of health systems with varying success leading to scepticisms about effectiveness. Health systems are complex, influenced by contexts and characterized by numerous interests. Thus, a shift in focus from examining whether improvement models work, to understanding why, when and where they work most effectively is essential. Nigeria introduced DIVA (Diagnose-Intervene-Verify-Adjust) as a model to strengthen decentralized PHC planning. However, implementation has been poorly sustained. This article explores the role of actors and context in implementation and sustainability of DIVA in two local government areas (LGAs) in Nigeria. We employed an integrated mixed method approach in which qualitative data was used in conjunction with quantitative to understand effects of actors and contexts on implementation outcomes. We analysed policy documents and conducted interviews with PHC managers. Then using the Model for Understanding Success in Quality (MUSIQ), we measured contextual factors affecting implementation of DIVA in the selected LGAs. The LGAs scored 117.42 and 104.67 out of 168 points on the MUSIQ scale, respectively, indicating contextual barriers exist. Both have strong DIVA team attributes, but these could not independently ensure quality implementation. Although external support accounted for the greatest contextual disparities, the utmost implementation challenges relate to subnational government leadership, management, financial and technical support. Although higher levels of government may set visionary goals for PHC, interventions are potentially skewed towards donor interests at lower (implementation) levels. Thus, subnational political will is a key determinant of quality implementation. Consequently, advocacy for responsible and accountable political governance is essential in comparable decentralized contexts.

Expectations as a key to understanding actor strategies in the field of fuel cell and hydrogen vehicles

PubMed Central

Budde, Björn; Alkemade, Floortje; Weber, K. Matthias

2012-01-01

Due to its environmental impact, the mobility system is increasingly under pressure. The challenges to cope with climate change, air quality, depleting fossil resources imply the need for a transition of the current mobility system towards a more sustainable one. Expectations and visions have been identified as crucial in the guidance of such transitions, and more specifically of actor strategies. Still, it remained unclear why the actors involved in transition activities appear to change their strategies frequently and suddenly. The empirical analysis of the expectations and strategies of three actors in the field of hydrogen and fuel cell technology indicates that changing actor strategies can be explained by rather volatile expectations related to different levels. Our case studies of the strategies of two large car manufacturers and the German government demonstrate that the car manufacturers refer strongly to expectations about the future regime, while expectations related to the socio-technical landscape level appear to be crucial for the strategy of the German government. PMID:24850974

Expectations as a key to understanding actor strategies in the field of fuel cell and hydrogen vehicles.

PubMed

Budde, Björn; Alkemade, Floortje; Weber, K Matthias

2012-07-01

Due to its environmental impact, the mobility system is increasingly under pressure. The challenges to cope with climate change, air quality, depleting fossil resources imply the need for a transition of the current mobility system towards a more sustainable one. Expectations and visions have been identified as crucial in the guidance of such transitions, and more specifically of actor strategies. Still, it remained unclear why the actors involved in transition activities appear to change their strategies frequently and suddenly. The empirical analysis of the expectations and strategies of three actors in the field of hydrogen and fuel cell technology indicates that changing actor strategies can be explained by rather volatile expectations related to different levels. Our case studies of the strategies of two large car manufacturers and the German government demonstrate that the car manufacturers refer strongly to expectations about the future regime, while expectations related to the socio-technical landscape level appear to be crucial for the strategy of the German government.

Consumer trust in the Australian food system - The everyday erosive impact of food labelling.

PubMed

Tonkin, Emma; Webb, Trevor; Coveney, John; Meyer, Samantha B; Wilson, Annabelle M

2016-08-01

Consumer trust in food system actors is foundational for ensuring consumer confidence in food safety. As food labelling is a direct communication between consumers and food system actors, it may influence consumer perceptions of actor trustworthiness. This study explores the judgements formed about the trustworthiness of the food system and its actors through labelling, and the expectations these judgements are based on. In-depth, semi-structured interviews with 24 Australian consumers were conducted. Theoretical sampling focussed on shopping location, dietary requirements, rurality, gender, age and educational background. The methodological approach used (adaptive theory) enabled emerging data to be examined through the lens of a set of guiding theoretical concepts, and theory reconsidered in light of emerging data. Food labelling acted as a surrogate for personal interaction with industry and government for participants. Judgements about the trustworthiness of these actors and the broader food system were formed through interaction with food labelling and were based on expectations of both competence and goodwill. Interaction with labelling primarily reduced trust in actors within the food system, undermining trust in the system as a whole. Labelling has a role as an access point to the food system. Access points are points of vulnerability for systems, where trust can be developed, reinforced or broken down. For the participants in this study, in general labelling demonstrates food system actors lack goodwill and violate their fiduciary responsibility. This paper provides crucial insights for industry and policy actors to use this access point to build, rather than undermine, trust in food systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Health in All (Foreign) Policy: challenges in achieving coherence.

PubMed

Labonté, Ronald

2014-06-01

Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Livelihoods, power, and food insecurity: adaptation of social capital portfolios in protracted crises--case study Burundi.

PubMed

Vervisch, Thomas G A; Vlassenroot, Koen; Braeckman, Johan

2013-04-01

The failure of food security and livelihood interventions to adapt to conflict settings remains a key challenge in humanitarian responses to protracted crises. This paper proposes a social capital analysis to address this policy gap, adding a political economy dimension on food security and conflict to the actor-based livelihood framework. A case study of three hillsides in north Burundi provides an ethnographic basis for this hypothesis. While relying on a theoretical framework in which different combinations of social capital (bonding, bridging, and linking) account for a diverse range of outcomes, the findings offer empirical insights into how social capital portfolios adapt to a protracted crisis. It is argued that these social capital adaptations have the effect of changing livelihood policies, institutions, and processes (PIPs), and clarify the impact of the distribution of power and powerlessness on food security issues. In addition, they represent a solid way of integrating political economy concerns into the livelihood framework. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Exploring Legal Restrictions, Regulatory Reform, and Geographic Disparities in Abortion Access in Thailand.

PubMed

Arnott, Grady; Sheehy, Grace; Chinthakanan, Orawee; Foster, Angel M

2017-06-01

Despite decades of advocacy among Thai governmental and nongovernmental actors to remove abortion from the country's 1957 Criminal Code, this medically necessary service remains significantly legally restricted. In 2005, in the most recent regulatory reform to date, the Thai Medical Council established regulatory measures to allow a degree of physician interpretation within the confines of the existing law. Drawing on findings from a review of institutional policies and legislative materials, key informant interviews, and informal discussions with health service providers, government representatives, and nonprofit stakeholders, this article explores how legal reforms and health policies have shaped the abortion landscape in Thailand and influenced geographic disparities in availability and accessibility. Notwithstanding a strong medical community and the recent introduction of mifepristone for medication abortion (also known as medical abortion), the narrow interpretation of the regulatory criteria by physicians further entrenches these disparities. This article examines the causes of subnational disparities, focusing on the northern provinces and the western periphery of Thailand, and explores strategies to improve access to abortion in this legally restricted setting.

Exploring Legal Restrictions, Regulatory Reform, and Geographic Disparities in Abortion Access in Thailand

PubMed Central

Arnott, Grady; Sheehy, Grace; Chinthakanan, Orawee; Foster, Angel M.

2017-01-01

Abstract Despite decades of advocacy among Thai governmental and nongovernmental actors to remove abortion from the country’s 1957 Criminal Code, this medically necessary service remains significantly legally restricted. In 2005, in the most recent regulatory reform to date, the Thai Medical Council established regulatory measures to allow a degree of physician interpretation within the confines of the existing law. Drawing on findings from a review of institutional policies and legislative materials, key informant interviews, and informal discussions with health service providers, government representatives, and nonprofit stakeholders, this article explores how legal reforms and health policies have shaped the abortion landscape in Thailand and influenced geographic disparities in availability and accessibility. Notwithstanding a strong medical community and the recent introduction of mifepristone for medication abortion (also known as medical abortion), the narrow interpretation of the regulatory criteria by physicians further entrenches these disparities. This article examines the causes of subnational disparities, focusing on the northern provinces and the western periphery of Thailand, and explores strategies to improve access to abortion in this legally restricted setting. PMID:28630551

Health system challenges of NCDs in Tunisia.

PubMed

Ben Romdhane, Habiba; Tlili, Faten; Skhiri, Afef; Zaman, Shahaduz; Phillimore, Peter

2015-01-01

The objective of this study was to present a qualitative 'situation analysis' of the healthcare system in Tunisia, as it applies to management of cardiovascular disease (CVD) and diabetes. A primary concern was the institutional capacity to manage non-communicable diseases (NCDs). Research took place during 2010 (analysis of official documents, semi-structured interviews with key informants, and case studies in four clinics). Walt and Gilson's framework (1994) for policy analysis was used: content, actors, context, and process. Problems of integration and coordination have compounded funding pressures. Despite its importance in Tunisian healthcare, primary health is ill-equipped to manage NCDs. With limited funds, and no referral or health information system, staff morale in the public sector was low. Private healthcare has been the main development filling the void. This study highlights major gaps in the implementation of a comprehensive approach to NCDs, which is an urgent task across the region. In strategic planning, research on the health system is vital; but the capacity within Ministries of Health to use research has first to be built, with a commitment to grounding policy change in evidence.

The (Missed) Potential of the Patient-centered Medical Home for Disparities.

PubMed

Reibling, Nadine; Rosenthal, Meredith B

2016-01-01

Disparities in health care and health outcomes are a significant problem in the United States. Delivery system reforms such as the patient-centered medical home (PCMH) could have important implications for disparities. To investigate what role disparities play in current PCMH initiatives and how their set-up might impact on disparities. We selected 4 state-based PCMH initiatives (Colorado, Massachusetts, Pennsylvania, and Rhode Island), 1 regional initiative in New Orleans, and 1 multistate initiative. We interviewed 30 key actors in these initiatives and 3 health policy experts on disparities in the context of PCMH. Interview data were coded using the constant comparative method. We find that disparities are not an explicit priority in PCMH initiatives. Nevertheless, many policymakers, providers, and initiative leaders believe that the model has the potential to reduce disparities. However, because of the funding structure of initiatives and the lack of adjustment of quality metrics, health policy experts do not share this optimism and safety-net providers report concerns and frustration. Even though disparities are currently not a priority in the PCMH community, the design of initiatives has important implications for disparities.

An Institutional Mechanism for Assortment in an Ecology of Games

PubMed Central

Smaldino, Paul E.; Lubell, Mark

2011-01-01

Recent research has revived Long's “ecology of games” model to analyze how social actors cooperate in the context of multiple political and social games. However, there is still a paucity of theoretical work that considers the mechanisms by which large-scale cooperation can be promoted in a dynamic institutional landscape, in which actors can join new games and leave old ones. This paper develops an agent-based model of an ecology of games where agents participate in multiple public goods games. In addition to contribution decisions, the agents can leave and join different games, and these processes are de-coupled. We show that the payoff for cooperation is greater than for defection when limits to the number of actors per game (“capacity constraints”) structure the population in ways that allow cooperators to cluster, independent of any complex individual-level mechanisms such as reputation or punishment. Our model suggests that capacity constraints are one effective mechanism for producing positive assortment and increasing cooperation in an ecology of games. The results suggest an important trade-off between the inclusiveness of policy processes and cooperation: Fully inclusive policy processes reduce the chances of cooperation. PMID:21850249

Prioritising sexuality education in Mississippi and Nigeria: The importance of local actors, policy windows and creative strategy.

PubMed

Sullivan Robinson, Rachel; Kunnuji, Michael; Shawar, Yusra Ribhi; Shiffman, Jeremy

2018-03-20

Mississippi and Nigeria are two socially conservative places unlikely to prioritise sexuality education. Nonetheless, Mississippi passed a bill in 2011 mandating all school districts to offer sexuality education, and Nigeria approved a national sexuality education curriculum in 2001. To identify the factors that drove the process of prioritisation of sexuality education in each context, we conducted more than 70 semi-structured interviews with nongovernmental organisations/nonprofits, donor organisations and federal and state ministries involved in the prioritisation and implementation of sexuality education in Mississippi and Nigeria. Prioritisation of sexuality education occurred for similar reasons in both Mississippi and Nigeria: (1) local individuals and organisations committed to sexuality education and supported by external actors; (2) the opening of a policy window that made sexuality education a solution to a pressing social problem (teen pregnancy in Mississippi and HIV/AIDS in Nigeria) and (3) strategic action on the part of proponents. We conclude that promoting sexuality education in challenging contexts requires fostering committed local individuals and organisations, identifying external resources to support implementation costs and building on existing relationships of trust between actors, even if those relationships are unrelated to sexuality education.

Evidence-informed policy formulation and implementation: a comparative case study of two national policies for improving health and social care in Sweden.

PubMed

Strehlenert, H; Richter-Sundberg, L; Nyström, M E; Hasson, H

2015-12-08

Evidence has come to play a central role in health policymaking. However, policymakers tend to use other types of information besides research evidence. Most prior studies on evidence-informed policy have focused on the policy formulation phase without a systematic analysis of its implementation. It has been suggested that in order to fully understand the policy process, the analysis should include both policy formulation and implementation. The purpose of the study was to explore and compare two policies aiming to improve health and social care in Sweden and to empirically test a new conceptual model for evidence-informed policy formulation and implementation. Two concurrent national policies were studied during the entire policy process using a longitudinal, comparative case study approach. Data was collected through interviews, observations, and documents. A Conceptual Model for Evidence-Informed Policy Formulation and Implementation was developed based on prior frameworks for evidence-informed policymaking and policy dissemination and implementation. The conceptual model was used to organize and analyze the data. The policies differed regarding the use of evidence in the policy formulation and the extent to which the policy formulation and implementation phases overlapped. Similarities between the cases were an emphasis on capacity assessment, modified activities based on the assessment, and a highly active implementation approach relying on networks of stakeholders. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was empirically useful to organize the data. The policy actors' roles and functions were found to have a great influence on the choices of strategies and collaborators in all policy phases. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was found to be useful. However, it provided insufficient guidance for analyzing actors involved in the policy process, capacity-building strategies, and overlapping policy phases. A revised version of the model that includes these aspects is suggested.

Building on the EGIPPS performance assessment: the multipolar framework as a heuristic to tackle the complexity of performance of public service oriented health care organisations.

PubMed

Marchal, Bruno; Hoerée, Tom; da Silveira, Valéria Campos; Van Belle, Sara; Prashanth, Nuggehalli S; Kegels, Guy

2014-04-17

Performance of health care systems is a key concern of policy makers and health service managers all over the world. It is also a major challenge, given its multidimensional nature that easily leads to conceptual and methodological confusion. This is reflected by a scarcity of models that comprehensively analyse health system performance. In health, one of the most comprehensive performance frameworks was developed by the team of Leggat and Sicotte. Their framework integrates 4 key organisational functions (goal attainment, production, adaptation to the environment, and values and culture) and the tensions between these functions.We modified this framework to better fit the assessment of the performance of health organisations in the public service domain and propose an analytical strategy that takes it into the social complexity of health organisations. The resulting multipolar performance framework (MPF) is a meta-framework that facilitates the analysis of the relations and interactions between the multiple actors that influence the performance of health organisations. Using the MPF in a dynamic reiterative mode not only helps managers to identify the bottlenecks that hamper performance, but also the unintended effects and feedback loops that emerge. Similarly, it helps policymakers and programme managers at central level to better anticipate the potential results and side effects of and required conditions for health policies and programmes and to steer their implementation accordingly.

The politics of toxic waste

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rahm, D.

1998-12-31

Toxic waste, and the public policy that deals with it, is a complex issue. Much of the complexity stems from the science and technology embedded in the topic, but a great deal also results from the intricate interactions between the social organizations and institutions involved. The politics of toxic waste plays out within three key aspects of this complexity. The first of these is the nature of the intergovernmental relations involved. For toxic waste issues, these intergovernmental relations can be between sovereign states or between a nation and an international governing organization, or they may be restricted to a domesticmore » context. If the later is the case, the relationship can be between federal, state, and local governments or between different bureaus, departments, or agencies within the same level of government. A second feature of this complexity can be seen in the consequences of divergent organizational or institutional interests. When conflicting organizational or institutional perspectives, positions, or concerns arise, public policy outcomes are affected.The tug and pull of competing actors move policy in the direction favored by the winner. This may or may not be the most rational alternative. A third aspect of this interorganizational puzzle involves the question of where the locus of authority for decisionmaking resides and to what extent stakeholders, who do not possess direct authority, can influence policy outcomes.« less

Brussels Declaration: a vehicle for the advancement of tobacco and alcohol industry interests at the science/policy interface?

PubMed

McCambridge, Jim; Daube, Mike; McKee, Martin

2018-06-25

The case for policies to be based on evidence appeared to gain a major boost with the publication of the Brussels Declaration, apparently with support from many leading scientists and institutions. Yet, as we show in this analysis, there are major concerns about how it was developed and, in particular, the extensive involvement of tobacco and alcohol industry actors. We describe how its coverage of conflicts of interest and vested interests is consistent with the perspectives of these same actors. The process of developing the Declaration successfully involved science advisors, other senior officials in governments and politicians in its preparation. Despite this, the final Declaration fails to address the need for safeguards to protect the integrity of science or policy from corporate interests, including in relation to the tobacco industry. This undermines Article 5.3 of the Framework Convention on Tobacco Control which seeks to protect public health policies from interference by the tobacco companies. More broadly, the Declaration offers potential to serve as a vehicle for advancing the vested interests of corporate sectors in public policymaking and appears to have been regarded in this way by a range of organisations related to the alcohol industry. This exercise is now being extended to the continent of Africa, which is strategically important to both the tobacco and alcohol industries. It will be important to study carefully to what extent initiatives like this form part of the global political strategies of tobacco and alcohol industry actors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Intersectionality and gender mainstreaming in international health: using a feminist participatory action research process to analyse voices and debates from the global south and north.

PubMed

Tolhurst, Rachel; Leach, Beryl; Price, Janet; Robinson, Jude; Ettore, Elizabeth; Scott-Samuel, Alex; Kilonzo, Nduku; Sabuni, Louis P; Robertson, Steve; Kapilashrami, Anuj; Bristow, Katie; Lang, Raymond; Romao, Francelina; Theobald, Sally

2012-06-01

Critiques of gender mainstreaming (GM) as the officially agreed strategy to promote gender equity in health internationally have reached a critical mass. There has been a notable lack of dialogue between gender advocates in the global north and south, from policy and practice, governments and non-governmental organisations (NGOs). This paper contributes to the debate on the shape of future action for gender equity in health, by uniquely bringing together the voices of disparate actors, first heard in a series of four seminars held during 2008 and 2009, involving almost 200 participants from 15 different country contexts. The series used (Feminist) Participatory Action Research (FPAR) methodology to create a productive dialogue on the developing theory around GM and the at times disconnected empirical experience of policy and practice. We analyse the debates and experiences shared at the seminar series using concrete, context specific examples from research, advocacy, policy and programme development perspectives, as presented by participants from southern and northern settings, including Kenya, Mozambique, India, the Democratic Republic of Congo, Canada and Australia. Focussing on key discussions around sexualities and (dis)ability and their interactions with gender, we explore issues around intersectionality across the five key themes for research and action identified by participants: (1) Addressing the disconnect between gender mainstreaming praxis and contemporary feminist theory; (2) Developing appropriate analysis methodologies; (3) Developing a coherent theory of change; (4) Seeking resolution to the dilemmas and uncertainties around the 'place' of men and boys in GM as a feminist project; and (5) Developing a politics of intersectionality. We conclude that there needs to be a coherent and inclusive strategic direction to improve policy and practice for promoting gender equity in health which requires the full and equal participation of practitioners and policy makers working alongside their academic partners. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Great Game redux: Energy security and the emergence of tripolarity in Eurasia

NASA Astrophysics Data System (ADS)

Ozdamar, Ibrahim Ozgur

Securing energy resources has become a key aspect of foreign policy-making since the 1970s. States have used military and economic foreign policy tools to secure the supply of energy to their domestic markets. With the fall of the USSR in 1991, political and economic competition for penetration into energy-rich regions spread through Eurasia. Inspired from the nineteenth century term to describe Russian-British rivalry in the region, the current rivalry among great powers and their allies is called the "New Great Game". This project analyzes three political conflicts that are shaped by such rivalry that can threaten global energy security. Empirical results from the expected utility model (Bueno de Mesquita 1985) suggest the rivalry among the Western (i.e. EU, US) and Eastern (i.e. Russia, China) powers about the Iranian nuclear program, Nagorno-Karabakh and South Ossetia conflicts is likely to continue and shows some Cold War characteristics. I have also found out the expected outcomes of these conflicts and foreign policy tools and obvious and unseen strategic moves available to actors. The major conclusion of the study is that the EU and US should pursue a coordinated foreign policy and balance the Russian and Chinese influence in the region to secure access to energy resources. Most effective foreign policy tools to achieve such aim appear to be the use of economic relations as leverage against Russia and China and support economic and democratic developments of the newly established republics in Eurasia.

Locating regional health policy: Institutions, politics, and practices

PubMed Central

Riggirozzi, Pia; Yeates, Nicola

2015-01-01

Poverty reduction and health became central in the agendas of Southern regional organisations in the last two decades. Yet, little is known about how these organisations address poverty, inclusion and social inequality, and how Southern regional formations are engaging in power constellations, institutions, processes, interests and ideological positions within different spheres of governance. This article reviews academic literatures spanning global social policy, regional studies and diplomacy studies, and the state of knowledge and understanding of the ‘place’ of regional actors in health governance as a global political practice therein. It identifies theoretical and thematic points of connection between disparate literatures and how these can be bridged through research focusing on the social policies of regional organisations and regional integration processes. This framework hence locates the contributions of each of the research articles of this Special Issue of Global Social Policy on the regional dimension of health policy and diplomacy in relation to Southern Africa and South America. It also highlights the ways in which the articles bring new evidence about how social relations of welfare are being (re)made over larger scales and how regional actors may initiate new norms to improve health rights in international arenas engaging in new forms of ‘regional’ diplomacy. PMID:26635495

Assessing political priority for reproductive health in Ethiopia.

PubMed

Prata, Ndola; Summer, Anna

2015-11-01

Ethiopia is among the top six countries contributing to the highest numbers of maternal deaths globally. The Ethiopian total fertility rate was estimated at 4.8 in 2011, and the use of contraceptives by married women was 29%. Lack of knowledge, cultural stigma surrounding abortion, and barriers to access of services contribute to persistently high rates of unsafe abortion and abortion-related mortality. This study seeks to assess the generation and institutionalization of political priority for reproductive health within the political systems of Ethiopia. Interviews with key policy makers, government ministers, academics, and leaders of prominent non-governmental organizations in Ethiopia between July 2010 and January 2011 were conducted, using Shiffman and Smith's Framework, to analyse the key actors and ideas behind the shift towards prioritization of reproductive health in Ethiopia, as well as the political context and primary characteristics of the issues that propelled progressive action in reproductive health in that country. Some of the key lessons point to the readiness of the Ethiopian government to reform and to improve the socio-economic status of the population. The role of civil society organizations working alongside the government was crucial to creating a window of opportunity in a changing political climate to achieve gains in reproductive health. To our knowledge, this is the first time Shiffman and Smith's Framework has been used for reproductive health policies. We conclude that Ethiopian experience fits well within this framework for understanding prioritization of global health issues and may serve as a model for other sub-Saharan African countries. Copyright © 2015 Elsevier Inc. All rights reserved.

Working with layers: The governance and regulation of healthcare quality in an institutionally layered system.

PubMed

van de Bovenkamp, Hester M; Stoopendaal, Annemiek; Bal, Roland

2017-01-01

Institutional arrangements used to steer public policies have increasingly become layered. Inspired by the literature on institutional layering and institutional work, this paper aims to make a contribution to our understanding of institutional layering. We do so by studying an interesting case of layering: the Dutch hospital sector. We focus on the actors responsible for the internal governance (Board of Directors and Supervisory Boards) and the external regulation (the Healthcare Inspectorate) of hospitals. In the paper, we explore the institutional work of these actors, more specifically how institutional work results from and is influenced by institutional layering and how this in turn influences the institutional makeup of both healthcare organizations and their institutional context. Our approach allowed us to see that layering changes the activities of actors in the public sector, can be used to strengthen one's position but also presents actors with new struggles, which they in turn can try to overcome by relating and using the institutionally layered context. Layering and institutional work are therefore in continuous interaction. Combining institutional layering with a focus on the lived experiences of actors and their institutional work makes it possible to move into the layered arrangement and better understand its consequences.

Theories of State Analyzing the Policy Process,

DTIC Science & Technology

1973-11-01

values and goals - which is the heart of the rational process-- in reality cannot be separated from the actor’s empirical analysis of the situation...rigorous and objective in analysis . How different would our foreign policy actually be? Would it necessarily be better? In fact, would one even need...State, but the fact is that much of the outside research and analysis of policy process is pointed at the 6 As Robert Rothstein says in his valuable

A Sophisticated Architecture Is Indeed Necessary for the Implementation of Health in All Policies but not Enough

PubMed Central

Breton, Eric

2016-01-01

In this commentary, I argue that beyond a sophisticated supportive architecture to facilitate implementation of actions on the social determinants of health (SDOH) and health inequities, the Health in All Policies (HiAP) project faces two main barriers: lack of awareness within policy networks on the social determinants of population health, and a tendency of health actors to neglect investing in other sectors’ complex problems. PMID:27285517

Translating for Linguistic Minorities in Northern Ireland: A Look at Translation Policy in the Judiciary, Healthcare, and Local Government

ERIC Educational Resources Information Center

González Núñez, Gabriel

2013-01-01

Europe as a multilingual continent hosts three main types of languages: dominant languages, autochthonous minority languages, and new minority languages. From a policy standpoint, planning for speakers of these languages and their needs become a complex matter in which many actors with different interests are involved. Of the many issues which…

Making Policy in the United States Department of Education: The Political Process of Federal Rulemaking for Higher Education

ERIC Educational Resources Information Center

Natow, Rebecca Spiro

2013-01-01

Higher education rulemaking is the procedure through which the United States Department of Education creates policy in the form of regulations that govern the provision of higher education funding and services. Until now, there has been a shortage of research into the politics of higher education rulemaking. This study investigates the actors that…

Central America: Current Crisis and Future Prospects. Foreign Policy Association Headline Series, No. 271.

ERIC Educational Resources Information Center

Dominguez, Jorge I.; Lindenberg, Marc

One of a series of booklets on world issues, this document summarizes some of the salient aspects of Central America with special attention given to Nicaragua and El Salvador. The booklet identifies the interests, policies, and choices of the major actors in the drama that engulfs the region and, increasingly, much of the world. Chapter one…

High Stakes Policy and Mandated Curriculum: A Rhetorical Argumentation Analysis to Explore the Social Processes That Shape School Leaders' and Teachers' Strategic Responses

ERIC Educational Resources Information Center

Dulude, Eliane; Spillane, James P.; Dumay, Xavier

2017-01-01

Several social processes guide and shape how school actors engage with high stakes state and district policies relative to mandated curriculum and instruction. In this article, we use rhetorical argumentation analysis to explore how stakeholders mobilize resources through argumentation and rhetorical appeals (logical, emotional, and…

What's a Charter School? How the Charter School Debate and Misinformation Mediate the Local Production of School Choice

ERIC Educational Resources Information Center

Convertino, Christina

2017-01-01

In this article, based on an ethnographic study in Sundale City, Arizona, I use an interpretive and anthropological approach to policy analysis to highlight how social actors interpreted the national charter school debate to enact local school choice policy development in their everyday lives. Specifically, findings from this study provide a…

From National Policy-Making to Global Edu-Business: Swedish Edu-Preneurs on the Move

ERIC Educational Resources Information Center

Rönnberg, Linda

2017-01-01

This study explores the movements of some Swedish former education policy-makers that are currently active as commercial edu-business actors with the ambition to expand in the Global Education Industry (GEI). The aim is to map and analyze how a selection of Swedish edu-preneurs affiliated with a particular Swedish school chain enter the GEI and…

Closing the Gap in Education and Technology. World Bank Latin American and Caribbean Studies.

ERIC Educational Resources Information Center

de Ferranti, David; Perry, Guillermo E.; Gill, Indermit; Guasch, J. Luis; Maloney, William F.; Sanchez-Paramo, Carolina; Schady, Norbert

This document examines the gap between the Latin America and Caribbean region and the world's developed nations in the areas of education and technology. It also examines policies and strategies to close the gap. The following are among the specific topics discussed: (1) skills upgrading and innovation policies (the major actors; the role of…

National poverty reduction strategies and HIV/AIDS governance in Malawi: a preliminary study of shared health governance.

PubMed

Wachira, Catherine; Ruger, Jennifer Prah

2011-06-01

The public health and development communities understand clearly the need to integrate anti-poverty efforts with HIV/AIDS programs. This article reports findings about the impact of the Poverty Reduction Strategy Paper (PRSP) process on Malawi's National HIV/AIDS Strategic Framework (NSF). In this article we ask, how does the PRSP process support NSF accountability, participation, access to information, funding, resource planning and allocation, monitoring, and evaluation? In 2007, we developed and conducted a survey of Malawian government ministries, United Nations agencies, members of the Country Coordination Mechanism, the Malawi National AIDS Commission (NAC), and NAC grantees (N = 125, 90% response rate), seeking survey respondents' retrospective perceptions of NSF resource levels, participation, inclusion, and governance before, during, and after Malawi's PRSP process (2000-2004). We also assessed principle health sector and economic indicators and budget allocations for HIV/AIDS. These indicators are part of a new conceptual framework called shared health governance (SHG), which seeks congruence among the values and goals of different groups and actors to reflect a common purpose. Under this framework, global health policy should encompass: (i) consensus among global, national, and sub-national actors on goals and measurable outcomes; (ii) mutual collective accountability; and (iii) enhancement of individual and group health agency. Indicators to assess these elements included: (i) goal alignment; (ii) adequate resource levels; (iii) agreement on key outcomes and indicators for evaluating those outcomes; (iv) meaningful inclusion and participation of groups and institutions; (v) special efforts to ensure participation of vulnerable groups; and (vi) effectiveness and efficiency measures. Results suggest that the PRSP process supported accountability for NSF resources. However, the process may have marginalized key stakeholders, potentially undercutting the implementation of HIV/AIDS Action Plans. Copyright © 2010. Published by Elsevier Ltd.

Accelerating learning for pro-poor health markets

PubMed Central

2014-01-01

Background Given the rapid evolution of health markets, learning is key to promoting the identification and uptake of health market policies and practices that better serve the needs of the poor. However there are significant challenges to learning about health markets. We discuss the different forms that learning takes, from the development of codified scientific knowledge, through to experience-based learning, all in relationship to health markets. Discussion Notable challenges to learning in health markets include the difficulty of acquiring data from private health care providers, designing evaluations that capture the complex dynamics present within health markets and developing communities of practice that encompass the diverse actors present within health markets, and building trust and mutual understanding across these groups. The paper proposes experimentation with country-specific market data platforms that can integrate relevant evidence from different data sources, and simultaneously exploring strategies to secure better information on private providers and health markets. Possible approaches to adapting evaluation designs so that they are better able to take account of different and changing contexts as well as producing real time findings are discussed. Finally capturing informal knowledge about health markets is key. Communities of practice that bridge different health market actors can help to share such experience-based knowledge and in so doing, may help to formalize it. More geographically-focused communities of practice are needed, and such communities may be supported by innovation brokers and/or be built around member-based organizations. Summary Strategic investments in and support to learning about health markets can address some of the challenges experienced to-date, and accelerate learning that supports health markets that serve the poor. PMID:24961671

The Expert and the Lay Public: Reflections on Influenza A (H1N1) and the Risk Society

PubMed Central

Williams-Jones, Bryn

2012-01-01

Trust between the lay public and scientific experts is a key element to ensuring the efficient implementation of emergency public health measures. In modern risk societies, the management and elimination of risk have become preeminent drivers of public policy. In this context, the protection of public trust is a complex task. Those actors involved in public health decision-making and implementation (e.g., mass vaccination for influenza A virus) are confronted with growing pressures and responsibility to act. However, they also need to accept the limits of their own expertise and recognize the ability of lay publics to understand and be responsible for public health. Such a shared responsibility for risk management, if grounded in participative public debates, can arguably strengthen public trust in public health authorities and interventions. PMID:22397338

Dilemmas and challenges for the shelter sector: lessons learned from the Sphere revision process.

PubMed

Saunders, Graham

2004-06-01

Key dilemmas and challenges for those involved in the shelter sector are described, based on issues that emerged from the extensive global consultative process undertaken to inform the revision of the Sphere handbook. The range of perspectives on the major themes is presented, with suggestions as to how these issues could be progressed. Themes include the poor definition of the sector and the lack of a consistent approach among the leading shelter actors; the absence of a common terminology; the conflict between "temporary" versus "durable" solutions; the disconnect between technical advisers and the field; the need for greater recognition of local coping strategies and the local context; the involvement of recipients and host governments in policy development; the need for better "how-to" guidance; and the limited incorporation of the emerging themes of livelihoods etc. to date.

Unpacking commercial sector opposition to European smoke-free policy: lack of unity, ‘fear of association’ and harm reduction debates

PubMed Central

Weishaar, Heide; Amos, Amanda; Collin, Jeff

2016-01-01

Objective Tobacco companies have made extensive efforts to build alliances against comprehensive smoke-free legislation. This article analyses the interaction between actors who opposed the development of the European Council Recommendation on smoke-free environments. Methods Drawing on data from 200 policy documents and 32 semistructured interviews and using qualitative textual analysis and organisational network analysis, opponents’ positions on, and responses to, the policy initiative, strategies to oppose the policy, and efforts to build alliances were investigated. Results The non-binding nature of the policy, scientific evidence and clear political will to adopt EU-wide measures combined to limit the intensity of commercial sector opposition to the comprehensive EU smoke-free policy. Most tobacco companies, led by the Confederation of European Community Cigarette Manufacturers (CECCM), voiced reservations against the proposal, criticised the policy process and fought flanking measures on product regulation. However, some companies focused on instigating harm reduction debates. These divergent approaches and the reluctance of other commercial actors to demonstrate solidarity with the tobacco sector prevented the establishment of a cohesive commercial sector alliance. Conclusions The comparatively limited opposition to EU smoke-free policy contrasts with previous accounts of tobacco industry resistance to tobacco control. While context-specific factors can partially explain these differences, the paper indicates that the sector's diminished credibility and lack of unity hampered political engagement and alliance building. Industry efforts to emphasise the benefits of smokeless tobacco during smoke-free policy debates highlight the potential of harm reduction as a gateway for tobacco companies to re-enter the political arena. PMID:26055268

The role of the Sheffield model on the minimum unit pricing of alcohol debate: the importance of a rhetorical perspective

PubMed Central

Katikireddi, Srinivasa Vittal; Hilton, Shona; Bond, Lyndal

2017-01-01

The minimum unit pricing (MUP) alcohol policy debate has been informed by the Sheffield model, a study which predicts impacts of different alcohol pricing policies. This paper explores the Sheffield model’s influences on the policy debate by drawing on 36 semi-structured interviews with policy actors who were involved in the policy debate. Although commissioned by policy makers, the model’s influence has been far broader than suggested by views of ‘rational’ policy making. While findings from the Sheffield model have been used in instrumental ways, they have arguably been more important in helping debate competing values underpinning policy goals. PMID:28111593

A window of opportunity for reform in post-conflict settings? The case of Human Resources for Health policies in Sierra Leone, 2002–2012

PubMed Central

2014-01-01

Background It is recognized that decisions taken in the early recovery period may affect the development of health systems. Additionally, some suggest that the immediate post-conflict period may allow for the opening of a political ‘window of opportunity’ for reform. For these reasons, it is useful to reflect on the policy space that exists in this period, by what it is shaped, how decisions are made, and what are their long-term implications. Examining the policy trajectory and its determinants can be helpful to explore the specific features of the post-conflict policy-making environment. With this aim, the study looks at the development of policies on human resources for health (HRH) in Sierra Leone over the decade after the conflict (2002–2012). Methods Multiple sources were used to collect qualitative data on the period between 2002 and 2012: a stakeholder mapping workshop, a document review and a series of key informant interviews. The analysis draws from political economy and policy analysis tools, focusing on the drivers of reform, the processes, the contextual features, and the actors and agendas. Findings Our findings identify three stages of policy-making. At first characterized by political uncertainty, incremental policies and stop-gap measures, the context substantially changed in 2009. The launch of the Free Health Care Initiative provided to be an instrumental event and catalyst for health system, and HRH, reform. However, after the launch of the initiative, the pace of HRH decision-making again slowed down. Conclusions Our study identifies the key drivers of HRH policy trajectory in Sierra Leone: (i) the political situation, at first uncertain and later on more defined; (ii) the availability of funding and the stances of agencies providing such funds; (iii) the sense of need for radical change – which is perhaps the only element related to the post-conflict setting. It also emerges that a ‘windows of opportunity’ for reform did not open in the immediate post-conflict, but rather 8 years later when the Free Health Care Initiative was announced, thus making it difficult to link it directly to the features of the post-conflict policy-making environment. PMID:25075212

Psychiatry in Portugal: Key actors and conceptual history (1884-1924).

PubMed

Morgado Pereira, José

2018-06-01

The aim of this article is the study of psychiatry in Portugal between 1884 and 1924, the period when it became institutionalized, and when works that marked its scientific evolution were published. This paper summarizes the various historiographical approaches, and its approach to the subject is closest to the conceptual history carried out by German Berrios in Cambridge. The study attempts to correlate the key actors and their works with the history of different scientific ideas, its differences, and the influences of foreign authors. The diseases, syndromes, symptoms and pathologizations in this historical period were also studied, justifying a constructionist perspective. Finally, the various therapies are discussed, from institutional to pharmacological and psychotherapeutical.

Scenario analysis and disaster preparedness for port and maritime logistics risk management.

PubMed

Kwesi-Buor, John; Menachof, David A; Talas, Risto

2016-08-01

System Dynamics (SD) modelling is used to investigate the impacts of policy interventions on industry actors' preparedness to mitigate risks and to recover from disruptions along the maritime logistics and supply chain network. The model suggests a bi-directional relation between regulation and industry actors' behaviour towards Disaster Preparedness (DP) in maritime logistics networks. The model also showed that the level of DP is highly contingent on forecast accuracy, technology change, attitude to risk prevention, port activities, and port environment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Negotiating water across levels: A peace and conflict "Toolbox" for water diplomacy

NASA Astrophysics Data System (ADS)

Grech-Madin, Charlotte; Döring, Stefan; Kim, Kyungmee; Swain, Ashok

2018-04-01

As a key policy tool, water diplomacy offers greater political engagement in the cooperative management of shared water. A range of initiatives has been dedicated to this end, almost invariably oriented around the interactions of nation states. Crucially, however, practitioners of water diplomacy also need to address water governance at sub-state levels. As a political, multi-level, and normative field, peace and conflict research offers a pluralism of approaches designed to bring actors together at all levels. Drawing upon this research, this paper offers new focal points for water diplomacy that can enhance its policy effectiveness and enrich its underlying academic current. More specifically, it presents three hitherto undervalued tools for water diplomacy: at the interstate level, to uncover the rich body of political norms that bind states to shared understandings of acceptable practice around water. At the intrastate level, to incorporate ethnography of water users and civil society groups' responses to state-led waterworks projects, and at the communal level to employ disaggregated georeferenced data on water resources in conflict-prone areas. Taken together, these analytical tools provide a multi-faceted political gauge of the dynamics of water diplomacy, and add vital impetus to develop water diplomacy across multiple levels of policy engagement.

Discovering the knowledge creation process of an expert group in women-friendly policy: The policy case of Seoul City.

PubMed

Oh, Young Sam; Nam, SungHee; Kim, Yuna

2016-01-01

This research explores how expert knowledge is created in the process of women-friendly policy making, based on actor network theory (ANT). To address this purpose, this study uses the "Women's Happiness in the City of Seoul" policy initiated by the local government of Seoul as one example of policy development. Research findings demonstrate that knowledge creation in expert groups followed the four stages suggested by ANT. In addition, this study found that various types of knowledge emerged from individual experts. This research elucidates the process of knowledge creation and its meanings for women-friendly policy.

The dynamic of non-communicable disease control policy in Indonesia.

PubMed

Christiani, Yodi; Dugdale, Paul; Tavener, Meredith; Byles, Julie E

2017-05-01

Objective The aim of the present study was to examine non-communicable disease (NCD) policy formation and implementation in Indonesia. Methods Interviews were conducted with 13 Indonesian health policy workers. The processes and issues relating to NCD policy formation were mapped, exploring the interactions between policy makers, technical/implementation bodies, alliances across various levels and the mobilisation of non-policy actors. Results Problems in NCD policy formation include insufficient political interest in NCD control, disconnected policies and difficulty in multisectoral coordination. These problems are well illustrated in relation to tobacco control, but also apply to other control efforts. Nevertheless, participants were optimistic that there are plentiful opportunities for improving NCD control policies given growing global attention to NCD, increases in the national health budget and the growing body of Indonesia-relevant NCD-related research. Conclusion Indonesia's success in the creation and implementation of NCD policy will be dependent on high-level governmental leadership, including support from the President, the Health Minister and coordinating ministries. What is known about the topic? The burden of NCD in Indonesia has increased gradually. Nationally, NCD-related mortality accounted for 65% of deaths in 2010. Indonesia is also a country with the highest burden of tobacco smoking in the world. However, the government has not instituted sufficient policy action to tackle NCDs, including tobacco control. What does this paper add? This paper deepens our understanding of current NCD control policy formation in Indonesia, including the possible underlying reason why Indonesia has weak tobacco control policies. It describes the gaps in the current policies, the actors involved in policy formation, the challenges in policy formation and implementation and potential opportunities for improving NCD control. What are the implications for practitioners? An effective NCD control program requires strong collaboration, including between government and health professionals. Health professionals can actively engage in policy formation, for example through knowledge production.

The change-makers of West Africa.

PubMed

Godt, Sue; Mhatre, Sharmila; Schryer-Roy, Anne-Marie

2017-07-12

West Africa was the focus of global attention during the Ebola virus disease outbreak, when systemic health system weaknesses compounded a serious emergency and complicated response efforts. Following the crisis, calls were made to strengthen health systems, but investments to date have fallen short of delivering the support needed to build strong health systems able to prevent and manage future outbreaks.In part, this reality serves to highlight the shortcomings of the solutions being repeatedly prioritised by external funders and experts, solutions that often fail to consider the wealth of West African evidence and actors actively working to strengthen the leadership and health systems needed to drive and sustainably improve national health outcomes. Unfortunately, this knowledge and experience are rarely heard in the global arena.This journal supplement is a contribution, although small, to changing this practice by putting the perspectives, experiences and knowledge of West Africans on the table. It presents findings from a series of research and capacity development projects in West Africa funded by the International Development Research Centre's Maternal and Child Health programme (formerly Governance for Equity in Health Systems).The evidence presented here centres around two key themes. First, the theme that context matters. The evidence shows how context can change the shape of externally imposed interventions or policies resulting in unintended outcomes. At the same time, it highlights evidence showing how innovative local actors are developing their own approaches, usually low-cost and embedded in the context, to bring about change. Second, the collection of articles discusses the critical need to overcome the existing fragmentation of expertise, knowledge and actors, and to build strong working relationships amongst all actors so they can effectively work together to identify priority issues that can realistically be addressed given the available windows of opportunity.Vibrant West African-led collaborations amongst researchers, decision-makers and civil society, which are effectively supported by national, regional and global funding, need to foster, strengthen and use locally-generated evidence to ensure that efforts to strengthen health systems and improve regional health outcomes are successful. The solutions are clearly not to be found in the 'travelling models' of standardised interventions.

Processes of local alcohol policy-making in England: Does the theory of policy transfer provide useful insights into public health decision-making?

PubMed

Gavens, Lucy; Holmes, John; Buykx, Penny; de Vocht, Frank; Egan, Matt; Grace, Daniel; Lock, Karen; Mooney, John D; Brennan, Alan

2017-06-13

Recent years have seen a rise in new and innovative policies to reduce alcohol consumption and related harm in England, which can be implemented by local, as opposed to national, policy-makers. The aim of this paper is to explore the processes that underpin the adoption of these alcohol policies within local authorities. In particular, it aims to assess whether the concept of policy transfer (i.e. a process through which knowledge about policies in one place is used in the development of policies in another time or place) provides a useful model for understanding local alcohol policy-making. Qualitative data generated through in-depth interviews and focus groups from five case study sites across England were used to explore stakeholder experiences of alcohol policy transfer between local authorities. The purposive sample of policy actors included representatives from the police, trading standards, public health, licensing, and commissioning. Thematic analysis was used inductively to identify key features in the data. Themes from the policy transfer literature identified in the data were: policy copying, emulating, hybridization, and inspiration. Participants described a multitude of ways in which learning was shared between places, ranging from formal academic evaluation to opportunistic conversations in informal settings. Participants also described facilitators and constraints to policy transfer, such as the historical policy context and the local cultural, economic, and bureaucratic context, which influenced whether or not a policy that was perceived to work in one place might be transferred successfully to another context. Theories of policy transfer provide a promising framework for characterising processes of local alcohol policy-making in England, extending beyond debates regarding evidence-informed policy to account for a much wider range of considerations. Applying a policy transfer lens enables us to move beyond simple (but still important) questions of what is supported by 'robust' research evidence by paying greater attention to how policy making is carried out in practice and the multiple methods by which policies diffuse across jurisdictions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Climate, Companies, and Public Policy: How Transparent Is the Private Sector in Reporting Climate Policy Influence?

NASA Astrophysics Data System (ADS)

Goldman, G. T.; Carlson, C.

2014-12-01

To enact effective policies to address climate change, decision makers need both scientific and political support. One major barrier to U.S. climate policy enactment has been the opposition of private sector actors to proposed policies and to climate science itself. Increasingly, the public and investors are holding companies accountable for their actions around climate change—including political activies, affiliations with trade groups, and involvement with climate science. However, this accountability is inhibited by the prominent role that trade associations have played in climate policy debates in recent years. The opaque nature of such groups is problematic, as it inhibits the public from understanding who is obstructing progress on addressing climate change, and in some cases, impedes the public's climate literacy. Voluntary climate reporting can yield some information on companies' climate engagement and demonstrates the need for greater transparency in corporate political activities around climate change. We analyze CDP climate reporting data from 1,824 companies to assess the degree to which corporate actors disclosed their political influence on climate policies through their trade associations. Results demonstrate the limitations of voluntary reporting and the extent to which companies utilize their trade associations to influence climate change policy debates without being held accountable for these positions. Notably, many companies failed to acknowledge their board seat on trade groups with significant climate policy engagement. Of those that did acknowledge their board membership, some claimed not to agree with their trade associations' positions on climate change. These results raise questions about who trade groups are representing when they challenge the science or obstruct policies to address climate change. Recommendations for overcoming this barrier to informed decision making to address climate change will be discussed.

Australian television news coverage of alcohol, health and related policies, 2005 to 2010: implications for alcohol policy advocates.

PubMed

Fogarty, Andrea S; Chapman, Simon

2012-12-01

To describe television news coverage between 2005 and 2010 of alcohol, health and relevant alcohol-control policies, with a view to informing policy advocacy. A content analysis of all alcohol stories archived by the Australian Health News Research Collaboration. We recorded what triggered a news item, the main topics covered, whether risks to health were communicated, whether alcohol-control policies were featured and which news-actors appeared. We identified 612 stories, where 69.2% were triggered by a particular newsworthy incident or the release of new findings. The most frequently reported alcohol stories were focused on associated harms (30.2%) and 'binge drinking' (19.0%). A majority (75.3%) reported a variety of positive and negative health effects, yet mainly focused on short-term consequences. Combined, 63% mentioned an alcohol-control policy, yet no one particular policy was featured in more than 10% of all stories. The most commonly featured news-actors included public-health professionals (50.0%), members of affected communities (28.4%) and government representatives (24.3%) Problems related to alcohol were well-established foci of news attention and reportage and covered a broad spectrum of issues related to public health goals, yet less coverage centred on long-term health consequences or effective policy solutions. Future policy advocacy could focus on moving the debate away from simple problem definition to better communication of long-term health risks, existing policies, and evidence of their effectiveness and arguments for their adoption. Future research might consider audience understanding of the information. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

A Model for Good Governance of Healthcare Technology Management in the Public Sector: Learning from Evidence-Informed Policy Development and Implementation in Benin

PubMed Central

Houngbo, P. Th.; Zweekhorst, M.; De Cock Buning, Tj.; Medenou, D.; Bunders, J. F. G.

2017-01-01

Good governance (GG) is an important concept that has evolved as a set of normative principles for low- and middle-income countries (LMICs) to strengthen the functional capacity of their public bodies, and as a conditional prerequisite to receive donor funding. Although much is written on good governance, very little is known on how to implement it. This paper documents the process of developing a strategy to implement a GG model for Health Technology Management (HTM) in the public health sector, based on lessons learned from twenty years of experience in policy development and implementation in Benin. The model comprises six phases: (i) preparatory analysis, assessing the effects of previous policies and characterizing the HTM system; (ii) stakeholder identification and problem analysis, making explicit the perceptions of problems by a diverse range of actors, and assessing their ability to solve these problems; (iii) shared analysis and visioning, delineating the root causes of problems and hypothesizing solutions; (iv) development of policy instruments for pilot testing, based on quick-win solutions to understand the system’s responses to change; (v) policy development and validation, translating the consensus solutions identified by stakeholders into a policy; and (vi) policy implementation and evaluation, implementing the policy through a cycle of planning, action, observation and reflection. The policy development process can be characterized as bottom-up, with a central focus on the participation of diverse stakeholders groups. Interactive and analytical tools of action research were used to integrate knowledge amongst actor groups, identify consensus solutions and develop the policy in a way that satisfies criteria of GG. This model could be useful for other LMICs where resources are constrained and the majority of healthcare technologies are imported. PMID:28056098

Validation of Rational Deterrence Theory: Analysis of U.S. Government and Adversary Risk Propensity and Relative Emphasis on Gain or Loss

DTIC Science & Technology

2010-03-01

policy (Achen & Snidal, 1989). Huth and Russett (1984) emphasize : “if we do not know how deterrence works when it is most needed, policies assigned...application of deterrence to U.S. adversaries in these policies. Analysis of risk propensity and relative emphases on loss/gain of those actors...research, the strategic environment. Evidence of such assessment may reflect an adversary’s risk propensities and relative emphases on loss/gain; however

A critical analysis of the implementation of a legal regulated market for new psychoactive substances ("legal highs") in New Zealand.

PubMed

Rychert, Marta; Wilkins, Chris

2018-05-01

In July 2013 New Zealand passed the Psychoactive Substances Act (PSA) to establish the world's first regulated legal market for new psychoactive substances (NPS) ("legal highs"). To critically analyse the implementation of the PSA. Synthesis of findings from interviews with 30 key informants (i.e. politicians, civil servants, legal high industry actors, toxicologists, NGO representatives and drug policy academics), analysis of relevant laws and policy documents, and a review of academic and grey literature on the PSA. Key challenges experienced during the implementation of the PSA included the harmfulness of interim approved products, the slowness in withdrawing products which caused adverse effects, enforcing retail restrictions, price competition by retailers, judicial challenges by the "legal high" industry, and growing opposition to the regime from local communities and key stakeholders (including local councils). The PSA lacks a tax on products and restrictions on retail opening hours which likely contributed to the problems above. The implementation of the PSA also appeared to suffer from a rushed legislative process and resource constraints on the regulatory agency which led to delays in the development of the full regulatory framework, including the product testing requirements, and issues with enforcing retail regulation, such as the minimum age of purchase. The decline in public support for the PSA regime reflected problems with communicating the aims of the policy to the general public. The troubled implementation of the PSA underlines a number of important lessons for consideration when developing a regulated legal drug market, including advanced development of regulatory systems, ensuring the sale of low risk products, adequately resourcing regulatory agencies and related enforcement activity, detailed regulation of retail outlets, establishing price controls, and ongoing engagement with stakeholders and the general public. Copyright © 2018 Elsevier B.V. All rights reserved.

The Field of Knowledge and the Policy Field in Education: PISA and the Production of Knowledge for Policy

ERIC Educational Resources Information Center

Mangez, Eric; Hilgers, Mathieu

2012-01-01

This article is about the Programme for International Student Assessment (PISA) and its actors. It analyses the development and role of PISA as a "cultural product" from the perspective of Bourdieu's field theory. The authors attempt to answer the following questions: Of which field is PISA the product? In which field and by whom is PISA…

Playing the Game and Speaking the Right Language: Language Policy and Materiality in a Bilingual Preschool Activity

ERIC Educational Resources Information Center

Martín-Bylund, Anna

2017-01-01

What are the material-semiotic relationships between a language policy and a table game activity in a bilingual preschool? Using Actor-Network Theory (ANT), the aim of this article is to explore this question, working with both human and nonhuman aspects of the activity, symmetrically, at the same level. The game playing activity takes place at a…

Policy Recommendations on Impact Bonds for Early Childhood Development in Low- and Middle-Income Countries. Policy Brief

ERIC Educational Resources Information Center

Gustafsson-Wright, Emily; Gardiner, Sophie

2016-01-01

The confluence of the agreement on 17 Sustainable Development Goals (SDGs, or Global Goals) in 2015, and the increased attention being paid to the role of non-traditional actors in contributing to shared prosperity, provide a unique opportunity to focus attention on attempts to identify promising new solutions to the barriers that impede the full…

Pharmacies as providers of expanded health services for people who inject drugs: a review of laws, policies, and barriers in six countries.

PubMed

Hammett, Theodore M; Phan, Son; Gaggin, Julia; Case, Patricia; Zaller, Nicholas; Lutnick, Alexandra; Kral, Alex H; Fedorova, Ekaterina V; Heimer, Robert; Small, Will; Pollini, Robin; Beletsky, Leo; Latkin, Carl; Des Jarlais, Don C

2014-06-17

People who inject drugs (PWID) are underserved by health providers but pharmacies may be their most accessible care settings. Studies in the U.S., Russia, Vietnam, China, Canada and Mexico employed a three-level (macro-, meso-, and micro-) model to assess feasibility of expanded pharmacy services for PWID. Studies employed qualitative and quantitative interviews, review of legal and policy documents, and information on the knowledge, attitudes, and practices of key stakeholders. Studies produced a mixed assessment of feasibility. Provision of information and referrals by pharmacies is permissible in all study sites and sale and safe disposal of needles/syringes by pharmacies is legal in almost all sites, although needle/syringe sales face challenges related to attitudes and practices of pharmacists, police, and other actors. Pharmacy provision of HIV testing, hepatitis vaccination, opioid substitution treatment, provision of naloxone for drug overdose, and abscess treatment, face more serious legal and policy barriers. Challenges to expanded services for drug users in pharmacies exist at all three levels, especially the macro-level characterized by legal barriers and persistent stigmatization of PWID. Where deficiencies in laws, policies, and community attitudes block implementation, stakeholders should advocate for needed legal and policy changes and work to address community stigma and resistance. Laws and policies are only as good as their implementation, so attention is also needed to meso- and micro- levels. Policies, attitudes, and practices of police departments and pharmacy chains as well as knowledge, attitudes, and practices of individual PWID, individual pharmacies, and police officers should support rather than undermine positive laws and expanded services. Despite the challenges, pharmacies remain potentially important venues for delivering health services to PWID.

Pharmacies as providers of expanded health services for people who inject drugs: a review of laws, policies, and barriers in six countries

PubMed Central

2014-01-01

Background People who inject drugs (PWID) are underserved by health providers but pharmacies may be their most accessible care settings. Methods Studies in the U.S., Russia, Vietnam, China, Canada and Mexico employed a three-level (macro-, meso-, and micro-) model to assess feasibility of expanded pharmacy services for PWID. Studies employed qualitative and quantitative interviews, review of legal and policy documents, and information on the knowledge, attitudes, and practices of key stakeholders. Results Studies produced a mixed assessment of feasibility. Provision of information and referrals by pharmacies is permissible in all study sites and sale and safe disposal of needles/syringes by pharmacies is legal in almost all sites, although needle/syringe sales face challenges related to attitudes and practices of pharmacists, police, and other actors. Pharmacy provision of HIV testing, hepatitis vaccination, opioid substitution treatment, provision of naloxone for drug overdose, and abscess treatment, face more serious legal and policy barriers. Discussion Challenges to expanded services for drug users in pharmacies exist at all three levels, especially the macro-level characterized by legal barriers and persistent stigmatization of PWID. Where deficiencies in laws, policies, and community attitudes block implementation, stakeholders should advocate for needed legal and policy changes and work to address community stigma and resistance. Laws and policies are only as good as their implementation, so attention is also needed to meso- and micro- levels. Policies, attitudes, and practices of police departments and pharmacy chains as well as knowledge, attitudes, and practices of individual PWID, individual pharmacies, and police officers should support rather than undermine positive laws and expanded services. Despite the challenges, pharmacies remain potentially important venues for delivering health services to PWID. PMID:24938376

Actor modelling and its contribution to the development of integrative strategies for management of pharmaceuticals in drinking water.

PubMed

Titz, Alexandra; Döll, Petra

2009-02-01

Widespread presence of human pharmaceuticals in water resources across the globe is documented. While some, but certainly not enough, research on the occurrence, fate and effect of pharmaceuticals in water resources has been carried out, a holistic risk management strategy is missing. The transdisciplinary research project "start" aimed to develop an integrative strategy by the participation of experts representing key actors in the problem field "pharmaceuticals in drinking water". In this paper, we describe a novel modelling method, actor modelling with the semi-quantitative software DANA (Dynamic Actor Network Analysis), and its application in support of identifying an integrative risk management strategy. Based on the individual perceptions of different actors, the approach allows the identification of optimal strategies. Actors' perceptions were elicited by participatory model building and interviews, and were then modelled in perception graphs. Actor modelling indicated that an integrative strategy that targets environmentally-responsible prescription, therapy, and disposal of pharmaceuticals on one hand, and the development of environmentally-friendly pharmaceuticals on the other hand, will likely be most effective for reducing the occurrence of pharmaceuticals in drinking water (at least in Germany where the study was performed). However, unlike most other actors, the pharmaceutical industry itself does not perceive that the production of environmentally-friendly pharmaceuticals is an action that helps to achieve its goals, but contends that continued development of highly active pharmaceutical ingredients will help to reduce the occurrence of pharmaceuticals in the water cycle. Investment in advanced waste or drinking water treatment is opposed by both the wastewater treatment company and the drinking water supplier, and is not mentioned as appropriate by the other actors. According to our experience, actor modelling is a useful method to suggest effective and realisable integrative risk management strategies in complex problem fields that involve many societal actors.

Reinforcement learning for a biped robot based on a CPG-actor-critic method.

PubMed

Nakamura, Yutaka; Mori, Takeshi; Sato, Masa-aki; Ishii, Shin

2007-08-01

Animals' rhythmic movements, such as locomotion, are considered to be controlled by neural circuits called central pattern generators (CPGs), which generate oscillatory signals. Motivated by this biological mechanism, studies have been conducted on the rhythmic movements controlled by CPG. As an autonomous learning framework for a CPG controller, we propose in this article a reinforcement learning method we call the "CPG-actor-critic" method. This method introduces a new architecture to the actor, and its training is roughly based on a stochastic policy gradient algorithm presented recently. We apply this method to an automatic acquisition problem of control for a biped robot. Computer simulations show that training of the CPG can be successfully performed by our method, thus allowing the biped robot to not only walk stably but also adapt to environmental changes.

Transcendental Political Systems and the Gravity Model

NASA Technical Reports Server (NTRS)

Lock, Connor

2012-01-01

This summer I have been working on an Army Deep Futures Model project named Themis. Themis is a JPL based modeling framework that anticipates possible future states for the world within the next 25 years. The goal of this framework is to determine the likelihood that the US Army will need to intervene on behalf of the US strategic interests. Key elements that are modeled within this tool include the world structure and major decisions that are made by key actors. Each actor makes decisions based on their goals and within the constraints of the structure of the system in which they are located. In my research I have focused primarily on the effects of structures upon the decision-making processes of the actors within them. This research is a natural extension of my major program at Georgetown University, where I am studying the International Political Economy and the structures that make it up. My basic goal for this summer project was to be a helpful asset to the Themis modeling team, with any research done or processes learned constituting a bonus.

Using Win-Win Strategies to Implement Health in All Policies: A Cross-Case Analysis

PubMed Central

Molnar, Agnes; Renahy, Emilie; O’Campo, Patricia; Muntaner, Carles; Freiler, Alix; Shankardass, Ketan

2016-01-01

Background In spite of increasing research into intersections of public policy and health, little evidence shows how policy processes impact the implementation of Health in All Policies (HiAP) initiatives. Our research sought to understand how and why strategies for engaging partners from diverse policy sectors in the implementation of HiAP succeed or fail in order to uncover the underlying social mechanisms contributing to sustainable implementation of HiAP. Methods In this explanatory multiple case study, we analyzed grey and peer-review literature and key informant interviews to identify mechanisms leading to implementation successes and failures in relation to different strategies for engagement across three case studies (Sweden, Quebec and South Australia), after accounting for the role of different contextual conditions. Findings Our results yielded no support for the use of awareness-raising or directive strategies as standalone approaches for engaging partners to implement HiAP. However, we found strong evidence that mechanisms related to “win-win” strategies facilitated implementation by increasing perceived acceptability (or buy-in) and feasibility of HiAP implementation across sectors. Win-win strategies were facilitated by mechanisms related to several activities, including: the development of a shared language to facilitate communication between actors from different sectors; integrating health into other policy agendas (eg., sustainability) and use of dual outcomes to appeal to the interests of diverse policy sectors; use of scientific evidence to demonstrate the effectiveness of HiAP; and using health impact assessment to make policy coordination for public health outcomes more feasible and to give credibility to policies being developed by diverse policy sectors. Conclusion Our findings enrich theoretical understanding in an under-unexplored area of intersectoral action. They also provide policy makers with examples of HiAP across wealthy welfare regimes, and improve understanding of successful HiAP implementation practices, including the win-win approach. PMID:26845574

A frame-critical policy analysis of Canada's response to the World Food Summit 1998-2008.

PubMed

Mah, Catherine L; Hamill, Catherine; Rondeau, Krista; McIntyre, Lynn

2014-01-01

The 2012 visit to Canada of Olivier De Schutter, the United Nations Special Rapporteur on the Right to Food, led to a public rebuff by Canadian governmental officials. This paper adapts the frame-critical policy analysis of Schön and Rein (1994), to explore the rhetorical basis for this conflict. This examination is offered as an illustrative example of how food insecurity is framed as a public policy problem in a high-income nation and how this framing has changed over time. We analyze Canada's decade of sequential responses to the 1996 World Food Summit, spanning 1998-2008, in the form of Canada's Action Plan on Food Security, and its subsequent Progress Reports. We conducted a qualitative policy analysis, adapting the frame-critical approach first delineated by Schön and Rein (1994). This analysis uses a social constructionist approach to map out the relationships between tacit understanding of policy by particular actors, explicit rhetoric in the public domain, and action in this policy area over time. We identify three key ways in which competing rhetorical frames arise over time: frame shifts (e.g., a shift away from language highlighting the right to food and health); frame blending (e.g., discussion about poverty becomes obscured by complexity discourse); and within-frame incongruence (e.g., monitoring for health indicators that are unrelated to policy solutions). Together, these frames illustrate how the conflict embodied in the UN Special Rapporteur's visit has been deeply woven into the policy discourse on food insecurity in Canada over time. Frame-critical analysis is instructive for exposing and also predicting tensions that impede forward progress on difficult policy issues. Accordingly, such analyses may be helpful in not only dissecting how policy can become 'stuck' in the process of change but in active reframing towards new policy solutions.

Policy Analysis of Road Traffic Injury Prevention in Iran

PubMed Central

Azami-Aghdash, Saber; Gorji, Hassan Abolghasem; Shabaninejad, Hosein; Sadeghi-Bazargani, Homayoun

2017-01-01

Introduction Due to the large number of Road Traffic Injuries (RTIs) in Iran, authorities have implemented a number of policies for the prevention of RTIs. However, a scientific analysis of these policies has thus far been neglected. Therefore, this study was conducted for policy analysis of RTIs prevention in Iran. Methods This qualitative study with a case study approach was conducted in Iran during 2016 in two phases: First, by reviewing literature and documents of the past ten years, policies that have been executed to prevent RTIs in Iran were identified. In the second phase of the study, the identified policies were ranked by prioritization matrices. The two policies with the highest scores were selected. ‘Policy triangle framework’ was used for Policy analyzing. Stakeholders of these policies (42 people) were interviewed. Data were analyzed manually by implementing Content-Analysis methods. Results The policies of “pupil liaisons” and “safety belt” were selected for analysis from thirteen potential identified polices. The results of some studies revealed that safety belts had not been properly used in Iran (less than 80%). There was an eight-year hiatus between the approval of the safety belts policy and implementation of this policy. Eight actors were identified for safety belts policy. Lack of diligence in implementation of the policy, failing to pay adequate attention to education and the culture of driving, and failing to select an organization for the implementation of the policy, were identified as the main weaknesses of this policy. For ‘pupil liaisons’ policy, five actors were identified. Following the implementation of this policy, the number of penalties was reduced (17.9%). Neglecting scientific findings and individual-based nature of the policy were identified as the primary weaknesses of this policy. Conclusions Taking serious measures to properly execute the policy, educating people, selecting an efficient organization that is responsible for the implementation of the policies, and using international experience are the measures that can be taken to reduce the number of RTIs in the country. PMID:28243417

Boundary‐spanning actors in complex adaptive governance systems: The case of multisectoral nutrition

PubMed Central

Gervais, Suzanne; Hafeez‐ur‐Rehman, Hajra; Sanou, Dia; Tumwine, Jackson

2017-01-01

Abstract A growing literature highlights complexity of policy implementation and governance in global health and argues that the processes and outcomes of policies could be improved by explicitly taking this complexity into account. Yet there is a paucity of studies exploring how this can be achieved in everyday practice. This study documents the strategies, tactics, and challenges of boundary‐spanning actors working in 4 Sub‐Saharan Africa countries who supported the implementation of multisectoral nutrition as part of the African Nutrition Security Partnership in Burkina Faso, Mali, Ethiopia, and Uganda. Three action researchers were posted to these countries during the final 2 years of the project to help the government and its partners implement multisectoral nutrition and document the lessons. Prospective data were collected through participant observation, end‐line semistructured interviews, and document analysis. All 4 countries made significant progress despite a wide range of challenges at the individual, organizational, and system levels. The boundary‐spanning actors and their collaborators deployed a wide range of strategies but faced significant challenges in playing these unconventional roles. The study concludes that, under the right conditions, intentional boundary spanning can be a feasible and acceptable practice within a multisectoral, complex adaptive system in low‐ and middle‐income countries. PMID:29024002

Perspectives on the role of stakeholders in knowledge translation in health policy development in Uganda.

PubMed

Nabyonga Orem, Juliet; Marchal, Bruno; Mafigiri, DavidKaawa; Ssengooba, Freddie; Macq, Jean; Da Silveira, Valeria Campos; Criel, Bart

2013-08-19

Stakeholder roles in the application of evidence are influenced by context, the nature of the evidence, the policy development process, and stakeholder interactions. Past research has highlighted the role of stakeholders in knowledge translation (KT) without paying adequate attention to the peculiarities of low-income countries. Here we identify the roles, relations, and interactions among the key stakeholders involved in KT in Uganda and the challenges that they face. This study employed qualitative approaches to examine the roles of and links among various stakeholders in KT. In-depth interviews were conducted with 21 key informants and focused on the key actors in KT, their perceived roles, and challenges. Major stakeholders included civil society organizations with perceived roles of advocacy, community mobilization, and implementation. These stakeholders may ignore unconvincing evidence. The community's role was perceived as advocacy and participation in setting research priorities. The key role of the media was perceived as knowledge dissemination, but respondents noted that the media may misrepresent evidence if it is received in a poorly packaged form. The perceived roles of policy makers were evidence uptake, establishing platforms for KT and stewardship; negative roles included ignoring or even misrepresenting evidence that is not in their favor. The roles of parliamentarians were perceived as advocacy and community mobilization, but they were noted to pursue objectives that may not be supported by the evidence. The researchers' main role was defined as evidence generation, but focusing disproportionately on academic interests was cited as a concern. The donors' main role was defined as funding research and KT, but respondents were concerned about the local relevance of donor-supported research. Respondents reported that links among stakeholders were weak due to the absence of institutionalized, inclusive platforms. Challenges facing the stakeholders in the process of KT were identified. Our investigation revealed the need to consider the roles that various stakeholders are best placed to play. Links and necessary platforms must be put in place to achieve synergy in KT. Relevant capacities need to be built to overcome the challenges faced by the various stakeholders.

Unpacking commercial sector opposition to European smoke-free policy: lack of unity, 'fear of association' and harm reduction debates.

PubMed

Weishaar, Heide; Amos, Amanda; Collin, Jeff

2016-07-01

Tobacco companies have made extensive efforts to build alliances against comprehensive smoke-free legislation. This article analyses the interaction between actors who opposed the development of the European Council Recommendation on smoke-free environments. Drawing on data from 200 policy documents and 32 semistructured interviews and using qualitative textual analysis and organisational network analysis, opponents' positions on, and responses to, the policy initiative, strategies to oppose the policy, and efforts to build alliances were investigated. The non-binding nature of the policy, scientific evidence and clear political will to adopt EU-wide measures combined to limit the intensity of commercial sector opposition to the comprehensive EU smoke-free policy. Most tobacco companies, led by the Confederation of European Community Cigarette Manufacturers (CECCM), voiced reservations against the proposal, criticised the policy process and fought flanking measures on product regulation. However, some companies focused on instigating harm reduction debates. These divergent approaches and the reluctance of other commercial actors to demonstrate solidarity with the tobacco sector prevented the establishment of a cohesive commercial sector alliance. The comparatively limited opposition to EU smoke-free policy contrasts with previous accounts of tobacco industry resistance to tobacco control. While context-specific factors can partially explain these differences, the paper indicates that the sector's diminished credibility and lack of unity hampered political engagement and alliance building. Industry efforts to emphasise the benefits of smokeless tobacco during smoke-free policy debates highlight the potential of harm reduction as a gateway for tobacco companies to re-enter the political arena. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Whose place is it anyway? Representational politics in a place-based health initiative.

PubMed

Rushton, Carole

2014-03-01

The association between place and poor health, such as chronic disease, is well documented and in recent years has given rise to public health strategies such as place-based initiatives (PBIs). This article reports on the emergence of one such initiative in Australia, in regions identified as culturally diverse and socially disadvantaged. The study draws on the intellectual resources provided by governmentality and actor-network theory to provide insights into the reasons why community actors were excluded from a new governance body established to represent their interests. Risk-thinking and representational politics determined who represented whom in the PBI partnership. Paradoxically, actors representing 'community', identified as being 'at risk', were excluded from the partnership during its translation because they were also identified as being 'a risk'. As a consequence, contrary to federal government health and social policy in Australia, it was state government interests rather than the interests of community actors that influenced decisions made in relation to local health planning and the allocation of resources. Copyright © 2013 Elsevier Ltd. All rights reserved.

Including policy and management in socio-hydrology models: initial conceptualizations

NASA Astrophysics Data System (ADS)

Hermans, Leon; Korbee, Dorien

2017-04-01

Socio-hydrology studies the interactions in coupled human-water systems. So far, the use of dynamic models that capture the direct feedback between societal and hydrological systems has been dominant. What has not yet been included with any particular emphasis, is the policy or management layer, which is a central element in for instance integrated water resources management (IWRM) or adaptive delta management (ADM). Studying the direct interactions between human-water systems generates knowledges that eventually helps influence these interactions in ways that may ensure better outcomes - for society and for the health and sustainability of water systems. This influence sometimes occurs through spontaneous emergence, uncoordinated by societal agents - private sector, citizens, consumers, water users. However, the term 'management' in IWRM and ADM also implies an additional coordinated attempt through various public actors. This contribution is a call to include the policy and management dimension more prominently into the research focus of the socio-hydrology field, and offers first conceptual variables that should be considered in attempts to include this policy or management layer in socio-hydrology models. This is done by drawing on existing frameworks to study policy processes throughout both planning and implementation phases. These include frameworks such as the advocacy coalition framework, collective learning and policy arrangements, which all emphasis longer-term dynamics and feedbacks between actor coalitions in strategic planning and implementation processes. A case about longter-term dynamics in the management of the Haringvliet in the Netherlands is used to illustrate the paper.

Working with layers: The governance and regulation of healthcare quality in an institutionally layered system

PubMed Central

Stoopendaal, Annemiek; Bal, Roland

2016-01-01

Institutional arrangements used to steer public policies have increasingly become layered. Inspired by the literature on institutional layering and institutional work, this paper aims to make a contribution to our understanding of institutional layering. We do so by studying an interesting case of layering: the Dutch hospital sector. We focus on the actors responsible for the internal governance (Board of Directors and Supervisory Boards) and the external regulation (the Healthcare Inspectorate) of hospitals. In the paper, we explore the institutional work of these actors, more specifically how institutional work results from and is influenced by institutional layering and how this in turn influences the institutional makeup of both healthcare organizations and their institutional context. Our approach allowed us to see that layering changes the activities of actors in the public sector, can be used to strengthen one’s position but also presents actors with new struggles, which they in turn can try to overcome by relating and using the institutionally layered context. Layering and institutional work are therefore in continuous interaction. Combining institutional layering with a focus on the lived experiences of actors and their institutional work makes it possible to move into the layered arrangement and better understand its consequences. PMID:28596640

Analysis of the corporate political activity of major food industry actors in Fiji.

PubMed

Mialon, Melissa; Swinburn, Boyd; Wate, Jillian; Tukana, Isimeli; Sacks, Gary

2016-05-10

Non-communicable diseases (NCDs) are the leading cause of mortality in Fiji, a middle-income country in the Pacific. Some food products processed sold and marketed by the food industry are major contributors to the NCD epidemic, and the food industry is widely identified as having strong economic and political power. However, little research has been undertaken on the attempts by the food industry to influence public health-related policies and programs in its favour. The "corporate political activity" (CPA) of the food industry includes six strategies (information and messaging; financial incentives; constituency building; legal strategies; policy substitution; opposition fragmentation and destabilisation). For this study, we aimed to gain a detailed understanding of the CPA strategies and practices of major food industry actors in Fiji, interpreted through a public health lens. We implemented a systematic approach to monitor the CPA of the food industry in Fiji for three months. It consisted of document analysis of relevant publicly available information. In parallel, we conducted semi-structured interviews with 10 stakeholders involved in diet- and/or public health-related issues in Fiji. Both components of the study were thematically analysed. We found evidence that the food industry adopted a diverse range of strategies in an attempt to influence public policy in Fiji, with all six CPA strategies identified. Participants identified that there is a substantial risk that the widespread CPA of the food industry could undermine efforts to address NCDs in Fiji. Despite limited public disclosure of information, such as data related to food industry donations to political parties and lobbying, we were able to identify many CPA practices used by the food industry in Fiji. Greater transparency from the food industry and the government would help strengthen efforts to increase their accountability and support NCD prevention. In other low- and middle-income countries, it is likely that a systematic document analysis approach would also need to be supplemented with key informant interviews to gain insight into this important influence on NCD prevention.

Development prospects of health and reform of the fiscal system in bosnia and herzegovina.

PubMed

Salihbasic, Sehzada

2011-01-01

The functions of the health system, according to the key objectives and relationships within the sub-systems that are available to the policy makers and managers in the Health Care system in Bosnia and Herzegovina - B&H, have been elaborated in detail, with the analytical overview of relevant indicators, thus confirming the limitations of the health promotion in B&H. The ability to overcome the expressed problems is in the startup of process for structural adjustment of the health sector, reform of the health care system and its financing. The reform in health system implies fundamental changes that need to take place, in B&H, as a state in health policy and institutions in the health care system, in order to improve the functioning of health systems with the aim of ensuring better health of the population. Reform implies the existence of documents with clearly formulated health policy objectives, for which the state stands, and for which a consensus was reached on the national level with all key actors in the political structure: public promotion of the basic principles for carrying out the reform, its implementation within a reasonable time frame, the corresponding effects for providers and customer satisfaction, as well as improving health services' efficacy (i.e. micro and macro) and the quality of healthcare. In this article, we elaborated the criteria for the classification of health systems, whereby the scientifically-based and empirical analysis is conducted on the health system in B&H and elaborated the key levers of the system. Leveraged organizational arrangements relating to the economic and political environment, organization and management functions, in connection with the services of finance, funds, customers and service providers, from which it follows the framework of state legislation related to health policy and health institutions at the state level are responsible for finance, planning, the organization, payment, regulation and conduct. If we start from the administrative criteria for the classification of "health sub-systems" in B&H, it is difficult to fit them in a pluralistic, decentralized or monistic, because in the system for each organization, there should be health policy at the state level, which is in the most countries represents the Ministry of Health.

Electricity Market Manipulation: How Behavioral Modeling Can Help Market Design

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gallo, Giulia

The question of how to best design electricity markets to integrate variable and uncertain renewable energy resources is becoming increasingly important as more renewable energy is added to electric power systems. Current markets were designed based on a set of assumptions that are not always valid in scenarios of high penetrations of renewables. In a future where renewables might have a larger impact on market mechanisms as well as financial outcomes, there is a need for modeling tools and power system modeling software that can provide policy makers and industry actors with more realistic representations of wholesale markets. One optionmore » includes using agent-based modeling frameworks. This paper discusses how key elements of current and future wholesale power markets can be modeled using an agent-based approach and how this approach may become a useful paradigm that researchers can employ when studying and planning for power systems of the future.« less

The supply of pharmaceuticals in humanitarian assistance missions: implications for military operations.

PubMed

Mahmood, Maysaa; Riley, Kevin; Bennett, David; Anderson, Warner

2011-08-01

In this article, we provide an overview of key international guidelines governing the supply of pharmaceuticals during disasters and complex emergencies. We review the World Health Organization's guidelines on pharmaceutical supply chain management and highlight their relevance for military humanitarian assistance missions. Given the important role of pharmaceuticals in addressing population health needs during humanitarian emergencies, a good understanding of how pharmaceuticals are supplied at the local level in different countries can help military health personnel identify the most appropriate supply options. Familiarity with international guidelines involved in cross-border movement of pharmaceuticals can improve the ability of military personnel to communicate more effectively with other actors involved in humanitarian and development spheres. Enhancing the knowledge base available to military personnel in terms of existing supply models and funding procedures can improve the effectiveness of humanitarian military operations and invite policy changes necessary to establish more flexible acquisition and funding regulations.

Evaluation of multi-level social learning for sustainable landscapes: perspective of a development initiative in Bergslagen, Sweden.

PubMed

Axelsson, Robert; Angelstam, Per; Myhrman, Lennart; Sädbom, Stefan; Ivarsson, Milis; Elbakidze, Marine; Andersson, Kenneth; Cupa, Petr; Diry, Christian; Doyon, Frederic; Drotz, Marcus K; Hjorth, Arne; Hermansson, Jan Olof; Kullberg, Thomas; Lickers, F Henry; McTaggart, Johanna; Olsson, Anders; Pautov, Yurij; Svensson, Lennart; Törnblom, Johan

2013-03-01

To implement policies about sustainable landscapes and rural development necessitates social learning about states and trends of sustainability indicators, norms that define sustainability, and adaptive multi-level governance. We evaluate the extent to which social learning at multiple governance levels for sustainable landscapes occur in 18 local development initiatives in the network of Sustainable Bergslagen in Sweden. We mapped activities over time, and interviewed key actors in the network about social learning. While activities resulted in exchange of experiences and some local solutions, a major challenge was to secure systematic social learning and make new knowledge explicit at multiple levels. None of the development initiatives used a systematic approach to secure social learning, and sustainability assessments were not made systematically. We discuss how social learning can be improved, and how a learning network of development initiatives could be realized.

Disaster mitigation and preparedness on the Nicaraguan post-Mitch agenda.

PubMed

Rocha, J L; Christoplos, I

2001-09-01

Nicaragua provides an example of how a major disaster, in this case Hurricane Mitch, can transform the national agenda for disaster mitigation and preparedness. Hurricane Mitch was a reminder of how extremely disaster prone Nicaragua is, and also how neoliberal reforms have weakened governmental response capacity. In the face of critiques of how governmental policies had affected preparedness and response, discussions of this transformation became a highly politicised process where the debate over alternative development models tended to overshadow the original calls to strengthen risk management. Progress can be seen in some areas, such as disaster mitigation through environmental management. This study of NGO roles, and their relations with other key actors, draws attention to the need to anchor improved risk management in local-level NGO-government collaboration. Structures are being put into place to achieve this aim, but dependence on donor financing raises questions regarding the longer-term sustainability of these efforts.

Global health diplomacy, 'smart power', and the new world order.

PubMed

Kevany, Sebastian

2014-01-01

Both the theory and practice of foreign policy and diplomacy, including systems of hard and soft power, are undergoing paradigm shifts, with an increasing number of innovative actors and strategies contributing to international relations outcomes in the 'New World Order'. Concurrently, global health programmes continue to ascend the political spectrum in scale, scope and influence. This concatenation of circumstances has demanded a re-examination of the existing and potential effectiveness of global health programmes in the 'smart power' context, based on adherence to a range of design, implementation and assessment criteria, which may simultaneously optimise their humanitarian, foreign policy and diplomatic effectiveness. A synthesis of contemporary characteristics of 'global health diplomacy' and 'global health as foreign policy', grouped by common themes and generated in the context of related field experiences, are presented in the form of 'Top Ten' criteria lists for optimising both diplomatic and foreign policy effectiveness of global health programmes, and criteria are presented in concert with an examination of implications for programme design and delivery. Key criteria for global health programmes that are sensitised to both diplomatic and foreign policy goals include visibility, sustainability, geostrategic considerations, accountability, effectiveness and alignment with broader policy objectives. Though diplomacy is a component of foreign policy, criteria for 'diplomatically-sensitised' versus 'foreign policy-sensitised' global health programmes were not always consistent, and were occasionally in conflict, with each other. The desirability of making diplomatic and foreign policy criteria explicit, rather than implicit, in the context of global health programme design, delivery and evaluation are reflected in the identified implications for (1) international security, (2) programme evaluation, (3) funding and resource allocation decisions, (4) approval systems and (5) training. On this basis, global health programmes are shown to provide a valuable, yet underutilised, tool for diplomacy and foreign policy purposes, including their role in the pursuit of benign international influence. A corresponding alignment of resources between 'hard' and 'smart' power options is encouraged.

Peer, professional, and public: an analysis of the drugs policy advocacy community in Europe.

PubMed

O'Gorman, Aileen; Quigley, Eoghan; Zobel, Frank; Moore, Kerri

2014-09-01

In recent decades a range of advocacy organisations have emerged on the drugs policy landscape seeking to shape the development of policy at national and international levels. This development has been facilitated by the expansion of 'democratic spaces' for civil society participation in governance fora at national and supranational level. However, little is known about these policy actors - their aims, scope, organisational structure, or the purpose of their engagement. Drug policy advocacy organisations were defined as organisations with a clearly stated aim to influence policy and which were based in Europe. Data on these organisations was collected through a systematic tri-lingual (English, French and Spanish) Internet search, supplemented by information provided by national agencies in the 28 EU member states, Norway and Turkey. In order to differentiate between the diverse range of activities, strategies and standpoints of these groups, information from the websites was used to categorise the organisations by their scope of operation, advocacy tools and policy constituencies; and by three key typologies - the type of advocacy they engaged in, their organisational type, and their advocacy objectives and orientation. The study identified over two hundred EU-based advocacy organisations (N=218) which included civil society associations, NGOs, and large-scale alliances and coalitions, operating at local, national and European levels. Three forms of advocacy emerged from the data analysis - peer, professional and public policy. These groups focused their campaigns on practice development (harm reduction or abstinence) and legislative reform (reducing or strengthening drug controls). The findings from this study provide a nuanced profile of civil society advocacy as a policy community in the drugs field; their legitimacy to represent cases, causes, social values and ideals; and their focus on both insider and outsider strategies to achieve their goals. The level of convergence and divergence in Europe in relation to policy positions on service provision ethos and drug control regulation is indicated. Copyright © 2014 Elsevier B.V. All rights reserved.

Policy dialogues - the "bolts and joints" of policy-making: experiences from Cabo Verde, Chad and Mali.

PubMed

Dovlo, Delanyo; Nabyonga-Orem, Juliet; Estrelli, Yolanda; Mwisongo, Aziza

2016-07-18

Policy processes that yield good outcomes are inherently complex, requiring interactions of stakeholders in problem identification, generation of political will and selection of practical solutions. To make policy processes rational, policy dialogues are increasingly being used as a policy-making tool. Despite their increasing use for policy-making in Africa, evidence is limited on how they have evolved and are being used on the continent or in low and middle income countries elsewhere. This was an exploratory study using qualitative methods. It utilised data related to policy dialogues for three specific policies and strategies to understand the interplay between policy dialogue and policy-making in Cabo Verde, Chad and Mali. The specific methods used to gather data were key informant interviews and document review. Data were analysed inductively and deductively using thematic content analysis. Participation in the policy dialogues was inclusive, and in some instances bottom-up participatory approaches were used. The respondents felt that the execution of the policy dialogues had been seamless, and the few divergent views expressed often were resolved in a unanimous manner. The policies and strategies developed were seen by all stakeholders as relating to priority issues. Other specific process factors that contributed to the success of the dialogues included the use of innovative approaches, good facilitation, availability of resources for the dialogues, good communication, and consideration of the different opinions. Among the barriers were contextual issues, delays in decision-making and conflicting coordination roles and mandates. Policy dialogues have proved to be an effective tool in health sector management and could be a crucial component of the governance dynamics of the sector. The policy dialogue process needs to be institutionalised for continuity and maintenance of institutional intelligence. Other essential influencing factors include building capacity for coordination and facilitation of policy dialogues, provision of sustainable financing for execution of the dialogues, use of inclusive and bottom-up approaches, and timely provision of reliable evidence. Ensuring continued participation of all the actors necessitates innovation to allow dialogue outside the formal frameworks and spaces that should feed into the formal dialogue processes.

Is Deliberation a Laudable Goal When Policy Is a "Done Deal"? The Habermasian Public Sphere and Legitimacy in a Market Era of Education Policymaking

ERIC Educational Resources Information Center

Pappas, Liza N.

2016-01-01

The state mandated public hearings concerning school closing proposals in New York City provide a window into a diverse set of policy actors and their deliberations. Opposition to school closures is often cast as entrenched interests, emotional attachment, support for the status quo or at worst negligence. However, content analysis reveals that…

Post detonation nuclear forensics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davis, Jay

2014-05-09

The problem of working backwards from the debris of a nuclear explosion to attempt to attribute the event to a particular actor is singularly difficult technically. However, moving from physical information of any certainty through the political steps that would lead to national action presents daunting policy questions as well. This monograph will outline the operational and physical components of this problem and suggest the difficulty of the policy questions that remain.

Innovation and participation for healthy public policy: the first National Health Assembly in Thailand

PubMed Central

Rasanathan, Kumanan; Posayanonda, Tipicha; Birmingham, Maureen; Tangcharoensathien, Viroj

2011-01-01

Abstract Aim  This paper aims to describe and disseminate the process and initial outcomes of the first National Health Assembly (NHA) in Thailand, as an innovative example of health policy making. Setting  The first NHA, held in December 2008 in Bangkok, brought together over 1500 people from government agencies, academia, civil society, health professionals and the private sector to discuss key health issues and produce resolutions to guide policy making. It adapted the approach used at the World Health Assembly of the World Health Organization. Method  Findings are derived from a literature review, document analysis, and the views and experiences of the authors, two of whom contributed to the organization of the NHA and two of whom were invited external observers. Results  Fourteen agenda items were discussed and resolutions passed. Potential early impacts on policy making have included an increase in the 2010 public budget for Thailand’s universal health coverage scheme as total public expenditure has decreased; cabinet endorsement of proposed Strategies for Universal Access to Medicines for Thai People; and establishment of National Commissions on Health Impact Assessment and Trade and Health. Discussion  The NHA was successful in bringing together various actors and sectors involved in the social production of health, including groups often marginalized in policy making. It provides an innovative model of how governments may be able to increase public participation and intersectoral collaboration that could be adapted in other contexts. Significant challenges remain in ensuring full participation of interested groups and in implementing, and monitoring the impact of, the resolutions passed. PMID:21281413

Innovation and participation for healthy public policy: the first National Health Assembly in Thailand.

PubMed

Rasanathan, Kumanan; Posayanonda, Tipicha; Birmingham, Maureen; Tangcharoensathien, Viroj

2012-03-01

This paper aims to describe and disseminate the process and initial outcomes of the first National Health Assembly (NHA) in Thailand, as an innovative example of health policy making. The first NHA, held in December 2008 in Bangkok, brought together over 1500 people from government agencies, academia, civil society, health professionals and the private sector to discuss key health issues and produce resolutions to guide policy making. It adapted the approach used at the World Health Assembly of the World Health Organization. Findings are derived from a literature review, document analysis, and the views and experiences of the authors, two of whom contributed to the organization of the NHA and two of whom were invited external observers. Fourteen agenda items were discussed and resolutions passed. Potential early impacts on policy making have included an increase in the 2010 public budget for Thailand's universal health coverage scheme as total public expenditure has decreased; cabinet endorsement of proposed Strategies for Universal Access to Medicines for Thai People; and establishment of National Commissions on Health Impact Assessment and Trade and Health. The NHA was successful in bringing together various actors and sectors involved in the social production of health, including groups often marginalized in policy making. It provides an innovative model of how governments may be able to increase public participation and intersectoral collaboration that could be adapted in other contexts. Significant challenges remain in ensuring full participation of interested groups and in implementing, and monitoring the impact of, the resolutions passed. © 2011 Blackwell Publishing Ltd.

The effectiveness of competency-based education in equipping primary health care workers to manage chronic disease in Australian general practice settings.

PubMed

Glasgow, Nicholas J; Wells, Robert; Butler, James; Gear, Anna

2008-04-21

To review the literature on the effectiveness of competency-based education (CBE) as a means of equipping the Australian general practice workforce to deliver optimal chronic disease outcomes to articulate policy options for the Australian context. Systematic review of the literature (1991-2005) using a narrative approach followed by analysis of the findings using the actors/context/ processes/content framework of Buse et al. Few high-quality studies were identified. National policy options include incorporating clear statements about education and training, research and evaluation in any policy document targeting chronic disease; and provision of funding to enhance general practice teaching facilities and/or facilitate the development of supportive coordinating and administrative structures for training practices. Designers of CBE should consider five key questions: Are the educational objectives of the CBE clearly aligned with the chronic disease or workforce-related outcomes of interest? Is the design of the CBE sound? Have similar educational programs targeting the same outcomes been identified and every attempt made to maximise synergies between programs? Are the educational designers fully aware of and working within the existing complexity of the training environment? Are all involved in the program actively managing the process of change? Policy options range from those relatively simple and achievable to more complex and difficult. The full report is available at http://www.anu.edu.au/aphcri/Domain/Workforce/final_25_glasgow.pdf.

Building on the EGIPPS performance assessment: the multipolar framework as a heuristic to tackle the complexity of performance of public service oriented health care organisations

PubMed Central

2014-01-01

Background Performance of health care systems is a key concern of policy makers and health service managers all over the world. It is also a major challenge, given its multidimensional nature that easily leads to conceptual and methodological confusion. This is reflected by a scarcity of models that comprehensively analyse health system performance. Discussion In health, one of the most comprehensive performance frameworks was developed by the team of Leggat and Sicotte. Their framework integrates 4 key organisational functions (goal attainment, production, adaptation to the environment, and values and culture) and the tensions between these functions. We modified this framework to better fit the assessment of the performance of health organisations in the public service domain and propose an analytical strategy that takes it into the social complexity of health organisations. The resulting multipolar performance framework (MPF) is a meta-framework that facilitates the analysis of the relations and interactions between the multiple actors that influence the performance of health organisations. Summary Using the MPF in a dynamic reiterative mode not only helps managers to identify the bottlenecks that hamper performance, but also the unintended effects and feedback loops that emerge. Similarly, it helps policymakers and programme managers at central level to better anticipate the potential results and side effects of and required conditions for health policies and programmes and to steer their implementation accordingly. PMID:24742181

Relaunch of the official community health worker programme in Mozambique: is there a sustainable basis for iCCM policy?

PubMed

Chilundo, Baltazar Gm; Cliff, Julie L; Mariano, Alda Re; Rodríguez, Daniela C; George, Asha

2015-12-01

In Mozambique, integrated community case management (iCCM) of diarrhoea, malaria and pneumonia is embedded in the national community health worker (CHW) programme, mainstreaming it into government policy and service delivery. Since its inception in 1978, the CHW programme has functioned unevenly, was suspended in 1989, but relaunched in 2010. To assess the long-term success of iCCM in Mozambique, this article addresses whether the current CHW programme exhibits characteristics that facilitate or impede its sustainability. We undertook a qualitative case study based on document review (n = 54) and key informant interviews (n = 21) with respondents from the Ministry of Health (MOH), multilateral and bilateral agencies and non-governmental organizations (NGOs) in Maputo in 2012. Interviews were mostly undertaken in Portuguese and all were coded using NVivo. A sustainability framework guided thematic analysis according to nine domains: strategic planning, organizational capacity, programme adaptation, programme monitoring and evaluation, communications, funding stability, political support, partnerships and public health impact. Government commitment was high, with the MOH leading a consultative process in Maputo and facilitating successful technical coordination. The MOH made strategic decisions to pay CHWs, authorize their prescribing abilities, foster guidance development, support operational planning and incorporate previously excluded 'old' CHWs. Nonetheless, policy negotiations excluded certain key actors and uncertainty remains about CHW integration into the civil service and their long-term retention. In addition, reliance on NGOs and donor funding has led to geographic distortions in scaling up, alongside challenges in harmonization. Finally, dependence on external funding, when both external and government funding are declining, may hamper sustainability. Our analysis represents a nuanced assessment of the various domains that influence CHW programme sustainability, highlighting strategic areas such as CHW payment and programme financing. These organizational and contextual determinants of sustainability are central to CHW programme strengthening and iCCM policy support. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Relaunch of the official community health worker programme in Mozambique: is there a sustainable basis for iCCM policy?

PubMed Central

Chilundo, Baltazar GM; Cliff, Julie L; Mariano, Alda RE; Rodríguez, Daniela C; George, Asha

2015-01-01

Background: In Mozambique, integrated community case management (iCCM) of diarrhoea, malaria and pneumonia is embedded in the national community health worker (CHW) programme, mainstreaming it into government policy and service delivery. Since its inception in 1978, the CHW programme has functioned unevenly, was suspended in 1989, but relaunched in 2010. To assess the long-term success of iCCM in Mozambique, this article addresses whether the current CHW programme exhibits characteristics that facilitate or impede its sustainability. Methodology: We undertook a qualitative case study based on document review (n = 54) and key informant interviews (n = 21) with respondents from the Ministry of Health (MOH), multilateral and bilateral agencies and non-governmental organizations (NGOs) in Maputo in 2012. Interviews were mostly undertaken in Portuguese and all were coded using NVivo. A sustainability framework guided thematic analysis according to nine domains: strategic planning, organizational capacity, programme adaptation, programme monitoring and evaluation, communications, funding stability, political support, partnerships and public health impact. Results: Government commitment was high, with the MOH leading a consultative process in Maputo and facilitating successful technical coordination. The MOH made strategic decisions to pay CHWs, authorize their prescribing abilities, foster guidance development, support operational planning and incorporate previously excluded ‘old’ CHWs. Nonetheless, policy negotiations excluded certain key actors and uncertainty remains about CHW integration into the civil service and their long-term retention. In addition, reliance on NGOs and donor funding has led to geographic distortions in scaling up, alongside challenges in harmonization. Finally, dependence on external funding, when both external and government funding are declining, may hamper sustainability. Conclusions: Our analysis represents a nuanced assessment of the various domains that influence CHW programme sustainability, highlighting strategic areas such as CHW payment and programme financing. These organizational and contextual determinants of sustainability are central to CHW programme strengthening and iCCM policy support. PMID:26516151

Multinationals' Political Activities on Climate Change

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kolk, A.; Pinkse, J.

2007-06-15

This article explores the international dimensions of multinationals' corporate political activities, focusing on an international issue - climate change - being implemented differently in a range of countries. Analyzing data from Financial Times Global 500 firms, it examines the influence on types and process of multinationals' political strategies, reckoning with institutional contexts and issue saliency. Findings show that the type of political activities can be characterized as an information strategy to influence policy makers toward market-based solutions, not so much withholding action on emission reduction. Moreover, multinationals pursue self-regulation, targeting a broad range of political actors. The process of politicalmore » strategy is mostly one of collective action. International differences particularly surface in the type of political actors aimed at, with U.S. and Australian firms focusing more on non-government actors (voluntary programs) than European and Japanese firms. Influencing home-country (not host-country) governments is the main component of international political strategy on climate change.« less

Creating a Knowledge Translation Platform: nine lessons from the Zambia Forum for Health Research.

PubMed

Kasonde, Joseph M; Campbell, Sandy

2012-10-03

The concept of the Knowledge Translation Platform (KTP) provides cohesion and leadership for national-level knowledge translation efforts. In this review, we discuss nine key lessons documenting the experience of the Zambia Forum for Health Research, primarily to inform and exchange experience with the growing community of African KTPs. Lessons from ZAMFOHR's organizational development include the necessity of selecting a multi-stakeholder and -sectoral Board of Directors; performing comprehensive situation analyses to understand not only the prevailing research-and-policy dynamics but a precise operational niche; and selecting a leader that bridges the worlds of research and policy. Programmatic lessons include focusing on building the capacity of both policy-makers and researchers; building a database of local evidence and national-level actors involved in research and policy; and catalyzing work in particular issue areas by identifying leaders from the research community, creating policy-maker demand for research evidence, and fostering the next generation by mentoring both up-and-coming researchers and policy-makers. Ultimately, ZAMFOHR's experience shows that an African KTP must pay significant attention to its organizational details. A KTP must also invest in the skill base of the wider community and, more importantly, of its own staff. Given the very real deficit of research-support skills in most low-income countries - in synthesis, in communications, in brokering, in training - a KTP must spend significant time and resources in building these types of in-house expertise. And lastly, the role of networking cannot be underestimated. As a fully-networked KTP, ZAMFOHR has benefited from the innovations of other KTPs, from funding opportunities and partnerships, and from invaluable technical support from both African and northern colleagues.

Regaining momentum for international climate policy beyond Copenhagen

PubMed Central

2010-01-01

The 'Copenhagen Accord' fails to deliver the political framework for a fair, ambitious and legally-binding international climate agreement beyond 2012. The current climate policy regime dynamics are insufficient to reflect the realities of topical complexity, actor coalitions, as well as financial, legal and institutional challenges in the light of extreme time constraints to avoid 'dangerous' climate change of more than 2°C. In this paper we analyze these stumbling blocks for international climate policy and discuss alternatives in order to regain momentum for future negotiations. PMID:20525341

Implementation lessons for school food policies and marketing restrictions in the Philippines: a qualitative policy analysis.

PubMed

Reeve, Erica; Thow, Anne Marie; Bell, Colin; Engelhardt, Katrin; Gamolo-Naliponguit, Ella Cecilia; Go, John Juliard; Sacks, Gary

2018-01-23

The school environment can enhance children's skills, knowledge and behaviours in relation to healthy eating. However, in many countries, unhealthy foods are commonly available in schools, and children can be exposed to aggressive marketing by the food industry. Taking the perspective of policymakers, this study aimed to identify barriers and enablers to effective school food policy development and implementation in the Philippines. In May 2016, semi-structured interviews were conducted with 21 policymakers and stakeholders involved in school food policymaking and implementation in the Philippines. The Health Policy Analysis Triangle was used to identify interview questions and to guide the thematic analysis. These included the political and socio-environmental context, strengths and limitations of existing policy content, roles and behaviours of actors, implementation processes, policy outcomes, and opportunities to improve policy coherence. The Department of Education's policy 'Orders' represented a relatively strong policy framework for the education sector of the Philippines. However, a lack of human and financial resources for implementation, planning, and policy enforcement limited the impact of the policy on the healthiness of school food provision. Ambiguity in policy wording allowed a wide interpretation of the foods eligible to be provided in schools, and led to difficulties in effective monitoring and enforcement. Food companies used existing relationships with schools to promote their brands and compromise the establishment of a stronger food policy agenda. We found a motivated group of actors engaging in policy-oriented learning and advocating for a stronger policy alternative so as to improve the school food environment. The adoption of policy mechanisms being used to promote healthy dietary practices in the school setting will be strengthened by more robust implementation planning processes, and resources to support implementation and enforcement. Policymakers should ensure policy language clearly and unequivocally promotes healthier food and beverage options. Steps should be taken to achieve policy coherence by ensuring the objectives of one agency or institution are not undermining that of any others. Where there is reliance on the private sector for school resources, safeguards should be established to protect against conflicts of interest.

[Health governance and social protection indicators in Latin-America: strengths, weaknesses and lessons-learned from six Mexican states].

PubMed

Arredondo-López, Armando; Orozco-Núñez, Emanuel

2014-01-01

Evaluative research projects for identifying good practice have been postponed regarding health system reform. This study was thus aimed at identifying health governance and social protection indicators. This study involved evaluative research regarding the health system for the uninsured part of the population in six Mexican states. The primary data was obtained from in-depth interviews with key players from the participating states; official statistics and the results of a macro-project concerned with Mexican health and governance reform and policy was used for secondary. Atlas Ti and Policy Maker software were used for processing and analysing the data. A list of strengths and weaknesses was presented as evidence of health system governance. Accountability at federal level (even though not lacking) was of a prescriptive nature and a system of accountability and transparency regarding the assignment of resources and strategies for the democratisation of health in the states and municipalities was still lacking. All six states had low levels of governance and experienced difficulty in conducting effective reform programmes and strategies involving a lack of precision regarding the rules and roles adopted by different health system actors.

Governance versus government: drug consumption rooms in Australia and the UK.

PubMed

Zampini, Giulia Federica

2014-09-01

To evaluate, through a case study, the extent to which elements of governance and elements of government are influential in determining the implementation or non-implementation of a drugs intervention. Comparative analysis of the case of a drug consumption room in the UK (England) and Australia (New South Wales), including 16 semi-structured interviews with key stakeholders and analysis of relevant documents according to characteristic features of governance and government (power decentralisation, power centralisation, independent self-organising policy networks, use of evidence, top-down steering/directing, legislation). Characteristic features of both governance and government are found in the data. Elements of governance are more prominent in New South Wales, Australia than in England, UK, where government prevails. Government is seen as the most important actor at play in the making, or absence, of drug consumption rooms. Both governance and government are useful frameworks in conceptualising the policy process. The governance narrative risks overlooking the importance of traditional government structures. In the case of drug consumption rooms in the UK and Australia, a focus on government is shown to have been crucial in determining whether the intervention was implemented. Copyright © 2014 Elsevier B.V. All rights reserved.

Ethos and Vision Realization in Sponsored Academy Schools

ERIC Educational Resources Information Center

Gibson, Mark T.

2015-01-01

This article investigates the realization of ethos and vision in the early stages of sponsored academy schools in England. It is a qualitative nested case study of ten academies. Nineteen key actors were interviewed, including principals and sponsor representatives. The nests were organized by sponsor type. Key themes are discussed within the…

The European Union Food Distribution programme for the Most Deprived Persons of the community, 1987-2013: From agricultural policy to social inclusion policy?

PubMed

Caraher, Martin

2015-07-01

The European Union Food Distribution programme for the Most Deprived Persons (MDP) of the community ran from 1987 until 2013. It was funded from Common Agricultural Policy budgets. The programme initially made use of surplus foods from the food mountains resulting from intervention stocks. This food was then distributed through aid agencies within member states, coordinated at a national government level. Reform of the CAP and global rises in food prices resulted in an increase in budget from €300 to €500 million Euros in 2010 with the added power to buy food on the open market. This led to a formal challenge to the scheme on the basis that buying goods on the open market shifted the emphasis from an agricultural/financial basis to a social one. A court ruling found that because the program was no longer used for removing surpluses the link to agriculture policy has become tenuous and therefore had no basis in community law. As a result of this legal challenge a number of policy compromises ensured the MDP would continue until the end of 2013 with a reduced budget. The scheme has been superseded by a new scheme in March 2014 called the Fund for European Aid to the Most Deprived (FEAD). This is seen as a social programme. The way that policy and politics developed and changed the MDP programme are set out. The article tracks its move from being an agricultural policy to a social welfare one. The key policy players and actors in this move are set out as are the changing context and policy frameworks. The replacement of the MDP by FEAD is discussed as is how intensive lobbying in 2012/13 resulted in the development of a new Fund for European Aid to the Most Deprived (FEAD). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Power and Agenda-Setting in Tanzanian Health Policy: An Analysis of Stakeholder Perspectives

PubMed Central

Fischer, Sara Elisa; Strandberg-Larsen, Martin

2016-01-01

Background: Global health policy is created largely through a collaborative process between development agencies and aid-recipient governments, yet it remains unclear whether governments retain ownership over the creation of policy in their own countries. An assessment of the power structure in this relationship and its influence over agenda-setting is thus the first step towards understanding where progress is still needed in policy-making for development. Methods: This study employed qualitative policy analysis methodology to examine how health-related policy agendas are adopted in low-income countries, using Tanzania as a case study. Semi-structured, in-depth, key informant interviews with 11 policy-makers were conducted on perspectives of the agenda-setting process and its actors. Kingdon’s stream theory was chosen as the lens through which to interpret the data analysis. Results: This study demonstrates that while stakeholders each have ways of influencing the process, the power to do so can be assessed based on three major factors: financial incentives, technical expertise, and influential position. Since donors often have two or all of these elements simultaneously a natural power imbalance ensues, whereby donor interests tend to prevail over recipient government limitations in prioritization of agendas. One way to mediate these imbalances seems to be the initiation of meaningful policy dialogue. Conclusion: In Tanzania, the agenda-setting process operates within a complex network of factors that interact until a "policy window" opens and a decision is made. Power in this process often lies not with the Tanzanian government but with the donors, and the contrast between latent presence and deliberate use of this power seems to be based on the donor ideology behind giving aid (defined here by funding modality). Donors who used pooled funding (PF) modalities were less likely to exploit their inherent power, whereas those who preferred to maintain maximum control over the aid they provided (ie, non-pooled funders) more readily wielded their intrinsic power to push their own priorities. PMID:27285513

Power and Agenda-Setting in Tanzanian Health Policy: An Analysis of Stakeholder Perspectives.

PubMed

Fischer, Sara Elisa; Strandberg-Larsen, Martin

2016-02-09

Global health policy is created largely through a collaborative process between development agencies and aid-recipient governments, yet it remains unclear whether governments retain ownership over the creation of policy in their own countries. An assessment of the power structure in this relationship and its influence over agenda-setting is thus the first step towards understanding where progress is still needed in policy-making for development. This study employed qualitative policy analysis methodology to examine how health-related policy agendas are adopted in low-income countries, using Tanzania as a case study. Semi-structured, in-depth, key informant interviews with 11 policy-makers were conducted on perspectives of the agenda-setting process and its actors. Kingdon's stream theory was chosen as the lens through which to interpret the data analysis. This study demonstrates that while stakeholders each have ways of influencing the process, the power to do so can be assessed based on three major factors: financial incentives, technical expertise, and influential position. Since donors often have two or all of these elements simultaneously a natural power imbalance ensues, whereby donor interests tend to prevail over recipient government limitations in prioritization of agendas. One way to mediate these imbalances seems to be the initiation of meaningful policy dialogue. In Tanzania, the agenda-setting process operates within a complex network of factors that interact until a "policy window" opens and a decision is made. Power in this process often lies not with the Tanzanian government but with the donors, and the contrast between latent presence and deliberate use of this power seems to be based on the donor ideology behind giving aid (defined here by funding modality). Donors who used pooled funding (PF) modalities were less likely to exploit their inherent power, whereas those who preferred to maintain maximum control over the aid they provided (ie, non-pooled funders) more readily wielded their intrinsic power to push their own priorities. © 2016 by Kerman University of Medical Sciences.

Policy and stakeholder analysis of infant and young child feeding programmes in Sri Lanka.

PubMed

Godakandage, Sanjeeva S P; Senarath, Upul; Jayawickrama, Hiranya S; Siriwardena, Indika; Wickramasinghe, S W A D A; Arumapperuma, Prasantha; Ihalagama, Sathyajith; Nimalan, Srisothinathan; Archchuna, Ramanathan; Umesh, Claudio; Uddin, Shahadat; Thow, Anne Marie

2017-06-13

Infant and young child feeding practices (IYCF) play a critical role in growth and development of children. A favourable environment supported by appropriate policies and positive contributions from all stakeholders are prerequisites for achieving optimal IYCF practices. This study aimed to assess the IYCF-related policy environment and role of stakeholders in policy making in Sri Lanka, in order to identify opportunities to strengthen the policy environment to better support appropriate IYCF and reduce childhood malnutrition. We mapped national level policy-related documents on IYCF, and conducted a stakeholder analysis of IYCF policy making. A matrix was designed to capture data from IYCF policy-related documents using a thematic approach. A narrative synthesis of data from different documents was conducted to achieve the first objective. We then conducted an analysis of technical and funding links of stakeholders who shape IYCF policies and programmes in Sri Lanka using the Net-Map technique, to achieve the second objective. A total of 35 respondents were purposively selected based on their knowledge on the topic, and individual interviews were conducted. Twenty four policies were identified that contained provisions in line with global recommendations for best-practice IYCF, marketing of breast milk substitutes, strengthening health and non-health systems, maternity benefits, inter-sectoral collaboration, capacity building, health education and supplementation. However, there is no separate, written policy on IYCF in Sri Lanka. Participants identified 56 actors involved in shaping IYCF policies and programmes through technical support, and 36 through funding support. The Government Health Sector was the most connected as well as influential, followed by development partners. Almost all actors in the networks were supportive for IYCF policies and programmes. All evidence-based recommendations are covered in related policies. However, advocacy should be targeted towards strategic support for IYCF in high-level policy documents. The stakeholder analysis confirmed a network led by the government health sector. Enhancing the multi-sectoral commitments stressed in policy documents is an opportunity to strengthen IYCF policy process in Sri Lanka.

Policy dialogue to improve health outcomes in low income countries: what are the issues and way forward?

PubMed

Nabyonga-Orem, Juliet; Dovlo, Delanyo; Kwamie, Aku; Nadege, Ade; Guangya, Wang; Kirigia, Joses Muthuri

2016-07-18

This paper has three objectives: to review the health development landscape in the World Health Organization African Region, to discuss the role of health policy dialogue in improving harmonisation and alignment to national health policies and strategic plans, and to provide an analytical view of the critical factors in realising a good outcome from a health policy dialogue process. Strengthening policy dialogue to support the development and implementation of robust and comprehensive national health policies and plans, as well as to improve aid effectiveness, is seen as a strategic entry point to improving health sector results. However, unbalanced power relations, the lack of contextualised and relevant evidence, the diverse interests of the actors involved, and the lack of conceptual clarity on what policy dialogue entails impact the outcomes of a policy dialogue process. The critical factors for a successful policy dialogue have been identified as adequate preparation; secured time and resources to facilitate an open, inclusive and informed discussion among the stakeholders; and stakeholders' monitoring and assessment of the dialogue's activities for continued learning. Peculiarities of low income countries pose a challenge to their policy dialogue processes, including the chaotic-policy making processes, the varied capacity of the actors and donor dependence. Policy dialogue needs to be appreciated as a complex and iterative process that spans the whole process of policy-making, implementation, review and monitoring, and subsequent policy revisions. The existence of the critical factors for a successful policy dialogue process needs to be ensured whilst paying special attention to the peculiarities of low income countries and potential power relations, and mitigating the possible negative consequences. There is need to be cognisant of the varied capacities and interests of stakeholders and the need for capacity building, and to put in place mechanisms to manage conflict of interest. The likelihood of a favourable outcome from a policy dialogue process will depend on the characteristics of the issue under consideration and whether it is contested or not, and the policy dialogue process needs to be tailored accordingly.

The Soviet Population Policy Debate: Actors and Issues,

DTIC Science & Technology

1986-12-01

the usual fertility and mortality trends, he gave estimates of their effect on the size of the working age population NO 25 - (20-59 years of age) in...toward limitation of family size . [621 Litvinova, a vocal member of the differentiated-policy school, published again in the journal of her institute...Ryabushkin regretted that population had not been incorporated in the system of concepts and categories expressing the optimum planning mechanism. [15

Perception Is Reality: Special Operations Forces In the Gray Zone

DTIC Science & Technology

2016-06-01

politics, policy, bureaucracy, and military action is complex, for simplicity this research assumes all players are rational actors who will maximize...Gray Zone—the primary tool being Special Operation Forces (SOF). This research finds that policymakers and others outside of SOF have often misapplied...effect on the ability of the Unites States to reach its foreign policy goals. This research analyzes U.S. SOF employment in the Gray Zone, breaking down

The benefits of setting the ground rules and regulating contracting practices.

PubMed Central

Kadaï, Abatcha; Sall, Farba Lamine; Andriantsara, Guy; Perrot, Jean

2006-01-01

In recent years, health systems have increasingly made use of contracting practices; despite results that are often promising, there have also been failures and occasionally harsh criticism of such practices. This has made it even more necessary to regulate contracting practices. As part of its stewardship function, in other words its responsibility to protect the public interest, the ministry of health has the responsibility of introducing the tools needed for such regulation. Several tools are available to help it do this. Some of them, such as standard contracts or framework contracts, useful as they may be, are nevertheless specific and ad hoc. Contracting policies, when carefully linked to overall health policies, are undoubtedly the most comprehensive of these tools, since they enable contracting to be accommodated within the management of the health system as a whole and thus take into account its potential contribution to improving health system performance. However, the requirements for success are not present automatically and it has to be ensured that there are mechanisms for vitalizing these regulatory mechanisms and that the key actors make proper use of the framework laid down by the ministry of health. The first three authors of this article have participated in the preparation and implementation of national policies on contracting in their own countries, viz. Chad, Madagascar and Senegal. PMID:17143464