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Summary Health Policies at EU Level and Global Health Europe
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EPH3022 EXAMCase 1 + related lecture(s)
● Policy analysis is about assessing a situation to see if it’s a problem,
analysing a problem to understand its drivers, engaging stakeholders
to set political agendas, leveraging science to implement solutions
● Policy definition → a deliberate system of guidelines to guide
decisions and achieve rational outcomes; a statement of intent and is
implemented as a procedure or protocol (generally adopted by a
governance body within an organisation)
● According to Buse:
– Actor → short-hand term used to denote any participant in the policy
process that affects policy, including individuals, organisations,
groups and even the government
– Content → substance of a particular policy which details its
constituent parts
– Context → systemic factors — political, economic, social or cultural,
both national and international — which may have an effect on health
policy
– Epistemic community → policy community market by shared political
values, and a shared understanding of a problem and its causes
– Ideas → the values, evidence, anecdote and argument that shape
policy, including the way a policy problem or solution is presented
– Interest → what an actor or group stands to gain or lose from a policy
change
– Institutions → the ‘rules of the game’ determining how government
and the wider state operate. Institutions can be formal structures and
procedures, but also informal norms of behaviour that may not be
written down
– Policy → broad statement of goals, objectives and means that create
the framework for activity. Often take the form of explicit written
documents, but may also be implicit or unwritten
– Policy elite → specific group of policy makers who hold high positions
,–
in a policy system, and often have privileged access to other top
members of the same, and other, organizations
– Policy makers → those who make policies in organisations such as
central or local government, multinational companies or local
businesses, clincs or hospitals
– Policy process → the way in which policies are initiated, formulated,
developed, negotiated, communicated, implemented and evaluated
● A few policy terminologies:
● Policy environment → complex arena in which policy process occurs
including government, political parties, society, organisation, culture,
media, public opinion etc.
● Policymakers → major players, elites, or key stakeholders in the policy
environment
● Policy actor → short-hand term used to denote individuals,
organisations or even the state and their actions that affect policy.
● Policy content → substance of a particular policy which details its
constituent parts
● Policy process → the way in which policies are initiated, developed,
negotiated, communicated, formulated, implemented and evaluated
● At the core of all public health policy is a singular mission towards
health
● Law vs policy:
– Law → set standards, principles, procedures that must be followed by
society / for the people / implementing justice
– Policy → only documents that can lead to law / made in the name of
the people / reflected the public opinion / a means to an end
● The analysis of policy context explains the feasibility, relevance and
appropriateness of the policy
● The health policy analysis triangle → content + context + process form
the outer triangle, inside there’s the actors
,● Categorisation of systemic factors (context):
– Situational factors → ‘focusing events’ such as war, droughts — might
be one-off occurence like earthquake
– Structural factors → unchanging elements of society (political system,
type of economy, empoyment base, ageing populations, country’s
wealth)
– Cultural factors → religion, formal hierarchies, position of ethnic
minorities, linguistic differences
– International or exogenous factors → inter-dependence between
states, national, regional or multilateral organisations
● Types of health reforms:
– Health care financing reforms → securing sustainable financing for
healthcare
– Health care provision reforms → adopting essential clinical and public
health packages
– Resource generation reforms → having equality, quantity and balance
of human resources for health
– Governance reforms → ensure the strengthening of policy and
planning functions, setting standards for health care provision and
development of appropriate systems for monitoring performance,
introducing new management policies and practice, defining national
and provincial disease priorities and introducing effective health
interventions
● Measures that can be done in the healthcare system → privitisation;
decentralisation:
– Deconcentration → less centralised approach which allows to be
closer to regional/local neeeds
, – Delegation → certain powers are given to other actors on a lower level,
but they still have to interact with the national actor that gave them
the powers
– Devolution → involves a full transfer of power and responsibility — the
sub-authority does not need to answer back to the state authority
anymore
● Principle of subsidiarity → a principle of social organisation that holds
that social and political issues should be dealt with at the most
immediate or local level that is consistent with their resolution
● The Ideal Clinic Realisation and Maintenance (ICRM) programme:
– National government → policy development, resource allocation,
monitoring and evaluation
– Provincial government → main implementing agency
– Local government → responsible for municipal health services
● Purpose of a health system → improving health through ensuring
goodness, fairness and generating resources/responsiveness, equity,
efficiency
● Approaches to the policy-making process:
– Rationalist approach → decision-making process is linear and rational;
based on information collection related to problems and alternative
solutions
– Incrementalist approach → looks at existing situation and where to go
from there — more interactive process of mutual adjustment
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