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AGP knowledge clip chapter 1: The health policyframework
Policy
A policy problem has different factors:
1. A gap between the ideal world and the current reality
2. The reason for difference is unclear
3. There is more than one possible solution for the problem
Policy = problem +end + means
a purposive course of action followed by an actor or set of actors in dealing with a
problem or matter concern
Public policy = government policy where the government chooses to do or not to do
Policy instruments
- Judicial: legislation
- Economic: subsides/taxes
- Communication: persuasion
- Modern: self-regulation
Policy is made on the highest level of a company/ministry etc.
Health policy triangle (1) (simple model)
Health policy triangle (2)
Actors:
- Individuals, organizations, groups
- Inside government: members of parliament, ministers etc.
- Outside government: groups that do not seek political power but may seek influence
o Civil society organizations (church)
o Pressure/interest groups
o Non-governmental organizations
o Privat sector companies
o International organization
o Social movements
3 levels:
1. Macro: political
2. Meso: institutional
, 3. Micro: societal
The influence of actors:
Agency the power or capacity of actors to act independently and make their own choices
Structure the arrangements which limit the choices available to specific actors
Context:
- Situational factors
o Focusing event
o Violent event (war)
o Earthquake
o HIV epidemic
- Structural factors
o Political system
o Type of economy
o Technology etc
- Cultural factors
o Religion
o Values
- International / exogenous factors
o National/regional/multilateral organizations
o Due to international organizational diseases can be limited
Data analysis
Actor chart
Labelling
Causal analysis
Process:
1. Problem identification
a. Explores how and why some problems gen on the agenda and some not.
2. Policy formulation
a. Explores how policies are arrived, agreed and how they are communicated.
3. Policy implementation
a. Most neglected phase. But one of most important phases.
4. Policy evaluation
a. Identifies what happens once a policy is put into effect.
feedback to everything
Summary
In this chapter you have been introduced to definitions of policy and health policy and an
analytical framework of context, process, and actors (the ‘policy triangle’), to help you make
sense of the politics which affect the policy making process. You have learned that the policy
triangle can be used both retrospectively – to analyse past policy, and prospectively – to help
shape existing policy. Many of the concepts you have been introduced to will be expanded
and illustrated in the chapters that follow.
, Knowledge clip chapter 2: Power and the policy process
Power – relational concept the ability to influence people and to control resources
- Where there is power, there is conflict (different opinions etc.)
Easton’s model how should it
work
Governmental power is the
biggest power we have
(health system)
Goods, services vaccines
etc
Demands, support people that need it
Rational model (Simon) to maximize the value
Policymakers logically move through a series of steps
1. Policy maker is faced with a particular problem
2. Goals, values, or objective is clarified and ranked
3. Various alternative solutions are considered
4. Costs and benefits of each alternative are investigated
5. Each alternative and its costs and benefits are compared with other alternatives
6. Policy makers chooses the alternative that has highest benefits (highest quality
lowest costs)
Critics:
- Whose goals and values are used?
- The problem definition is not always clear
- Not all possible strategies can be considered
- It is impractical, in the real world there is no budget or there are time constraints
How does it really work when power is involved?
The government has power at everything. They have influence on big institutions but also on
the smaller such as the doctors who treat you. Knowledge is research for powerplay.
Who are in the place of exercising power?
Who has power?
It is based on access to: (Dahl)
- Cash
- Holding official office
- Managing staff
- Control over information
Global multinational companies have most money and a lot of power
Three dimensions of power
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