All lectures Health Policies at EU Level and Global
Health Europe, EPH3022
1, Opening lecture
Polycrisis
Overlapping emergencies in which the whole becomes more dangerous than the
sum of parts.
2, The Context of Policy making
Policy
A broad statement of goals, objectives and strategies that enact frameworks for
actions.
Often it takes the form of explicit written documents but may also be implicit or
unwritten social practices.
Public policy – government policies
Private/organizational policy – policies of private organizations or entities
Health policy
One of the diverse social policies. It refers to:
Decisions on strategic direction in health (purpose oriented)
A set of principles guiding decision making
May cover both public and private policies about health
Often includes decision on which (international) standards use
Policy environment
Complex arena in which policy process occurs.
For example, governmental system, political parties, society, organization, culture,
media, public opinion etc.
Policymakers
Major players, elites, or key stakeholders in the policy environment.
Policy actors
Individuals, organizations or the state and their actions that affect policy.
Some policy actors can be involved in policy making, not all of them.
Policy content
Substance of a particular policy in which details its constituent parts.
The written outcomes of a policy process.
Policy process
The way in which policies are initiated, negotiated, communicated, formulated,
implemented, and evaluated.
,Policy context
Systemic factors such as political, economic, social, or cultural, both national and
international, which may have an effect on policy.
Health system
Health is a complex system. It’s an organization of parts/actors that are
interconnected for a specific purpose. To reach public health systems goals we need
sound public health policies.
o Stakeholders: patients, health providers, insurers, government, etc.
o Interconnections: compliance, collaboration, coordination
o Purpose and goals: responsiveness, equity, efficiency
Health is one of the basic human rights. Meaning people’s health is one of the prime
political, social, and economic agendas and responsibilities as well as a constitutional
mandate of all states.
Unorganized health system
Since ancient period when people tried to protect health and treat disease.
Organized health system
Nearly 140 years history influenced by power and interest of actors involved.
The Hammurabi code recognized the need of laws.
1. Heath service delivery
2. Actors: state, provider, patient, people, law, and order
3. Financing: method- Fee for services / user fees; equity; source
of financing- patient/state/mix?
Law
Formal – judiciary institution – for justice – enacted by law makers
Policy
Informal – government/private agency – for guidance – made by public/private/mix
, States roles in health policy:
Stewardship (governance and leadership)
Policy making and enforcing implementation
Setting priorities and standards
Provision
Regulating behaviours of providers
Articulating health in national development programmes
Multisectoral collaboration to put health agenda in institutions and organs
Generating and channelling resources
Ensuring compliance in the system (through regulatory framework)
Why health policy making is essential?
o Global diverse demographic transitions
o Globalization of power, politics, political economy
o Growing challenges on global to local health governors;
- Global health industry is 8% of world’s GDP
- Health expenditures leads to impoverishment of 100 million people/yr
- Shortage of health workforces
- Epidemiological transition (double/triple burden of diseases/pandemics)
- Resource shortage with inefficient use of resources
- Public-private hybridisation with weak regulation and corruption
- Controlling providers behaviour with payment systems
Types of policymaking:
Regulatory policy No policy
Service delivery policy Implicit idea-based policy
Financing policy Evidence-based policy
Policy of reformation Democratic versus autocratic policy