Political Analysis for Health Policy Implementation
Political Analysis for Health Policy Implementation
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DOI：
10.1080/23288604.2019.1625251
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发表时间：
2019-08-05
影响因子：
4.1
通讯作者：
Reich, Michael R.
中科院分区：
文献类型：
--
作者：
Campos, Paola Abril;Reich, Michael R.
任何改善卫生系统绩效的努力都必须解决政策实施方面的挑战。本文考察了实施的一个方面——卫生部门政策实施的政治，特别是利益相关者的管理，以帮助变革团队提高实现政策目标的机会。基于对低收入和中等收入国家卫生政策实施的政治分析和描述的文献扫描，我们提出了可能影响实施的六大类利益相关者群体：利益集团政治、官僚政治、预算政治、领导政治、受益人政治和外部行动者政治。涉众的类别可以重叠。我们研究了这些不同利益相关者类别的政治，然后给出了已发表案例研究的精选示例，这些案例研究显示了每个类别出现的实施挑战类型，以及实施者如何使用政治策略来管理特定的利益相关者群体和相关的政治过程。了解执行的政治层面可以帮助负责执行的人更有效地将政策付诸实践。理解和处理利益相关者之间的冲突、阻力和合作是管理实施过程的关键。系统和持续的政治分析可以帮助决策者和变革团队提高成功实施的机会。
Any effort to improve health system performance must address the challenges of policy implementation. This article examines one aspect of implementation-the politics of policy implementation for the health sector, particularly the management of stakeholders in order to help change teams improve the chances of achieving policy objectives. Based on a literature scan of political analyses and descriptions of health policy implementation in low- and middle-income countries, we propose six major categories of stakeholder groups that are likely to influence implementation: interest group politics, bureaucratic politics, budget politics, leadership politics, beneficiary politics, and external actor politics. The categories of stakeholders can be overlapping. We examine the politics of these different stakeholder categories, and then present selected examples of published case studies that show the types of implementation challenges that arise for each category and how implementers can use political strategies to manage specific stakeholder groups and related political processes. Understanding the political dimensions of implementation can help those responsible for implementation drive policy into practice more effectively. Understanding and addressing conflict, resistance and cooperation among stakeholders are key to managing the implementation process. Systematic and continuous political analysis can help decision makers and change teams improve the chances for successful implementation.