Prospective policy analysis: how an epistemic community informed policymaking on intentional self poisoning in Sri Lanka
Prospective policy analysis: how an epistemic community informed policymaking on intentional self poisoning in Sri Lanka
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DOI：
10.1186/1478-4505-8-19
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发表时间：
2010-01-01
影响因子：
4
通讯作者：
Buckley, Nicholas A.
中科院分区：
文献类型：
--
作者：
Pearson, Melissa;Zwi, Anthony B.;Buckley, Nicholas A.
背景资料：政策分析往往是回顾性的，不太适合帮助决策者决定做什么;相比之下，前瞻性政策分析旨在帮助制定对具有挑战性的公共政策问题的反应。自杀在斯里兰卡是一个主要的公共卫生问题，摄入杀虫剂是主要方法。以前的政策干预措施通过限制获得毒性最大的农药而降低了死亡率。方法：前瞻性政策分析包括两个阶段。第一种方法是在一个定义明确的政策社区内使用共识活动来生成和制定政策选项。第二个项目扩大了分析范围，纳入了其他利益攸关方。我们报告了来自农业，卫生和学术界的七个参与者的共识活动。通过两轮讨论沿着确定了政策备选方案，并由每位与会者对每一备选方案的支持程度进行评分。数据进行了定量分析和讨论分析与Nvivo 8代码突出和经常性的themes.Results：主要的发现是两个建议的强烈支持和共识：进一步规范农药和新的想法重新包装农药成非致命剂量。与会者确定了支持未来政策变化的若干因素，包括强有力的立法框架，农业、卫生和学术界之间的良好联系，以及与工业界的合作关系。确定的障碍和潜在的威胁，政策变化包括政治干预，跨部门合作的困难，可接受的选项，社区，在农村社区的实施困难和降低mortality.Conclusions的挑战：在这个认知社区的政策选择的发展和考虑反映了赞赏和理解的许多因素，可以促进或阻碍政策的变化。对背景、证据和想法、实施和影响的理解影响了参与者如何考虑和评价这些选项。使用认识型社区行为者可以确定对每个选项的支持程度，帮助阐述背景的特殊性以及思想的力量和影响力。进一步审查这些备选办法的潜在障碍和机会，将确定是否能够达成更广泛的共识，让更广泛的利益攸关方参与，并促进政策变革。
Background: Policy analysis is often retrospective and not well suited to helping policy makers decide what to do; in contrast prospective policy analysis seeks to assist in formulating responses to challenging public policy questions. Suicide in Sri Lanka is a major public health problem, with ingestion of pesticides being the primary method. Previous policy interventions have been associated with reduced mortality through restricting access to the most toxic pesticides. Additional means of reducing access are still needed.Methods: The prospective policy analysis comprised two stages. The first used a consensus activity within a well defined policy community to generate and frame policy options. The second broadened the analysis to include other stakeholders. We report the consensus activity with seven actors from agriculture, health, and academia. Policy options were identified through two rounds of discussion along with ratings by each participant on their degree of support for each option. Data were analysed quantitatively and discussions analysed with Nvivo 8 to code prominent and recurrent themes.Results: The main finding was the strong support and consensus for two proposals: further regulation of pesticides and the novel idea of repackaging pesticides into non-lethal doses. Participants identified several factors that were supportive of future policy change including a strong legislative framework, good links between agriculture, health and academia, and a collaborative relationship with industry. Identified barriers and potential threats to policy change included political interference, difficulties of intersectoral collaboration, acceptability of options to the community, difficulty of implementation in rural communities and the challenge of reducing mortality.Conclusions: The development and consideration of policy options within this epistemic community reflected an appreciation and understanding of many of the factors that can facilitate or thwart policy change. The understanding of context, evidence and ideas, implementation and impact influenced how the participants considered and rated the options. Use of epistemic community actors identified the level of support for each option, helped elaborate the particularities of context, as well as the power and influence of ideas. Further examination of the potential barriers and opportunities for these options will determine if broader consensus, involving a wider range of stakeholders, can be achieved and policy change promoted.