Doctoral Dissertation Research: The Making and Circulation of a Policy in Bolivia

博士生Alissa Bernstein（加州大学伯克利分校）将在Charles Briggs博士的指导下，对公共政策的制定和实施之间的关系进行研究。虽然这两个过程通常被认为是不同的阶段，但伯恩斯坦将探索它们可能紧密交织在一起的可能性，作为一个电路相互通知。这项研究将深入了解新的政策理念是如何产生的，以及它们如何改变根深蒂固的做法并改善结果。为了调查这些问题，Bernstein将对玻利维亚主要医疗改革政策Salud Familiar Communitaria Intercultural （SAFCI）的规划、制定、修订和实施进行为期12个月的研究。研究人员将研究这项政策是如何形成的，并可能改变，因为它在玻利维亚卫生保健系统的不同部门内流通。数据将在两个公共诊所和两个工人健康保险诊所收集。研究人员将采用各种社会科学方法，包括民族志访谈、参与性观察和流行病学分析。作为一种制度人种学，这项研究将在办公室、会议、研讨会和诊所进行，这些地方可能会产生、辩论、传播、修订和实施政策。本文的主要研究问题是：(1)改革决策过程是否真正具有协作性？如果是这样，谁参与其中，这种方法如何影响政策的形成？(2)特定部门或社区的背景如何影响政策的解释、重写和实施使用的方式？(3)改革政策实施的一些可衡量的成果是什么？哪些领域面临问题或阻力？除了对社会科学理论作出贡献外，这项研究的结果将在卫生领域和其他领域得到实际应用。这项研究的创新之处在于，它不仅着眼于政策结果，而且采用了一种新颖的方法来理解政策形成的过程。虽然在这些关于公共政策的辩论中经常被边缘化，但许多观察家认为，拉丁美洲最近产生了一些最具创造性的想法，并进行了重大的普遍变革，这使得玻利维亚成为追求这些问题的理想场所。资助这项研究也支持了研究生的教育。

Doctoral student Alissa Bernstein (University of California, Berkeley), with the supervision of Dr. Charles Briggs, will undertake research on the relationship between the making of public policy and its implementation. While the two processes generally are regarded as distinct phases, Bernstein will explore the possibility that they may be closely intertwined, informing each other as a circuit. This study will offer insights into how new policy ideas emerge and how they may alter entrenched practices and improve outcomes. To investigate these questions, Bernstein will conduct a twelve-month study of the planning, making, revising, and implementing of major health reform policy in Bolivia, Salud Familiar Communitaria Intercultural (SAFCI). The researcher will examine how this policy is shaped and possibly changed as it circulates within different sectors of the Bolivian health care system. Data will be gathered at two public clinics and two worker health insurance clinics. The researcher will employ a variety of social science methodologies, including ethnographic interviews, participant observation, and epidemiological analysis. As an institutional ethnography, the research will be carried out in offices, meetings, conferences, workshops, and clinics where policies may be generated, debated, circulated, revised, and implemented.The overarching research questions are: (1) Can the reform policy-making process be truly collaborative? If so, who is involved and how does this approach impact the form of policy that emerges? (2) How does the context of a particular sector or community shape the ways that policy is interpreted, rewritten, and implemented for use? (3) What are some of the measurable outcomes of reform policy implementation and what areas are facing problems or resistance? In addition to contributing to social science theory, findings from this research will have practical application, in the health field and beyond. This study is innovative in that it looks not just at policy outcomes, but also takes an original approach to understanding processes of policy formation. Though often marginalized in these debates about public policy, many observers argue that Latin America has recently generated some of the most creative ideas and undertaken significant pervasive transformations, which makes Bolivia an ideal site for pursuing these questions. Funding this research also supports the education of a graduate student.