Based on the policy science literature, we formulate nine core questions that can guide the formulation, negotiation, development and implementation of Health in All Policies (HiAP). Each question is grounded in the political and policy science literature and culminates in checklist items that HiAP developers must consider.
Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate.
Intersectoral policy networks may be effective in dealing with complex public health problems. Their performance is assumed to depend on network management and trust, as well as on integrated public health policy (i.e. policy coordination and integration). We studied the role of network management and trust in the realization of integrated public health policy and network performance, as well as the relation between integrated public health policy and network performance. In 34 Dutch local policy networks, we measured the perceptions of 278 actors through a Web-based survey and used regression analyses to assess the relations between policy variables. Management and trust were positively related to perceived integrated public health policy and network performance, while integrated public health policy was also positively related to perceived network performance. In public health, the performance of intersectoral policy networks may be improved by adequate network management, the creation of trust and policy coordination and integration. Future research could further explore the role of specific characteristics of the network manager, like the manager’s background, relation to the other actors and leadership style. Points for practitioners Regarding inter-sectoral policy networks in public health: first, when aiming for the realization of policy coordination and integration, the employment of network management strategies and the creation of trust are of importance for the network manager; and, second, when also aiming for the realization of network performance, the creation of policy coordination and integration is of additional importance for the network manager.
This paper suggests a new conceptual gaze at theorizing the policy process. Alternating between practical, empirical, and theoretical perspectives, we describe how the hybridization of Multiple Streams, Policy Network, and Frame theories leads to a juggling metaphor to describe the process. From the initiation of this research program, we found that the information our research yielded was vastly more complex and dynamic than what is generally reported in similar research. In particular we discovered that dynamic interactions between actors in the different (policy, problem, and politics) streams, when appraised through a policy network lens, produce different network configurations in each stream. We also found that Kingdon's “Policy entrepreneurs” are likely to engage more in shaping the problem stream network configuration (through the process Kingdon labels “alternative specification”—which requires great perspicacity with words) than in the other streams. We therefore postulate that hybridization of policy network theory with Multiple Streams theory would create a more powerful conceptual toolbox. This toolbox can be enhanced further by insights from network management conceptualisations and frame theory. Finally, we have embraced the criticism that has been voiced of the stages heuristic and proposes that a more useful metaphor for policy processes is juggling: those processes may appear chaotic, but keen discipline, coordination, and acuity are required for policy students and operators to keep all balls in the air.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.