Modelling the Health Policy Process: One Size Fits all or Horses for Courses?

Abstract

A range of conceptual models for understanding the policy process have been applied to the health policy process, largely in particular sub areas or policy domains such as public health. However, these contributions appear to offer different rationales and present different frameworks for understanding the policy process. This Editorial critically examines articles that explore the health policy process with models from wider public policy and from health policy. It can be seen that very few of the ‘wider models have been applied in studies of the health policy process. Conversely, some models feature in studies of the health policy process, but not in the wider policy process literature, which suggests that literature on the health policy process is semi-detached from the wider policy process literature. There seem to be two very different future research directions: focusing on ‘home grown’ models, or taking greater account of the wider policy process literature. Does ‘one size fit all’ or is it ‘horses for courses’?

Perceptions of key stakeholders on taxes on tobacco and alcohol products in Nepal

“…In terms of allocations of revenues from health taxes to specific activities, there are a number of effective efforts from other countries that can be replicated. For example, Turkey has earmarked some of its tobacco tax revenues to help tobacco farmers shift to other crops 24. Youth smoking prevention and cessation programmes and Alcohol Anonymous-type efforts are some other examples of prevention programmes health tax revenues can finance.…”

“…Our analysis of the context, key actors and processes follows the Health Policy Analysis Triangle framework 23. The framework assumes that an understanding of policy should be informed by an analysis of policy context, content, process and actors, with actors at the centre of the triangle 24. We used NVivo software to organise and analyse the data 25…”

Doing Health Policy Analysis: The Enduring Relevance of Simple Models Comment on "Modelling the Health Policy Process: One Size Fits All or Horses for Courses"

“…At least some of the public policy models recommended by Powell and Mannion 1 were developed in decades past, and so it is appropriate to consider whether they adequately address the complex forces currently influencing health policy processes in LMICs and elsewhere. These include “complex cross-border, inter-organizational and network relationships, with policies influenced by global decisions as well as by domestic actions” (p. 309).…”

“…These pieces have raised interesting points about the role of theory in such analysis, the bodies of theory used and how to deepen future research through the use of different theoretical lenses. Reflecting on the existing research, particularly in low- and middle-income countries (LMICs), the editorial’s authors 1 specifically argue that this health policy analysis is “semi-detached” from wider policy process research, and could be strengthened by applying the “conceptually stronger” public policy models. Using these models would, they suggest, generate better understanding and explanations of health policy processes.…”

Is It Time to Explore the Health Policy Process Within Governance and Health Systems Frameworks? Comment on "Modelling the Health Policy Process: One Size Fits All or Horses for Courses?"

“…John 2 has highlighted the abundance of approaches to explaining and understanding policy-making and noted that there is little agreement about what a model of the policy process should look like. For Powell and Mannion 1 the key question is whether analysis of the health policy process constitutes a sufficiently distinct and self-contained area of analysis. They suggest that "There seem to be two very different future research directions: focusing on 'home grown' models, or taking greater account of the wider policy process literature" (p. 4) asking "Does 'one size fit all' or is it 'horses for courses'?"…”