Multi-Sectoral Approach to Noncommunicable Disease Prevention Policy in Sub-Saharan Africa: A Conceptual Framework for Analysis

Abstract

Conceptual frameworks for health policy analysis guide investigations into interactions between institutions, interests, and ideas to identify how to improve policy decisions and outcomes. This review assessed constructs from current frameworks and theories of health policy analysis to (1) develop a preliminary synthesis of findings from selected frameworks and theories; (2) analyze relationships between elements of those frameworks and theories to construct an overarching framework for health policy analysis; and then, (3) apply that overarching framework to analyze tobacco control policies in Togo and in South Africa. This Comprehensive Framework for Multi-Sectoral Approach to Health Policy Analysis has 4 main constructs: context, content, stakeholders, and strategies. When applied to analyze tobacco control policy processes in Togo and in South Africa, it identified a shared goal in both countries to have a policy content that is compliant with the provisions of international tobacco treaties and differences in strategic interactions between institutions (e.g., tobacco industry, government structures) and in the political context of tobacco control policy process. These findings highlight the need for context-specific political mapping identifying the interests of all stakeholders and strategies for interaction between health and other sectors when planning policy formulation or implementation.

Towards a framework for multisector and multilevel collaboration: case of HIV and AIDS governance in South Africa

“…There has been more focus on the design of multisector collaborations and what they require, with very limited reflection on the implementation process and its challenges. All except three frameworks [5,26,41] offer an explanation of the process of collaboration. Except for the three frameworks [5,26,41] and the approach defined Multisector collaboration also requires regular interaction to identify synergies and areas of collaboration Evaluation…”

“…Also noted as a gap in the existing frameworks is that most authors, other than Rasanathan, Bennett [3], draw lessons and conclusion about mulitsectoral action based on a generic instead of a specific case. Furthermore, only one framework [41] provides evidence of being developed and applied to a case study (e.g. Togo and South Africa).…”

“…Buy-in to the process of collaboration is a crucial factor in driving implementation (or not) and ultimately determines success. While the donor community (World Bank and International Monitory Fund) played a critical role advocating for adoption of the Governing multisector action for health [3] Multisector governance for health [9] Multisector action for health [8] Multi-sectoral approach to NCD Prevention [41] Definition of MSA Governing multisector action for health [3] Multisector governance for health [9] Multisector action for health [8] Multi-sectoral approach to multisector approach on HIV in most African countries, implementation was poor in some countries where there was lack of country ownership of the process. Buy-in to implement multisector action and ownership of the process is essential amongst stakeholders and sectors involved in a collaborative.…”

Comprehensive primary health care and non-communicable diseases management: a case study of El Salvador

“…The rapid rise in NCDs is predicted to impede poverty reduction initiatives in low-income countries, particularly by increasing household costs associated with health care. The multifactorial aetiology of NCDs [6] implies the need for the implementation of integral, intersectoral [7] and political strategies through accountability for health impact [8]. Health in all policies [9] involve an explicit concern for health in all areas of public policy.…”

Trends in the proportionate mortalities attributed to noncommunicable diseases in sub‐Saharan Africa for the period 2000 to 2016

“…Under the MSA approach, interventions for NCDs in SSA requires collaborative efforts of multiple stakeholders such as government, civil sectors, academia, industry, private sector, and nongovernmental organizations. [14][15][16][17] For example, policies on tobacco control, exercise, and healthy diets will require concerted efforts of lawmakers, private sector and food processing companies. However, one bottleneck in MSA for NCDs in SSA is that some nontraditional public health stakeholders are not aware of the problem of NCDs and do not know their potential contribution to NCD prevention and control.…”