Crichton Joanna
African Population and Health Research Center, Nairobi, Kenya.
Health Policy Plan. 2008 Sep;23(5):339-50. doi: 10.1093/heapol/czn020. Epub 2008 Jul 24.
Policies relating to contraceptive services (population, family planning and reproductive health policies) often receive weak or fluctuating levels of commitment from national policy elites in Southern countries, leading to slow policy evolution and undermining implementation. This is true of Kenya, despite the government's early progress in committing to population and reproductive health policies, and its success in implementing them during the 1980s. This key informant study on family planning policy in Kenya found that policy space contracted, and then began to expand, because of shifts in contextual factors, and because of the actions of different actors. Policy space contracted during the mid-1990s in the context of weakening prioritization of reproductive health in national and international policy agendas, undermining access to contraceptive services and contributing to the stalling of the country's fertility rates. However, during the mid-2000s, champions of family planning within the Kenyan Government bureaucracy played an important role in expanding the policy space through both public and hidden advocacy activities. The case study demonstrates that policy space analysis can provide useful insights into the dynamics of routine policy and programme evolution and the challenge of sustaining support for issues even after they have reached the policy agenda.
与避孕服务相关的政策（人口、计划生育和生殖健康政策）在南方国家往往得不到国家政策精英的有力支持或持续承诺，导致政策演变缓慢并影响实施。肯尼亚的情况就是如此，尽管该国政府在早期致力于人口和生殖健康政策方面取得了进展，并且在20世纪80年代成功实施了这些政策。这项关于肯尼亚计划生育政策的关键信息人研究发现，由于背景因素的变化以及不同行为体的行动，政策空间先缩小，然后开始扩大。在20世纪90年代中期，国家和国际政策议程中对生殖健康的优先重视程度减弱，这导致政策空间缩小，影响了避孕服务的获取，并导致该国生育率停滞不前。然而，在21世纪中期，肯尼亚政府官僚机构内的计划生育倡导者通过公开和隐蔽宣传活动在扩大政策空间方面发挥了重要作用。该案例研究表明，政策空间分析可以为常规政策和项目演变的动态以及即使问题已进入政策议程后仍维持对这些问题支持的挑战提供有用见解。
