Berlan David, Buse Kent, Shiffman Jeremy, Tanaka Sonja
Askew School of Public Administration and Policy, Florida State University, 650 Bellamy, Tallahassee, FL 32306-2250, USA The Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland American University, Washington, DC, USA
Askew School of Public Administration and Policy, Florida State University, 650 Bellamy, Tallahassee, FL 32306-2250, USA The Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland American University, Washington, DC, USA.
Health Policy Plan. 2014 Dec;29 Suppl 3:iii23-34. doi: 10.1093/heapol/czu060.
Policy formulation and adoption are poorly understood phases of the health policy process. We conducted a narrative synthesis of 28 articles on health policy in low- and middle-income countries to provide insight on what kinds of activities take place in these phases, the actors crafting policies and the institutions in which policy making occurs. The narrative synthesis involved an inductive process to identify relevant articles, extract relevant data from text and reach new understandings. We find that actors exercising decision-making power include not just various governmental entities, but also civil society, commissioners, nongovernmental organizations and even clergy. We also find that most articles identified two or more distinct institutions in which policy formulation and adoption occurred. Finally, we identify seven distinct activities inherent in policy formulation and adoption: generation of policy alternatives, deliberation and/or consultation, advocacy of specific policy alternatives, lobbying for specific alternatives, negotiation of policy decisions, drafting or enacting policy and guidance/influence on implementation development. Health policy researchers can draw on these categories to deepen their understanding of how policy formulation and adoption unfolds.
政策制定和采纳是卫生政策过程中鲜为人理解的阶段。我们对28篇关于低收入和中等收入国家卫生政策的文章进行了叙述性综述，以深入了解这些阶段会开展哪些活动、制定政策的行为主体以及进行决策的机构。叙述性综述涉及一个归纳过程，以确定相关文章、从文本中提取相关数据并达成新的理解。我们发现，行使决策权的行为主体不仅包括各种政府实体，还包括民间社会、委托方、非政府组织甚至神职人员。我们还发现，大多数文章确定了两个或更多不同的政策制定和采纳所涉及的机构。最后，我们确定了政策制定和采纳过程中固有的七种不同活动：生成政策备选方案、审议和/或磋商、倡导特定政策备选方案、游说特定备选方案、政策决策谈判、起草或颁布政策以及对实施发展的指导/影响。卫生政策研究人员可以利用这些类别来加深对政策制定和采纳过程的理解。
