Daire J, Khalil D
Faculty of Health Sciences, School of Public Health, Health Economics Unit, University of Cape Town; Faculty of Nursing, University of Cape Town.
Faculty of Nursing, University of Cape Town.
Malawi Med J. 2015 Dec;27(4):135-9.
The question of why most health policies do not achieve their intended results continues to receive a considerable attention in the literature. This is in the light of the recognized gap between policy as intent and policy as practice, which calls for substantial research work to understand the factors that improve policy implementation. Although there is substantial work that explains the reasons why policies achieve or fail to achieve their intended outcomes, there are limited case studies that illustrate how to analyze policies from the methodological perspective. In this article, we report and discuss how a mixed qualitative research method was applied for analyzing maternal and child health policies in Malawi. For the purposes of this article, we do not report research findings; instead we focus our dicussion on the methodology of the study and draw lessons for policy analysis research work. We base our disusssion on our experiences from a study in which we analyzed maternal and child health policies in Malawi over the period from 1964 to 2008. Noting the multifaceted nature of maternal and child health policies, we adopted a mixed qualitative research method, whereby a number of data collection methods were employed. This approach allowed for the capturing of different perspectives of maternal and child health policies in Malawi and for strengthening of the weaknesses of each method, especially in terms of data validity. This research suggested that the multidimensional nature of maternal and child health policies, like other health policies, calls for a combination of research designs as well as a variety of methods of data collection and analysis. In addition, we suggest that, as an emerging research field, health policy analysis will benefit more from case study designs because they provide rich experiences in the actual policy context.
为何大多数卫生政策未能实现其预期效果这一问题在文献中持续受到相当多的关注。鉴于政策意图与政策实践之间存在公认的差距，这就需要开展大量研究工作来了解促进政策实施的因素。尽管有大量工作解释了政策实现或未实现预期结果的原因，但从方法论角度说明如何分析政策的案例研究却很有限。在本文中，我们报告并讨论了如何运用混合定性研究方法来分析马拉维的母婴健康政策。就本文而言，我们不报告研究结果；相反，我们将讨论重点放在研究方法上，并为政策分析研究工作吸取经验教训。我们的讨论基于我们在一项研究中的经验，在该研究中我们分析了1964年至2008年期间马拉维的母婴健康政策。鉴于母婴健康政策具有多面性，我们采用了混合定性研究方法，即运用了多种数据收集方法。这种方法能够捕捉马拉维母婴健康政策的不同观点，并弥补每种方法的不足，尤其是在数据有效性方面。这项研究表明，与其他卫生政策一样，母婴健康政策的多维度性质要求结合多种研究设计以及各种数据收集和分析方法。此外，我们建议，作为一个新兴研究领域，卫生政策分析将从案例研究设计中获益更多，因为它们能在实际政策背景中提供丰富的经验。
