Chaire Approches communautaires et inégalités de santé (CACIS), C.P. 6128, Succursale Centre-ville, Montréal, Québec H3C 3J7, Canada; Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), C.P. 6128, Succursale Centre-ville, Montréal, Québec H3C 3J7, Canada; Département de Médecine sociale et préventive, École de santé publique de l'Université de Montréal (ESPUM), C.P. 6128, Succursale Centre-ville, Montréal, Québec H3C 3J7, Canada; Regroupement stratégique Politiques publiques et santé des populations, Réseau de recherche en santé des populations du Québec, Pavillon 7101 du Parc, 7101 ave du Parc 3e étage, Montréal, Québec H3N 1X7, Canada.
Département de science politique de l'Université du Québec à Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec H3C 3P8, Canada; Regroupement stratégique Politiques publiques et santé des populations, Réseau de recherche en santé des populations du Québec, Pavillon 7101 du Parc, 7101 ave du Parc 3e étage, Montréal, Québec H3N 1X7, Canada.
Soc Sci Med. 2017 Mar;177:69-77. doi: 10.1016/j.socscimed.2017.01.048. Epub 2017 Jan 24.
National policies on global health appear as one way that actors from health, development and foreign affairs sectors in a country coordinate state action on global health. Next to a burgeoning literature in which international relations and global governance theories are employed to understand global health policy and global health diplomacy at the international level, little is known about policy processes for global health at the national scale. We propose a framework of the policy process to understand how such policies are developed, and we identify challenges for public health researchers integrating conceptual tools from political science. We developed the framework using a two-step process: 1) reviewing literature to establish criteria for selecting a theoretical framework fit for this purpose, and 2) adapting Real-Dato's synthesis framework to integrate a cognitive approach to public policy within a constructivist perspective. Our framework identifies multiple contexts as part of the policy process, focuses on situations where actors work together to make national policy on global health, considers these interactive situations as spaces for observing external influences on policy change and proposes policy design as the output of the process. We suggest that this framework makes three contributions to the conceptualisation of national policy on global health as a research object. First, it emphasizes collective action over decisions of individual policy actors. Second, it conceptualises the policy process as organised interactive spaces for collaboration rather than as stages of a policy cycle. Third, national decision-making spaces are opportunities for transferring ideas and knowledge from different sectors and settings, and represent opportunities to identify international influences on a country's global health policy. We discuss two sets of challenges for public health researchers using interdisciplinary approaches in policy research.
国家全球卫生政策似乎是卫生、发展和外交部门的行为体在国家一级协调全球卫生行动的一种方式。除了越来越多的文献利用国际关系和全球治理理论来理解国际层面的全球卫生政策和全球卫生外交之外，对于国家层面的全球卫生政策进程知之甚少。我们提出了一个政策进程框架，以了解这些政策是如何制定的，并确定了将政治学概念工具整合到公共卫生研究中的挑战。我们使用两步法制定了该框架：1）审查文献，以确定适合该目的的理论框架的标准，2）调整 Real-Dato 的综合框架，以在建构主义视角内纳入公共政策的认知方法。我们的框架确定了多个背景作为政策进程的一部分，侧重于行为体共同努力制定国家全球卫生政策的情况，将这些互动情况视为观察政策变化的外部影响的空间，并提出政策设计作为该进程的输出。我们认为，该框架为将全球卫生国家政策作为研究对象的概念化做出了三个贡献。首先，它强调集体行动而不是个别政策行为者的决策。其次，它将政策进程概念化为协作的有组织互动空间，而不是政策周期的阶段。第三，国家决策空间是从不同部门和环境转移思想和知识的机会，也是确定国际对一国全球卫生政策影响的机会。我们讨论了两组公共卫生研究人员在政策研究中采用跨学科方法所面临的挑战。
