Faculty of Social Sciences and History, Volda University College, Volda, Norway.
Department of Health Promotion and Development, University of Bergen, Bergen, Norway.
Int J Health Policy Manag. 2018 Nov 1;7(11):982-992. doi: 10.15171/ijhpm.2018.59.
Intersectoral action is often presented as essential in the promotion of population health and health equity. In Norway, national public health policies are based on the Health in All Policies (HiAP) approach that promotes whole-of-government responsibility. As part of the promotion of this intersectoral responsibility, planning is presented as a tool that every Norwegian municipality should use to integrate public health policies into their planning and management systems. Although research on implementing the HiAP approach is increasing, few studies apply a planning perspective. To address this gap in the literature, our study investigates how three Norwegian municipalities experience the use of planning as a tool when implementing the HiAP approach.
To investigate planning practices in three Norwegian municipalities, we used a qualitative multiple case study design based on face-to-face interviews. When analysing and discussing the results, we used the dichotomy of instrumental and communicative planning approaches, in addition to a collaborative planning approach, as the theoretical framework.
The municipalities encounter several dilemmas when using planning as a tool for implementing the HiAP approach. Balancing the use of qualitative and quantitative knowledge and balancing the use of structural and processual procedures are two such dilemmas. Other dilemmas include balancing the use of power and balancing action and understanding in different municipal contexts. They are also faced with the dilemma of whether to place public health issues at the forefront or to present these issues in more general terms.
We argue that the dilemmas experienced by the municipalities might be explained by the difficult task of combining instrumental and communicative planning approaches because the balance between them is seldom fixed.
跨部门行动常被视为促进人群健康和健康公平的关键。在挪威，国家公共卫生政策基于“健康融入所有政策”（Health in All Policies，HiAP）方法，倡导政府各部门共同承担责任。作为促进这种跨部门责任的一部分，规划被视为每个挪威城市都应采用的工具，以将公共卫生政策纳入其规划和管理系统。尽管有关实施 HiAP 方法的研究在不断增加，但很少有研究从规划角度进行。为了弥补这一文献空白，我们的研究调查了三个挪威城市在实施 HiAP 方法时如何将规划作为一种工具来使用。
为了调查三个挪威城市的规划实践，我们采用了基于面对面访谈的定性多案例研究设计。在分析和讨论结果时，我们使用了工具性和沟通性规划方法的二分法，以及协作规划方法作为理论框架。
这些城市在将规划作为实施 HiAP 方法的工具时遇到了一些困境。例如，平衡使用定性和定量知识，以及平衡使用结构性和程序性程序。其他困境包括平衡权力的使用，以及在不同的城市背景下平衡行动和理解。此外，他们还面临着将公共卫生问题置于首位还是更一般地提出这些问题的两难境地。
我们认为，城市所面临的困境可以用工具性和沟通性规划方法相结合的困难任务来解释，因为两者之间的平衡很少是固定的。
