College of Medicine, University of the Philippines Manila, Manila, Philippines
Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK.
BMJ Glob Health. 2020 Nov;5(11). doi: 10.1136/bmjgh-2020-002661.
Policy is shaped and influenced by a diverse set of stakeholders at the global, national and local levels. While stakeholder analysis is a recognised practical tool to assess the positions and engagement of actors relevant to policy, few empirical studies provide details of how complex concepts such as power, interest and position are operationalised and assessed in these types of analyses. This study aims to address this gap by reviewing conceptual approaches underlying stakeholder analyses and by developing a framework that can be applied to policy implementation in low-and-middle income countries.
The framework was developed through a three-step process: a scoping review, peer review by health policy experts and the conduct of an analysis using key informant interviews and a consensus building exercise. Four characteristics were selected for inclusion: levels of knowledge, interest, power and position of stakeholders related to the policy.
The framework development process highlighted the need to revisit how we assess the power of actors, a key issue in stakeholder analyses, and differentiate an actor's potential power, based on resources, and whether they exercise it, based on the actions they take for or against a policy. Exploration of the intersections between characteristics of actors and their level of knowledge can determine interest, which in turn can affect stakeholder position on a policy, showing the importance of analysing these characteristics together. Both top-down and bottom-up approaches in implementation must also be incorporated in the analysis of policy actors, as there are differences in the type of knowledge, interest and sources of power among national, local and frontline stakeholders.
The developed framework contributes to health policy research by offering a practical tool for analysing the characteristics of policy actors and tackling the intricacies of assessing complex concepts embedded in the conduct of stakeholder analyses.
政策是由全球、国家和地方各级的一系列利益相关者制定和影响的。虽然利益相关者分析是评估与政策相关的行为者的立场和参与情况的公认实用工具，但很少有实证研究详细说明如何在这些类型的分析中操作和评估权力、利益和立场等复杂概念。本研究旨在通过审查利益相关者分析背后的概念方法，并开发一个可应用于中低收入国家政策实施的框架来解决这一差距。
该框架是通过三步过程开发的：范围审查、卫生政策专家的同行审查以及使用关键知情人访谈和共识建立练习进行分析。选择了四个特征纳入其中：与政策相关的利益相关者的知识、利益、权力和地位水平。
框架开发过程强调了需要重新评估我们评估行为者权力的方法，这是利益相关者分析中的一个关键问题，并根据资源区分行为者的潜在权力，以及他们是否根据他们为或反对政策采取的行动来行使它。探索行为者特征与其知识水平之间的交叉点可以确定利益，这反过来又会影响利益相关者对政策的立场，表明一起分析这些特征的重要性。必须在政策行为者的分析中纳入自上而下和自下而上的方法，因为国家、地方和一线利益相关者之间在知识、利益和权力来源方面存在差异。
所开发的框架通过提供一种实用工具来分析政策行为者的特征，并解决利益相关者分析中嵌入的复杂概念的评估复杂性，为卫生政策研究做出了贡献。
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