Department of Public Health, Aarhus University, Aarhus, Denmark.
Faculty I, Sociology, University of Siegen, Siegen, Germany.
Int J Health Plann Manage. 2023 Sep;38(5):1135-1141. doi: 10.1002/hpm.3686. Epub 2023 Jul 21.
The COVID-19 pandemic has pushed health policy frontstage and exposed the stark differences in government capacities to respond to the crisis. This has created new demands for comparative heath policy to support knowledge creation on a large scale. However, comparative health policy has not necessarily been well prepared; studies have focused on health systems and used typologies together with descriptive, quantitative methods. This makes it difficult to capture the multi-level nature of health policy, the diverse actors involved and the many societal facets of governance performance. We argue for broadening the perspective to include health policy as a bottom-up process with diverse interests. This calls for expanding the methodology of comparative health policy by also using approaches that make greater use of explorative, qualitative research. We introduce possible developmental pathways to illustrate what this may look like. The Pan-European Commission shows how to broaden the definition of comparative health policy, notably as transnational and planetary. The gender analysis matrix illustrates how comparative health policy can strengthen its assessment of performance by focussing on gender equity. The street-level bureaucrat framework highlights how analysing frontline work can help conduct small-scale bottom-up comparisons of health policy. Together, these developmental pathways demonstrate the potential to broaden comparative health policy towards greater responsiveness to the societal performance of governments, such as social inequalities created by the COVID-19 pandemic. This also opens opportunities for strengthening the global outlook of comparative health policy.
新冠疫情大流行将卫生政策推到了前台,暴露出各国政府应对危机的能力存在明显差异。这对比较卫生政策提出了新的要求,需要大规模支持知识创造。然而,比较卫生政策可能还没有做好充分的准备;研究主要集中在卫生系统上,并使用了分类法和描述性、定量方法。这使得比较卫生政策难以捕捉卫生政策的多层次性、所涉及的多样化行为体以及治理绩效的众多社会层面。我们主张拓宽视角,将卫生政策纳入具有不同利益相关者的自下而上的过程。这需要通过采用更多利用探索性、定性研究的方法来扩展比较卫生政策的方法。我们介绍了可能的发展途径来说明这可能是什么样子。泛欧委员会展示了如何扩大比较卫生政策的定义,特别是将其作为跨国和全球性的政策。性别分析矩阵说明了比较卫生政策如何通过关注性别平等来加强其对绩效的评估。街头官僚框架强调了分析一线工作如何有助于对卫生政策进行小规模的自下而上的比较。这些发展途径共同展示了将比较卫生政策拓宽,以更好地应对政府的社会绩效的潜力,例如新冠疫情造成的社会不平等。这也为加强比较卫生政策的全球视野提供了机会。