Health Policy how its made and how to influence it

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Health Policy how its made and how to
influence it

• Johanna Hanefeld Health Policy Unit
• London School of Hygiene and Tropical Medicine
• Johanna.Hanefeld_at_lshtm.ac.uk

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Outline

• Definition
• Introduction of some main concepts
• Where to intervene and some tools
• Changing international health policy an example

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Whats policy

• Decisions taken by those with responsibility for
  a particular area, such as health.
• Often this refers to a written document

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How is it made

• Can be made by the government, or in the private
  sector
• Policy made by the government is referred to as
  public policy
• Policy can be made at every level, national,
  provincial (state) or district

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Health Policy

• Action or (inaction) that affect institutions,
  funding, resources and services relating to the
  health system.
• Other factors that impact peoples health, e.g.
  tobacco
• Health policy may cover private or public
  policies about health
• Made by government, a private party, or
  international bilateral and multilateral bodies

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How policy changes the policy process

• Stages or Cycle
• Problem identification/agenda-setting
• Policy formulation
• Policy implementation
• Policy evaluation

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But,

• The reality is often messy

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Policy triangle

• What factors are important to understand, analyse
  and influence this process

Context
Actors
Content
Process
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Context

• Situational factors
• Structural factors
• Cultural factors
• Global factors

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Policy Content

• Objectives aims
• Assumptions
• Values
• Distributional impact

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Process

• Why do issues reach the agenda?
• Who formulates policy?
• How is policy implemented?
• What makes policies change?

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Actors

• The state
• Multilateral organisations
• The market
• Civil society
• Networks

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Where to intervene

• Issue recognition Bring the issue onto the
  agenda make it a problem
• Policy formulation - ensure evidence is
  considered and best options are selected
• Policy implementation monitor and hold
  accountable. Ensure that
• Policy evaluation outcomes

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How to do this policy analysis

• Example Planning to ban smoking in public spaces
  in UK or USA
• Content
• What are the components and costs of the policy?
• Context (Historical and international)
• Increasing evidence of harm of tobacco smoke,
  secondhand smoke
• Increasing burden of chronic disease e.g.
  cancers
• Other country bans (e.g. Ireland)
• Context (Situational)
• Decreasing population of smokers, reduced public
  acceptance of smoking
• Financial problems to care for smoking related
  diseases
• Actors
• Who will support? Who will resist? How to
  neutralise?
• Process
• How is public health policy made at country level
  (US vs UK)?
• Are there paths for compromise?

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Campaign examples

• UNGASS 5
• Universal Access
• Others

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• Thank you and good luck!