EPH 3022 Summary Case 1
Case 1 Summary: Public health policy: drivers of diversities across global health systems
Learning goals
1. Understanding the concept of policy and public health policy with examples.
2. Understanding distinction between concepts of law and policy
3. Understanding the concept of policy context with examples and developing solid concepts of understanding - why
context analysis is important prior making and analysing a policy. Developing skills of topic-based concept model of
policy context.
4. Understanding different types of health system reforms (in brief)
5. Participatory case study Georgia: involving in open discussion on the context of the case of health system reform policy
of post-Soviet Georgia addressing the key contextual factors which influenced the policymakers and ultimately policy
outcomes.
1) Understanding the concept of policy and public health policy with examples.
- Policy
o Broad statement of goals and statements
o Used as a field of activity, or to a specific proposal
o In form of a document or verbally
o May be made at many levels
Central or local government, multinational company or local business, in a school or a hospital
o Refers to the decisions taken or not taken by the people who are responsible for a particular policy area
E.g. health, environment, education or trade
o Health policy
Covers courses of action (and inaction) that affect the set of institutions, organisations, services and
funding arrangements of the health care system (both public and private)
Main goal: UHC (equity and financial protection)
o Public policy: soft synonym for public opinion or general will or consensus
- Private and public sectors
o Private: multinational conglomerates may establish policies for all their companies around the world, BUT local
companies to decide their own polices on condition of service
o Public: government policy or the policies of government agencies
- Example: Public health policy
o Anti tobacco regulation, alcohol policies
o Maastricht: recycle policies, catering services in UM
2) Understanding distinction between concepts of law and policy
- Public policy fused with law
o Law and policy became more or less synonymous
o Democratisation favoured public policy
Law sounded too official, unilateral, hierarchical, authoritative, policy more soft, more human.
o Law is too close to permanent for a liberal state → policy remains a continual part of the process (neverending
phenomenon)
o Agency law making sounds like an accusation that the government is about to violate the separation of powers
principle → policy more at home
o Policy is attractive because it holds hope that governments will be more participatory, not just at election
times
1
,EPH 3022 Summary Case 1
The main
difference: law is a final decision or a document made by the government after discussing the policy for the
Welfare of society. The policy is an outline of governmental plans
Policies are more informal and can change
3) Understanding the concept of policy context with examples and developing solid concepts of understanding – why
context analysis is important prior making and analysing a policy. Developing skills of topic – based concept model of
policy context.
- Health policy triangle
o Content: goals
o Process: agenda setting, policy formulation
o Context: structural, cultural, economic, etc. factors
- Highly simplified representation of a complex set of inter-relationships, and may give the impression that the four
factors can be considered separately
o Too little attention to other factors, that explain why and how policies change
- Can help to analyse or understand a particular policy or you can apply it to plan a particular policy
o Analysis of policy: retrospective, explanatory
o Analysis for policy: prospective
2
, EPH 3022 Summary Case 1
- Actors:
o Individuals (e.g. Nelson Mandela)
o Organizations (e.g. World Bank, multinational companies)
o State or government
- Actors may try to influence the policy process at the local, national, regional and international level
- power may be characterized by a mixture of individual wealth, personality, level of or access to knowledge, or
authority, but it is strongly tied up with the organizations and structures
Contextual factors that affect policy:
- situational factors: less transient or idiosyncratic conditions which may influence policy
o e.g. wars, droughts, earthquake, HIV epidemic
- structural factors: unchanging elements of society
o political system extent to which it is open or closed and the opportunities for civil society to participate in
policy discussions and decisions
o demographic features or technological advance; e.g. long-term care costs rise for countries with ageing
populations
technological change has increased with the increase of numbers of women giving birth by caesarean
o e.g. type of economy and the employment base
- Cultural factors
o Countries where formal hierarchy is important, can be difficult to question high officials
o Position of ethnic minorities or linguistic differences may lead to certain groups being poorly informed about
their rights, or services that do not meet their needs
o E.g. ethnic minorities or linguistic differences, religious factors
- International or exogenous factors
- Policy context: background against which policies are made
o Specific context: refers to previous policy decisions made and the influence of geographical location on the
implemented policy
- Structural context: refers to the actors’ position in governance, their interaction with other actors, actors’ roles and
responsibilities, and the availability of resources
- Wider context: refers to cultural, political and economic issues that influence the implementation
Link context to process: context of political form may influence how the policy process runs
Context may change – has an influence on how the policy is implemented and how well it works
3
Case 1 Summary: Public health policy: drivers of diversities across global health systems
Learning goals
1. Understanding the concept of policy and public health policy with examples.
2. Understanding distinction between concepts of law and policy
3. Understanding the concept of policy context with examples and developing solid concepts of understanding - why
context analysis is important prior making and analysing a policy. Developing skills of topic-based concept model of
policy context.
4. Understanding different types of health system reforms (in brief)
5. Participatory case study Georgia: involving in open discussion on the context of the case of health system reform policy
of post-Soviet Georgia addressing the key contextual factors which influenced the policymakers and ultimately policy
outcomes.
1) Understanding the concept of policy and public health policy with examples.
- Policy
o Broad statement of goals and statements
o Used as a field of activity, or to a specific proposal
o In form of a document or verbally
o May be made at many levels
Central or local government, multinational company or local business, in a school or a hospital
o Refers to the decisions taken or not taken by the people who are responsible for a particular policy area
E.g. health, environment, education or trade
o Health policy
Covers courses of action (and inaction) that affect the set of institutions, organisations, services and
funding arrangements of the health care system (both public and private)
Main goal: UHC (equity and financial protection)
o Public policy: soft synonym for public opinion or general will or consensus
- Private and public sectors
o Private: multinational conglomerates may establish policies for all their companies around the world, BUT local
companies to decide their own polices on condition of service
o Public: government policy or the policies of government agencies
- Example: Public health policy
o Anti tobacco regulation, alcohol policies
o Maastricht: recycle policies, catering services in UM
2) Understanding distinction between concepts of law and policy
- Public policy fused with law
o Law and policy became more or less synonymous
o Democratisation favoured public policy
Law sounded too official, unilateral, hierarchical, authoritative, policy more soft, more human.
o Law is too close to permanent for a liberal state → policy remains a continual part of the process (neverending
phenomenon)
o Agency law making sounds like an accusation that the government is about to violate the separation of powers
principle → policy more at home
o Policy is attractive because it holds hope that governments will be more participatory, not just at election
times
1
,EPH 3022 Summary Case 1
The main
difference: law is a final decision or a document made by the government after discussing the policy for the
Welfare of society. The policy is an outline of governmental plans
Policies are more informal and can change
3) Understanding the concept of policy context with examples and developing solid concepts of understanding – why
context analysis is important prior making and analysing a policy. Developing skills of topic – based concept model of
policy context.
- Health policy triangle
o Content: goals
o Process: agenda setting, policy formulation
o Context: structural, cultural, economic, etc. factors
- Highly simplified representation of a complex set of inter-relationships, and may give the impression that the four
factors can be considered separately
o Too little attention to other factors, that explain why and how policies change
- Can help to analyse or understand a particular policy or you can apply it to plan a particular policy
o Analysis of policy: retrospective, explanatory
o Analysis for policy: prospective
2
, EPH 3022 Summary Case 1
- Actors:
o Individuals (e.g. Nelson Mandela)
o Organizations (e.g. World Bank, multinational companies)
o State or government
- Actors may try to influence the policy process at the local, national, regional and international level
- power may be characterized by a mixture of individual wealth, personality, level of or access to knowledge, or
authority, but it is strongly tied up with the organizations and structures
Contextual factors that affect policy:
- situational factors: less transient or idiosyncratic conditions which may influence policy
o e.g. wars, droughts, earthquake, HIV epidemic
- structural factors: unchanging elements of society
o political system extent to which it is open or closed and the opportunities for civil society to participate in
policy discussions and decisions
o demographic features or technological advance; e.g. long-term care costs rise for countries with ageing
populations
technological change has increased with the increase of numbers of women giving birth by caesarean
o e.g. type of economy and the employment base
- Cultural factors
o Countries where formal hierarchy is important, can be difficult to question high officials
o Position of ethnic minorities or linguistic differences may lead to certain groups being poorly informed about
their rights, or services that do not meet their needs
o E.g. ethnic minorities or linguistic differences, religious factors
- International or exogenous factors
- Policy context: background against which policies are made
o Specific context: refers to previous policy decisions made and the influence of geographical location on the
implemented policy
- Structural context: refers to the actors’ position in governance, their interaction with other actors, actors’ roles and
responsibilities, and the availability of resources
- Wider context: refers to cultural, political and economic issues that influence the implementation
Link context to process: context of political form may influence how the policy process runs
Context may change – has an influence on how the policy is implemented and how well it works
3
