Health policy and other policies (economical, political) have an impact on health. Policies are made by policy makers/policy elite in the private sector (non-governmental) and in the public sector (governmental). Health policy can be both private and public. When making health policies, it is important to keep external determinants in mind such as transport of food, pharmaceuticals and tobacco. Programs are the embodiment of policies.
The health policy triangle is a simplified representation of inter-relationships that may help to think systematically about different factors affecting policy.
Actors influence the policy process at the local, national, regional and/or international level. Context refers to systemic factors which may have an effect on health policy. They can be categorized (Leichter, 1979) in:
Situational factors: transient situations (epidemic, earthquake)
Structural factors: unchanging element of society (economical, political)
Cultural factors: relatively unchanging element (religion, ethnicity)
International or exogenous factors: international cooperation (WHO, programs)
Process refers to the way in which policies are initiated, developed, implemented and evaluated. They can be categorized (Sabatier and Jenkins-Smith, 1993) in:
Problem identification and issue recognition
Policy formulation: who/how
Policy implementation
Policy evaluation: effectiveness, monitoring, consequences
Additional notes (lecture)
Health policy: steering the health system in a direction.
Parliament: yes/no to laws. Cabinet: enforces laws, puts them into practice
Chapter 2
Power is the ability to achieve a desired result irrespective of the