What is Public Health Policy ?
Health policy according to the World Health Organization, refers to plans, actions and decisions that are taken to achieve specific health care goals in a society.
There are factors that interplay to define which is finally adopted, knowing the various concept of public policy will enhance the quality of advocacy and lead to better overall results.
CONCEPTS IN PUBLIC HEALTH POLICY
Globalization : Globalization Refers to the free movement of, services, goods and people across the world in a seamless and integrated manner. Globalization can be thought to be the result of the opening up of the global economy and the concomitant increase in trade between nations. The world as they say is gradually becoming a global village and the need of synergy has become highly imperative, globalization allows nations especially developing countries to leverage on the strength of thriving economies and collaborate in a manner that helps in finding solutions to political, social and economic challenges.
Countries in Africa and other emerging markets have leverage on the power of great nations like United States, United Kingdom, India and China in the area of health care and infrastructure in order to bridge the gaps that exist, such mutual collaborations has greatly enhanced the living standards and general well-being of the population of such countries. Globalization has made it much earlier for cost effective generic drugs to from India to reach needy markets in Africa saving millions of lives in the process.
Policy Agenda: refers to a set of issues and problems that gets the serious attention of people involved in policymaking (e.g., government officials, government decision-makers) with a view of taking some sort of action.
Understanding these concept will enable public health practitioners as interested parties in public health policy seek ways of ensuring that issues, problem or subject that affect their members, and practice makes it into the policy agenda so that these issues can get the desired attention.
Policy Stream: The set of possible policy solutions or alternatives developed by experts, politicians, bureaucrats and interest groups with the activities of those interested in these options (Eg. debates between researchers).
A clear understanding of policy stream can save time and resources because these set of alternatives provides options to policy makers because it provides a clear view of pathways available and how they interact to create a window of opportunity for policy change.
Policy Windows: These are points in time when the opportunity arises for an issue to come on to the policy agenda and be taken seriously with a view of taking action. In practice , participants in the policy process rarely move from the identification of an issue or problem to seeking possible solutions. For example hand sanitation and hygiene promotion have been canvassed for ages in Nigeria but was never taken serious by the authorities until the recent outbreak of Ebola. This prompted the government to adopt the National hygiene policy.
Health Policy Triangle: Walt and Gibson proposed the health policy triangle as a way of systematically thinking about all the different factors at play in policy making.
The health policy triangle is a highly simplified approach to a complex set of inter – relationships, and may give the impression that the four factors can be considered separately.
Top-down implementation theory: This approach views policy formation and policy execution as two distinct activities. Policies are agreed and decided at higher levels of an organization and then communicated to subordinate levels which are then given the responsibility of putting policy into practice.
In developing countries, the culture over the years have tended towards the top bottom implementation process which researches have found to be encumbered with a lot of limitation. Understanding the intricacies and inadequacies of this concepts will enable policy makers as well as interested groups to either seek alternatives or strive to meet the pre-conditions that will ensure that policy implementation will be effective under this approach.
Bottom-up implementation theory: This system recognizes that individuals at lower levels of authority are likely to play an active part in implementation and may have some discretion to reshape objectives of the policy and change the way it is implemented.
As one of the successful models in policy implementation, understanding this theory and the benefits that come with implementing it is a key ingredient especially for project managers. For instance the involvement of local actors in population and social interest groups in a project adopting the bottom-up approach will ensure participation and mobilization of the local population which will help in the identification of the strengths and weakness of the area and the drawing up a local development strategy that will ensure the effective implementation of the policy.
Principal-agent theory: under this theory an agency relationship is defined as a contract under which one or more individuals engage another Person referred to as ” agent” under this context to perform some form of duty or service on their behalf which will involve some form of transfer of some decision-making authority to the agent,”
The principal-agent models may be employed to elucidate central problems in interaction between principals and agents in both policy implementation and public policy-making concerning performance and remuneration, furthermore, Principal-agent theory can be used to better understand and resolve dilemmas associated with so called ‘information asymmetries’ between two sets of players – principals and agents – who frequently have divergent motivations, goals and attitudes to risk.
Transaction Cost Economics Theory: this states that the efficient production of goods and services depends on lowering costs of transactions between buyers and sellers by removing as much uncertainty as possible on both sides and Maximizing the ability of the buyer to monitor and control transaction.
Uncertainty leads to volatility therefore the removal of as much uncertainty as possible will reduce the tendency to over speculate thereby minimizing cost of transaction improving and enhancing profitability across board which is the main reason why firms exist.
Policy Evaluation: Policy Evaluation Identifies what happens once a policy is put into effect – how it is monitored, whether it achieves its objectives and whether it has unintended consequences.
The rising growth and increase in the significance of evaluation reflects the rising interest in ensuring that public programs are appropriate, efficient and effective. Findings from policy evaluation also helps to determine if policies should be changed or terminated and whether new policies should be introduced.
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