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EPH3022: Health Policies at EU Level and Global Health Europe > Case 3: Balancing power ensuring voice of stakeholders: leadership approaches in health policy making and analyzing > Flashcards

Case 3: Balancing power ensuring voice of stakeholders: leadership approaches in health policy making and analyzing Flashcards

1
Q

What is a cause group?

A

interest/pressure group whose main goal is to promote a particular issue or cause

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2
Q

What is civil society?

A

part of society between the private sphere of the family or household and the sphere of government.

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3
Q

What is influence in health policy?

A
  • outcome of power in policy process
  • Basically: extent to which an actor is capable to persuade/intimidate others into making decisions
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4
Q

Why is infleunce important for health policy?

A
  • Reflection of one’s interest in - priorisitation, agenda setting, policy contents, implementation, adapatation, etc.
  • Can be seen in every phase of policy cycle/policy process.
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5
Q

What is importance in health policy?

A

indicates level of priority given to satisfying diverse stakeholders interests in a policy.

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6
Q

Why is importance relevant for health policy?

A
  • Higher important people = need to prioritise in higher level to satisfy them.
  • E.g. important of media is different from importance from ministers so you need to prioritise the importance so it is the gradation of prioritisation.
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7
Q

What is interest in health policy?

A

perception of actors about assumtpions/benefits related to a policy, be it financial, value-based, cultural, social equity, etc

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8
Q

Why is interest important for health policy?

A
  • E.g. if government does this, it could be beneficial for my business or maybe risky.
  • Kind of assumption/perception based on previous experience or maybe there is no previous experience but then they assume something that could happen.
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9
Q

What is policy environment?

A

complex arena in which policy process occurs including government, political parties, political system, society, organisation, culture, media, state of public opinions/voice, etc.

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10
Q

What are policymakers?

A

major players in policy environment who are involved in making policy

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11
Q

What are policy elites?

A
  • small group of power using personnel within government and/or outside government who appear as actors of making decisions.
  • Have access to each and every level of the government.
  • Have high power!
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12
Q

What are policy actors?

A

individuals, groups, organisations (local/global), or even the state who are capable of influencing steps of policy process

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13
Q

What can actors be included as?

A

Actors may be included as policy makers and/or elites

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14
Q

Do policy actors have power?

A

Holds perceived or actual power to influence policy process and contents.

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15
Q

What is a stakeholder?

A

Individual/group who can affect the achievement of an organisation’s objectives or who is affected by the achievement of an organisation’s objectives

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16
Q

What are primary stakeholders?

A
  • those primarily affected, either + or - by policy intervention and/or outcomes.
  • Directly invoved!
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17
Q

Who do primary stakeholder groups include?

A

Groups mainly include:
* shareholders
* employees
* customers
* suppliers
* public sector: governments & communities that provide infrastructure, regulate organisational activity, & enforce taxes.

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18
Q

What are secondary stakeholders?

A

not directly affected by policy but may be involved directly or indirectly in the decision making.

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19
Q

Who do secondary stakeholder groups include?

A
  • competition
  • media
  • trade associations
  • support groups (special interest)
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20
Q

What are key stakeholders?

A
  • can significantly influence OR
  • important to the success of implementing intervention
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21
Q

Draw a stakeholders map of banning of tobacco production & sales

A

See q1 doc
* Energy invested to satisfy the primary stakeholders will be much higher than secondary stakeholders.
* Think about who my primary & secondary stakeholders are.

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22
Q

What are core attributes of identifying stakeholders?

A

Power & legitimacy

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23
Q

How shold stakeholder relationships be evaluated?

A

In terms of the attributes of power, legitimacy & urgency

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24
Q

What is power?

A

Relationship among parties whereby one party can get another party to do something they would not have originally intended to do → power is temporary

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25
Q

Is power a variable or a stable state?

A

Due to its nature, power is a variable & not a stable state, & is therefore temporary: it can be gained or lost.

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26
Q

Why is power used?

A

to protect each actor’s own interests & preferences rather than to pursue legitimate public policy goals.

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27
Q

Give an example about how power is used in health policy

A
  • E.g. impossible to stop tobacco exporting, selling, importing, production, etc of tobacco products because other issues arise such as many people being unemployed, a lot of tobacco related tax will be reduced.
  • So solution → ask people not to smoke, advise, raise awareness of harms of smoking, motivate them instead of closing the entire tobacco market.
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28
Q

How does power impact the policy cycle?

A

Power can be excised + or - in each and every phase of policy cycle/process.

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29
Q

What are the sources of power?

A

Power may derive from nature of the:

  • Political structure of a state
  • Organisational culture
  • social/poltical/organisaitonal position of actors (e.g. minister) or informal relations (patronage)
  • Control over resources
30
Q

What is legitimacy?

A

Socially accepted norms & behaviours & is integrated with power when society evaluates relationships, & legitimacy is an assumption that an entity’s actions are desirable, applicable, and socially accepted.

31
Q

Explain legitimacy

A

if a firm has a legitimate standing in society, or a stakeholder has a legitimate claim on a firm, if it doesn’t have power to enforce its will or a perceived urgent claim, they would not fall within a manager’s salience.

32
Q

What is urgency?

A

Extent to which stakeholder claims require immediate attention& exists only when two conditions are encountered:
* when a claim is of a time sensitive nature
* when the claim is significant to the stakeholder.

33
Q

What is an interest (pressure) group?

A

type of civil society group that attempts to influence the policy process to achieve specific goals

34
Q

What are interest groups involved in health policy?

A
  • Staff, e.g. medical, nursing , health proffessionals (e.g. physio, etc)
  • Providers such as hospital associations
  • Insurers e.g. sickness funds
  • Payers e.g. employers associations
  • Different groups of patients
  • Suppliers e.g. pharmaceutical companies & medical equipment manufacturers.
35
Q

What are the types of interest groups?

Check if have all interest groups

A
  • Sectional groups
  • cause groups
36
Q

What is a sectional group?

A

main goal to protect & enhance interests of their members and/or of section of society they stand for.

37
Q

Give examples of sectional interest groups

A
  • trade unions
  • employers associations
  • bodies representing the professions.
38
Q

What is a cause group?

A

main goal to promote an issue/cause & whose membership is open to anyone who supports the cause without necessarily having anything to gain personally if the cause is successful.

39
Q

What are stratgies & relaitons to the state?

A
  • insider groups (IG)
  • outsider groups (OG)
40
Q

What are insider groups?

A

Groups which aren’t officially part of machinery of government but are regarded as:

  • legitimate by government policy makers
  • are consulted regularly
  • are expected ot play by the ‘rules of the game’.
41
Q

What are outsider groups?

A

either organisations that reject close involvement in government processes on strategic grounds or have been unable to gain reputation as legitimate participants in the policy process.

42
Q

*How do different democratic systems and contextual factors influence policy making?

double check this

A
  • Liberal democracy
  • liberal systems
  • theory of pluralism
  • elitist system
  • authoritarian - inegalitarian
  • populist
  • egalitarian system
  • inegalitarian system
  • traditional inegalitarian
43
Q

Explain how liberal democracy infleunces policymaking

A
44
Q

Explain egalitarian - authoritarian with regards to liberal democracy and how it influences policymaking

A
  • egalitarian = equal
  • authoritarian = in which the ruling authority (generally a single person)” is maintained in power
45
Q

What are liberal systems & how does it influence policymaking?

A

are participatory & certain actors can have more power than the state itself (eg. the tobacco industry) → state should intervene & regulate market

46
Q

What is the theory of pluralism?

A

view that power is widely dispersed throughout society such that no group holds absolute power.

47
Q

What is an elitist system & how does it influence policymaking

A

policy making process dominated by an elite group of people which influences the outcomes, more likely to be the case in countries with high inequalities & that are authoritarian (eg Russia, China)

48
Q

What is authoritarian - inegalitarian and how does it influence policymaking?

A
  • Varying degrees of representation & lacks voice of people.
  • Examples: in the mid - 1980s over 50% Sub-Saharan African states.
49
Q

What is a populist & how does it infleunce policymaking?

A
  • Populist: single/dominant political party(s)
  • Highly nationalist & leadership tends to be personalized.
  • Elites keep influence on the government
  • E.g: post colonial independent states of Africa and South America
50
Q

What is the difference between a egalitarian and inegalitarian system?

A
  • Egalitarian system: more equal
  • Inegaliatrian: no human rights, one single leader
51
Q

What is the traditional inegalitarian?

A
  • ruled by traditional monarchs (king), provides few opportunities for participation (eg. Saudi Arabia, not the case of UK or NL where the monarchs are not ultimate rulers and owners of the state).
  • It relies heavily on the private sector.
52
Q

What does a political system indicate?

A

Indicates where the power is.

53
Q

What power do stakeholders have?

A

Stakeholders have varying degrees of power to influence outcomes - and also to decide which other stakeholders may be invited to participate and to what extent.

54
Q

What are the 3 dimensions of power?

A
  • Power as decision making
  • Power as non-decision making
  • Power as thought control
55
Q

Explain power as decision making

A

focuses on acts of individuals & groups which influence policy decisions.

56
Q

Explain power as non-decision making

A

Not about decision making but a preliminary power

57
Q

Explain power as thought control

A

function of ability by shaping their preferences (persuading people to vote/do something even if it is not in their interests)

58
Q

How do you balance power?

A
  • Transparency
  • Involving multiple stakeholders
  • opportunities for feedback
  • participation in management of resources
  • those with power are hesitant to give up some of it
59
Q

What are policy risks?

A
  • every policy carries levels or risks and they can be identified through research (eg. risk of bias).
  • risks are defined as potential negative consequences/unintended outcomes stemming from a policy proposal.
60
Q

How do policy risks arise?

A
  • from incomplete information,
  • unforeseen circumstances,
  • unintended consequences during policy implementation.
61
Q

*How to reduce policy risks?

A
62
Q

*What are assumptions?

A
  • a policy cannot satisfy all stakeholders’ interests
  • risk assumption management: meetings with multiple stakeholders, reach compromise/ consensus, developing a causal map, a power-interest matrix
  • policy assumptions, rooted in cultural, social, or political factors, shape the design and implementation of policies, influencing their effectiveness
63
Q

What does the success of an intervention in meetings its objective depend on?

A

On the acceptance of change by a wide range of parties, not just those involved in implementing the programme in view.

64
Q

What is a stakeholder analysis?

A

Identification of key stakeholders, an assessment of their interests, how those interests may affect a policy process & outcome & ways to manage/balance those in order to optimise satisfaction & achieving goals.

65
Q

How do you categorise stakeholders based on influence & importance?

A

Stakeholder analysis?

66
Q

What is the key leadership objective of stakeholder analysis?

A

Understanding & balancing the voice of interest groups

67
Q

Why do a stakeholder analysis?

A
  • Assess interests of stakeholder in relation to policy probelm
  • Identify conflicts of interests between stakeholders for assessing risk/assumption
  • Identify relations between stakeholders for enabling ownership & cooperation within the different interest groups.
  • Helps to assess the appropriate type of participation by different stakeholders at successive stages of the project (i.e., policy cycle)
68
Q

What are the 3 steps of a stakeholder analysis?

A
  1. drawing up a “stakeholder table” including stakeholder, type (primary/secondary), interests & assumptions/risks
  2. Assessment of each stakeholder’s importance and relative power/influence & interest
  3. identifying risks & assumptions which will affect the policy design, implementaiton & success
69
Q

Explain step 1 of the stakeholder analysis

A
  • Identify all potential stakeholders, their interest in relation to the problems to be addressed & the relative priority to give to each stakeholder in meeting their interests.
  • stakeholder
  • type (primary/secondary)
  • interests
  • assumptions/risks

must analyse context & stakeholders interest!

see table q7

70
Q

Exlain step 2 of the stakeholder analysis

A

ranked according firstly to the extent to which they can influence the performance of the project and its “success”, & extent to which their problems and interests are the concern of the donors or other parties sponsoring the project - i.e. deciding to provide resources and defining the objectives at the higher levels.

see table q7

71
Q

What are the strategies to address different power & interest groups for a stakeholder analysis?

A
  • High power - high interest people must be fully engaged. This group is the one that organisations will work with closely.
  • High power - low interest people need to be involved
  • Low power - high interest people need to be kept well informed & consulted.
  • Low power - low interest people should be monitored/informed but they may not want to become heavily involved in the organisations work.

see table q7

72
Q

What is step 3 of the stakeholder analysis?

A

identifying risks & assumptions which will affect the policy design, implementaiton & success

EPH3022: Health Policies at EU Level and Global Health Europe (6 decks)

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