Health policy Flashcards
What is health policy
decisions, plans, and actions that are undertaken to achieve
specific health care goals within a society…it defines a vision
for the future …outlines priorities and the expected roles
of different groups; and it builds consensus and informs
people
green paper
Discussion document with proposals
White paper
Concrete proposals for legislative change
– Government Departments
bill
Draft Act is introduced in Parliament by a Minister, a Deputy Minister, or
MEC or deputy MEC
– Debated in relevant Committee e.g. Standing Committee for Health and Public
Hearing
– Deliberation in National Assembly and/or NCOP or Provincial Assembly
– Passed into an Act of Parliament
Regulations of the act
specifics of the act
examples of clinical policy
PPE policy
– Occupational TB policy
– Mental Health Policy
example of administrative policy
– Overtime policy
– Intern working hours policy
– Data Management Policy
policy triangle
context
content
process
actors
What does the ‘context’ component of the Policy Triangle refer to?
The ‘context’ component refers to the setting or environment in which the policy is developed and implemented. This includes political, economic, social, and cultural factors that can influence the policy process.
Who are the ‘actors’ in the Policy Triangle framework?
‘Actors’ refer to the individuals, organizations, and groups who are involved in the policy process. This includes policymakers, government agencies, non-governmental organizations, interest groups, and the public.
What does ‘content’ mean in the context of the Policy Triangle?
‘Content’ refers to the actual substance of the policy, including its goals, strategies, and the specific measures it proposes. This component focuses on what the policy aims to achieve and how it plans to do so.
What is meant by ‘process’ in the Policy Triangle framework?
‘Process’ refers to the way in which policies are formulated, implemented, and evaluated. This includes the steps taken, the procedures followed, and the interactions among different actors during the policy development cycle
Types of stakeholders
primary
secondary
tertiary
key
Primary stakeholders
those ultimately most affected, either positively
or negatively by an organization’s actions
Secondary stakeholders
the “intermediaries,” that is, persons or
organizations who are indirectly affected by an organization’s
actions
Tertiary stakeholders
those who will be impacted the least
Key stakeholders
those with significant influence upon or importance
within an organization; can also belong to the other groups
Process- The stages model
- agenda setting
- policy formulation
- policy implementation
-policy evaluation
Policy implementation
.* Most difficult
step
* Often great
policies in
writing, but poor
implementation
* LEADERSHIP
Barriers and Facilitators of policy
implementation
- health professional context
- patient context
- political and social context
- health organizational system context
- clinical practice guideline context
Why is leadership considered essential in health systems according to Frenk J. (2010)
Leadership is essential because it involves developing strategic vision, technical knowledge, political skills, and ethical orientation to lead complex processes of policy formulation and implementation. Without effective leaders, even the best-designed systems will fail.
What is one of the fault lines in health sector transformation identified by L. Rispel (2016)?
One of the fault lines is the tolerance of ineptitude and failures in leadership, management, and governance. This indicates a critical need for competent leadership to drive successful health sector transformation.
How do first-level leaders who directly supervise clinicians impact the implementation of evidence-based guidelines?
irst-level leaders who have strong expectations, provide support, and offer rewards for the use of organizational commitment can lead to an 11% increase in the implementation of evidence-based guidelines.
Approaches to implementation: Top down
– Policy decided at national level & translated into
operating instructions for use by lower level operatives
– Implementation a technical process conducted by
administrative agencies (Command & Control leadership
Approaches to implementation: Bottom up
– Implementing actors have own power, & re-make policy
through practice;
– They may undermine or enable achievement of central actors’
goals, and they often generate unexpected consequences
What is the top-down approach to implementation?
The top-down approach to implementation involves directives from higher levels of authority or leadership that are then executed at lower levels. It focuses on centralized decision-making, clear guidelines, and a hierarchical chain of command to ensure policies are implemented as intended.
What is the bottom-up approach to implementation?
The bottom-up approach to implementation emphasizes input and actions from lower levels of the organization or community. It involves engaging frontline workers, local stakeholders, and communities in the decision-making process, allowing for more flexibility and adaptation to local needs and contexts.
How do the top-down and bottom-up approaches differ in terms of decision-making and flexibility?
The top-down approach is characterized by centralized decision-making and a structured, hierarchical implementation process, which can ensure consistency but may lack flexibility. In contrast, the bottom-up approach involves decentralized decision-making with greater input from local levels, which can enhance flexibility and adaptability but may lead to inconsistencies.
4 essential PRACTICES for FRONTLINE
leaders
- ethical behaviour
-collective sense making - stakeholder analysis
- celebrate small wins
