Intro

Question 1

Policy making defined

Answer 1

“A purposeful course of action followed by an actor or set of actors in dealing with a problem or matter of concern.”
Anderson, 1973

“A series of more or less related activities and their intended and unintended consequences for those concerned.” Walt, 1994

“The authoritative allocation of values” Easton, 1953

Question 2

The policy process - all about change

Answer 2

“there is only one constant in this universe, and that
constant is… Change” - Eistein
• Change involves a political struggle
– Some people win, others lose out
• Political struggle involves power
• Policy analysis focuses on How? Who? And Why? – not What

Question 3

Change is political

Answer 3

• Politics as “who gets what, when, and how” (Lasswell, 1936);
• Politics as competing interests/values;
• Policy decisions not just about technical evidence concerns;
• Policy making is about deciding on what society should be like. Science cannot tell you this (Brecht, 1959).

Question 4

Question of how policy change actually happens

Answer 4

‘Rational’ view – policy change follows a system of clear steps.
• Problem is identified, values/goals decided, alternatives considered, choice is made, decision is implemented
• Stages Heuristic: Problem identification -> agenda setting -> policy formulation -> policy implementation -> policy evaluation

OR

• Incrementalism. Policy change often consists of small changes and adjustments to existing policies
  – Dynamic models – focus on policy change as occurring over time, resulting from shifting processes (e.g. changes in balance of power between groups, windows of opportunity opening, etc.)
  • E.g. Kingdon’s 3 streams model, Sabatier’s Advocacy Coalitions Framework – addressed later in term.

Question 5

Health policy analysis

Answer 5

• Content analysis or process analysis?
• Content analysis focuses on the ‘What’ questions:
– What is the policy goal?
– What interventions are recommended? – How is it financed?
• Process analysis – How/Why?
– Howdidtheissuegetontheagenda?
– Why did change happen at particular times (and not at
others)?
– Why not other alternatives?

Question 6

The Walt and Gilson Health Policy Framework (1994)

Answer 6

3 triangles: 
Context: 
• Situational factors • Structural factors • Cultural factors
• Global factors
Content: 
• Objectives&aims
• Assumptions •Values
• Distributional impact
Process:
• Why do issues reach the agenda? • Whoformulatespolicy?
• How is policy implemented?
• Whatmakespolicieschange?

And

Actors:
• The state
• The market • Civil society

Question 7

Evidence based policy movement

Answer 7

• Evidence-Based Policy movement often calls for ‘what works’
• ‘What works’ implies generalisability (external validity) - it works everywhere and always

– Experimentation ensures internal validity
– it worked there
– Not external validity – it will work (in the same way) elsewhere
– Nor policy relevance – It will work for us here *

Question 8

Male Circumcision for HIV prevention in Malawi

Answer 8

• Resisted as a national policy (embraced elsewhere e.g. Kenya)
– History of colonisation and dominance of groups
– Historyofcontestationforpowerbetweengroups – Importance and meaning of circumcision for those
groups.
• Majority Chewa do not circumcise,
• Historical contestation for power between Chewa and Yao (and other) groups
• Circumcision used as an ethnic identifier
• Past president was Muslim – fears over
‘islamification’ were heard
• Perception of a ‘donor agenda’ – history of
donor dependence and external influence on agendas