How can the analysis of power and process in policy-making improve health outcomes?

An area that contributes to slow progress in achieving the health-related Millennium Development Goals is the analysis of how and why national health policies achieve less than expected, perform differently from expected, or even fail. This briefing paper from the Overseas Development Institute (ODI) argues that national health policies have received less attention than other areas and considers the factors influencing the patterns and effectiveness of health policy change. It then examines how can we move the agenda forward in order to improve health outcomes.

The authors highlight how policy analysis can contribute to meeting health objectives by untangling the complex forces of power and process that underpin change. They argue that health policy analysis has not been adequately developed and applied in low and middle income countries. Building a critical mass of networked researchers and policymakers provides the key to developing the field and improving its contribution to health outcomes. The document then examines what should be on a health policy agenda and provides an outline of commonly used policy frameworks including the Kingdon model of Agenda Setting, which helps make sense of how certain health issues get onto the government policy agenda. The Michael Lipsky’s Street Level Bureaucrats model, which is also explained as a method, examines what happens at the point where policy is translated into practice, in various human service bureaucracies.