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      ‘Doing’ health policy analysis: methodological and conceptual reflections and challenges

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          Abstract

          The case for undertaking policy analysis has been made by a number of scholars and practitioners. However, there has been much less attention given to how to do policy analysis, what research designs, theories or methods best inform policy analysis. This paper begins by looking at the health policy environment, and some of the challenges to researching this highly complex phenomenon. It focuses on research in middle and low income countries, drawing on some of the frameworks and theories, methodologies and designs that can be used in health policy analysis, giving examples from recent studies. The implications of case studies and of temporality in research design are explored. Attention is drawn to the roles of the policy researcher and the importance of reflexivity and researcher positionality in the research process. The final section explores ways of advancing the field of health policy analysis with recommendations on theory, methodology and researcher reflexivity.

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          Most cited references71

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          Situating knowledges: positionality, reflexivities and other tactics

          G Rose (1997)
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            Case study research: Design and methods

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              Reforming the health sector in developing countries: the central role of policy analysis.

              Policy analysis is an established discipline in the industrialized world, yet its application to developing countries has been limited. The health sector in particular appears to have been neglected. This is surprising because there is a well recognized crisis in health systems, and prescriptions abound of what health policy reforms countries should introduce. However, little attention has been paid to how countries should carry out reforms, much less who is likely to favour or resist such policies. This paper argues that much health policy wrongly focuses attention on the content of reform, and neglects the actors involved in policy reform (at the international, national sub-national levels), the processes contingent on developing and implementing change and the context within which policy is developed. Focus on policy content diverts attention from understanding the processes which explain why desired policy outcomes fail to emerge. The paper is organized in 4 sections. The first sets the scene, demonstrating how the shift from consensus to conflict in health policy established the need for a greater emphasis on policy analysis. The second section explores what is meant by policy analysis. The third investigates what other disciplines have written that help to develop a framework of analysis. And the final section suggests how policy analysis can be used not only to analyze the policy process, but also to plan.
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                Author and article information

                Journal
                Health Policy Plan
                heapol
                heapol
                Health Policy and Planning
                Oxford University Press
                0268-1080
                1460-2237
                September 2008
                12 August 2008
                12 August 2008
                : 23
                : 5 , Future directions for health policy analysis: a tribute to the work of Professor Gill Walt
                : 308-317
                Affiliations
                1Health Policy Unit, London School of Hygiene and Tropical Medicine, UK.
                2Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA.
                3Centre for Health Policy, University of the Witwatersrand, Johannesburg, South Africa.
                4King's College London, UK.
                5Department of Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland.
                6Health Economics and Financing Programme, London School of Hygiene and Tropical Medicine, UK.
                7School of Public Health and Family Medicine, University of Cape Town, South Africa.
                Author notes
                *Corresponding author. Health Policy Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. E-mail: gill.walt@ 123456lshtm.ac.uk
                Article
                czn024
                10.1093/heapol/czn024
                2515406
                18701552
                f40cd139-022f-4b8a-8a3a-fd08faa4dd60
                Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2008; all rights reserved.

                The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

                History
                : 22 June 2008
                Categories
                Original Articles

                Social policy & Welfare
                process,health policy,methodology,policy analysis
                Social policy & Welfare
                process, health policy, methodology, policy analysis

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