The document discusses different frameworks for health policy analysis including the stages framework, triangle framework, and network framework. The triangle framework consists of four elements: context, content, actors, and process. An example is provided analyzing Pakistan's National Health Vision 2016-2025 using the triangle framework. The context is establishing a new national vision after decentralization. The content identifies priorities but lacks targets. The process was driven by limited provincial control. Actors are not well addressed beyond healthcare providers.

1. What does a health policy
analysis is:
….the systematic study of all factors, people, processes that impact on
the way in which a policy is developed, formulated and implemented
(Walt and Gilson, 1994).

2. What does a health policy analysis involve?
Explains the interaction between
Institution Interest Ideas

3. We need a conceptual framework for that
What is then a conceptual framework?

4. Conceptual frameworks provide a particular perspective, or lens,
through which to examine a topic.

5. Continued….
Frameworks organize inquiry by identifying elements and relationships
among elements that needs to be considered for theory building. (
Ostrom 2007)

6. Three major health policy analysis frameworks
• Agenda setting
• Formulation
• Implementation
• Evaluation
Stages
framework
(Lasswell 1956, Brewer,
Deleon 1983)
• Content
• Actor
• Context
• Process
Triangle
Framework
(Walt, Gilson 1994)
• Interactions
• Interconnectedness
Network
Framework
(Thatcher 1998)

7. Policy triangle framework:
Policy analysis triangle consist of:
Context: why need this policy?
Content: what is the policy mainly about?
Process: How was the policy brought forward and implemented?
Actors: Who participates in and influences formulation and
implementation?

8. Policy Triangle Framework
Content
Actor
Process
Context

9. Content
Policy
Documents
Strategies
Guidelines
Research
papers

10. Actors
Public
Sector
Donor
agency
Private
Sector
NGO
Insurance
Company
Media
People

11. Context
Political
Historical
Cultural
Environm
ental

12. Process
How agenda is
set?
Who is
consulted?
How policies are
communicated ?
How policies
are executed
and assessed?

13. National health vision Pakistan 2016-
2025

14. Example continued….
Context: This is the broad federal-level health policy currently in the
country. Developed 15 years after the earlier National Health Policy in
2001, this document acknowledged the challenges and lack of
progress following decentralization.
Content: National Health Vision Pakistan, under the Every Newborn
impact framework, identifies the care around birth and care of small
and sick newborns as important outcomes impacting newborn
survival. The vision is clearly inspired from the global every newborn
action plan but gives little guidance on how to implement the vision
or if, and how, federal government would support the provinces. The
document does not contain any service-level, procedural, or
intermittent targets to monitor progress

15. Example continued..
Process: Overall, the development of the national vision was driven by a
sense of limited control over healthcare systems in the provinces after
the decentralization and a realization that country’s health indicators
were stagnant.
Stakeholders: The national vision document does not address how the
private sector, a major provider of health services in Pakistan, and other
stakeholders beyond healthcare would be involved in achieving the 10
highly generic, priority actions it lays out. Although the vision document
stipulated that health service delivery would remain a provincial
obligation, it also cited the re-establishment of a health ministry as the
Ministry of National Health Services, Regulation and Coordination

17. Network framework policy:
This Framework refers to establishment of relationships between
stakeholders and identification of clinical leaders to drive evidence
integration and translation into policy.

20. Reference
Merson, M., Black, R., Mills, A. (Eds) (2012) Global Health: Diseases, Programs,
Systems and Policies. London: Jones & Bartlett Publisher
Ahmed et al. Health Res Policy Sys (2021) 19:86
https://doi.org/10.1186/s12961-021-00735-9