KEYSTONE HPSR Initiative // Module 6: Policy Analysis // Slideshow 3: Researching Health Policy
This is the third slideshow of Module 6: Policy Analysis, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 6: Policy analysis
This module focuses on the policy analysis approach to understand who makes policy decisions (power) and how and why these decisions are made (process). As a field primarily preoccupied with understanding decision-making, contemporary policy analysis approaches place actors at the heart of systems, problematize policy content, are attentive to context, and can see implementation as a series of social relationships rather than as an obvious consequence of policymaking.
There are 5 slideshows in this module.
Module 6: Policy analysis
-Module 6 Slideshow 1: Introducing Health Policy
-Module 6 Slideshow 2: Policy Approach & Frameworks
-Module 6 Slideshow 3: Researching Health Policy
-Module 6 Slideshow 4: Group work
-Module 6 Slideshow 5: Group work
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Research Plan Writing
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative
KEYSTONE HPSR Initiative // Module 1: Introducing Health Systems & Health Policy // Slideshow 3 Health Systems and Health Policy Frameworks - 2
This is the third slideshow of Module 1: Introducing Health Systems & Health Policy, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 1: Introducing Health Systems & Health Policy
This module introduces students to the KEYSTONE initiative, the objectives and design of the inaugural course, and the field of Health Policy and Systems Research. Common frameworks used to understand health systems and health policy are delineated, including the WHO building blocks framework, health systems hardware and software, systems thinking, social construction, and people-centred health systems.
There are 5 slideshows in this module.
Module 1: Introducing Health Systems & Health Policy
-Module 1 Slideshow 1: KEYSTONE Course: Getting Oriented
-Module 1 Slideshow 2: Health Systems and Health Policy Frameworks - 1
-Module 1 Slideshow 3: Health Systems and Health Policy Frameworks - 2
-Module 1 Slideshow 4: Health Systems and Health Policy: Wrap Up
-Module 1 Slideshow 5: Epistemological self-diagnosis
The other modules in this series are:
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy & Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Research Plan Writing
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
KEYSTONE HPSR Initiative // Module 6: Policy Analysis // Slideshow 2: Policy Approach and Frameworks
This is the second slideshow of Module 6: Policy Analysis, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 6: Policy analysis
This module focuses on the policy analysis approach to understand who makes policy decisions (power) and how and why these decisions are made (process). As a field primarily preoccupied with understanding decision-making, contemporary policy analysis approaches place actors at the heart of systems, problematize policy content, are attentive to context, and can see implementation as a series of social relationships rather than as an obvious consequence of policymaking.
There are 5 slideshows in this module.
Module 6: Policy analysis
-Module 6 Slideshow 1: Introducing Health Policy
-Module 6 Slideshow 2: Policy Approach & Frameworks
-Module 6 Slideshow 3: Researching Health Policy
-Module 6 Slideshow 4: Group work
-Module 6 Slideshow 5: Group work
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Research Plan Writing
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative
KEYSTONE HPSR Initiative // Module 7: Realist evaluation // Slideshow 1: Realist and theory driven approaches in HPSR
This is the only slideshow of Module 7: Realist evaluation, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 7: Realist evaluation
Programmes and policies are complex in their design and implementation because of the number of interacting agents, components and forces that influence people and organisations in a given system. In this module through the realist evaluation approach explores why programmes/interventions work for some and not for others and getting to the core issue of trying to understand the conditions under which the interventions works.
There is 1 slideshow in this module.
Module 7: Realist evaluation
Module 7 Slideshow 1: Realist and theory- driven approaches in HPSR
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Research Plan Writing
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
KEYSTONE HPSR Initiative // Module 4: Health Policy & Systems Research frameworks // Slideshow 1: Health Policy & Systems Research Frameworks- 1
This is the first slideshow of Module 4: Health Policy and Systems Research Frameworks, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 4: Health Policy & Systems Research frameworks
Health systems are knowable and researchable and their study calls for a range of inputs from different disciplines. Different questions and different understandings of health system problems lend themselves to different and complementary research approaches under the HPSR umbrella. Evolving concepts of ethics and rigour in HPSR are also delineated and knowledge translation as being integrated and continuous with the production of knowledge in HPSR is also considered.
There are 3 slideshow in this module.
Module 4: Health Policy & Systems Research frameworks
-Module 4 Slideshow 1: Health Policy and Systems Research Frameworks -1
-Module 4 Slideshow 2: Health Policy and Systems Research Frameworks - 2
-Module 4 Slideshow 3: Health Policy and Systems Research Frameworks - 3
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 5: Economic analysis
Module 6: Policy analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Preparing a Research Plan
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
KEYSTONE HPSR Initiative // Module 9: Ethnography // Slideshow 4: Ethnographic approach: Rigour & Ethics
This is the fourth slideshow of Module 9: Ethnography, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 9: Ethnography
The ethnographic approach offers a unique research space to better understand context (political, social, institutional, and historical) of health policies and policy formulation; and how these policies are translated and come alive in health systems. This approach lends itself well for a nuanced analysis of the relationships between power, knowledge and practice in health systems. In this module the (a) roots of ethnographic approach, (b) distinguishing ethnography per se from qualitative research; (c) ethnographic approach and health systems as social institutions & (d) ethical issues and rigour are explored.
There are 4 slideshows in this module.
Module 9: Ethnography
-Module 9 Slideshow 1: Ethnography
-Module 9 Slideshow 2: Qualitative Research and Ethnography: Overlaps and Distinctions
-Module 9 Slideshow 3: Health Systems Ethnography
-Module 9 Slideshow 4: Ethnographic approach: Rigour & Ethics
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Preparing a Research Plan
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
KEYSTONE HPSR Initiative // Module 9: Ethnography // Slideshow 1: Ethnography
This is the first slideshow of Module 9: Ethnography, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 9: Ethnography
The ethnographic approach offers a unique research space to better understand context (political, social, institutional, and historical) of health policies and policy formulation; and how these policies are translated and come alive in health systems. This approach lends itself well for a nuanced analysis of the relationships between power, knowledge and practice in health systems. In this module the (a) roots of ethnographic approach, (b) distinguishing ethnography per se from qualitative research; (c) ethnographic approach and health systems as social institutions & (d) ethical issues and rigour are explored.
There are 4 slideshows in this module.
Module 9: Ethnography
-Module 9 Slideshow 1: Ethnography
-Module 9 Slideshow 2: Qualitative Research and Ethnography: Overlaps and Distinctions
-Module 9 Slideshow 3: Health Systems Ethnography
-Module 9 Slideshow 4: Ethnographic approach: Rigour & Ethics
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Preparing a Research Plan
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
KEYSTONE HPSR Initiative // Module 1: Introducing Health Systems & Health Policy // Slideshow 3 Health Systems and Health Policy Frameworks - 2
This is the third slideshow of Module 1: Introducing Health Systems & Health Policy, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 1: Introducing Health Systems & Health Policy
This module introduces students to the KEYSTONE initiative, the objectives and design of the inaugural course, and the field of Health Policy and Systems Research. Common frameworks used to understand health systems and health policy are delineated, including the WHO building blocks framework, health systems hardware and software, systems thinking, social construction, and people-centred health systems.
There are 5 slideshows in this module.
Module 1: Introducing Health Systems & Health Policy
-Module 1 Slideshow 1: KEYSTONE Course: Getting Oriented
-Module 1 Slideshow 2: Health Systems and Health Policy Frameworks - 1
-Module 1 Slideshow 3: Health Systems and Health Policy Frameworks - 2
-Module 1 Slideshow 4: Health Systems and Health Policy: Wrap Up
-Module 1 Slideshow 5: Epistemological self-diagnosis
The other modules in this series are:
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy & Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Research Plan Writing
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
KEYSTONE HPSR Initiative // Module 6: Policy Analysis // Slideshow 2: Policy Approach and Frameworks
This is the second slideshow of Module 6: Policy Analysis, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 6: Policy analysis
This module focuses on the policy analysis approach to understand who makes policy decisions (power) and how and why these decisions are made (process). As a field primarily preoccupied with understanding decision-making, contemporary policy analysis approaches place actors at the heart of systems, problematize policy content, are attentive to context, and can see implementation as a series of social relationships rather than as an obvious consequence of policymaking.
There are 5 slideshows in this module.
Module 6: Policy analysis
-Module 6 Slideshow 1: Introducing Health Policy
-Module 6 Slideshow 2: Policy Approach & Frameworks
-Module 6 Slideshow 3: Researching Health Policy
-Module 6 Slideshow 4: Group work
-Module 6 Slideshow 5: Group work
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Research Plan Writing
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative
KEYSTONE HPSR Initiative // Module 7: Realist evaluation // Slideshow 1: Realist and theory driven approaches in HPSR
This is the only slideshow of Module 7: Realist evaluation, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 7: Realist evaluation
Programmes and policies are complex in their design and implementation because of the number of interacting agents, components and forces that influence people and organisations in a given system. In this module through the realist evaluation approach explores why programmes/interventions work for some and not for others and getting to the core issue of trying to understand the conditions under which the interventions works.
There is 1 slideshow in this module.
Module 7: Realist evaluation
Module 7 Slideshow 1: Realist and theory- driven approaches in HPSR
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Research Plan Writing
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
KEYSTONE HPSR Initiative // Module 4: Health Policy & Systems Research frameworks // Slideshow 1: Health Policy & Systems Research Frameworks- 1
This is the first slideshow of Module 4: Health Policy and Systems Research Frameworks, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 4: Health Policy & Systems Research frameworks
Health systems are knowable and researchable and their study calls for a range of inputs from different disciplines. Different questions and different understandings of health system problems lend themselves to different and complementary research approaches under the HPSR umbrella. Evolving concepts of ethics and rigour in HPSR are also delineated and knowledge translation as being integrated and continuous with the production of knowledge in HPSR is also considered.
There are 3 slideshow in this module.
Module 4: Health Policy & Systems Research frameworks
-Module 4 Slideshow 1: Health Policy and Systems Research Frameworks -1
-Module 4 Slideshow 2: Health Policy and Systems Research Frameworks - 2
-Module 4 Slideshow 3: Health Policy and Systems Research Frameworks - 3
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 5: Economic analysis
Module 6: Policy analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Preparing a Research Plan
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
KEYSTONE HPSR Initiative // Module 9: Ethnography // Slideshow 4: Ethnographic approach: Rigour & Ethics
This is the fourth slideshow of Module 9: Ethnography, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 9: Ethnography
The ethnographic approach offers a unique research space to better understand context (political, social, institutional, and historical) of health policies and policy formulation; and how these policies are translated and come alive in health systems. This approach lends itself well for a nuanced analysis of the relationships between power, knowledge and practice in health systems. In this module the (a) roots of ethnographic approach, (b) distinguishing ethnography per se from qualitative research; (c) ethnographic approach and health systems as social institutions & (d) ethical issues and rigour are explored.
There are 4 slideshows in this module.
Module 9: Ethnography
-Module 9 Slideshow 1: Ethnography
-Module 9 Slideshow 2: Qualitative Research and Ethnography: Overlaps and Distinctions
-Module 9 Slideshow 3: Health Systems Ethnography
-Module 9 Slideshow 4: Ethnographic approach: Rigour & Ethics
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Preparing a Research Plan
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
KEYSTONE HPSR Initiative // Module 9: Ethnography // Slideshow 1: Ethnography
This is the first slideshow of Module 9: Ethnography, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 9: Ethnography
The ethnographic approach offers a unique research space to better understand context (political, social, institutional, and historical) of health policies and policy formulation; and how these policies are translated and come alive in health systems. This approach lends itself well for a nuanced analysis of the relationships between power, knowledge and practice in health systems. In this module the (a) roots of ethnographic approach, (b) distinguishing ethnography per se from qualitative research; (c) ethnographic approach and health systems as social institutions & (d) ethical issues and rigour are explored.
There are 4 slideshows in this module.
Module 9: Ethnography
-Module 9 Slideshow 1: Ethnography
-Module 9 Slideshow 2: Qualitative Research and Ethnography: Overlaps and Distinctions
-Module 9 Slideshow 3: Health Systems Ethnography
-Module 9 Slideshow 4: Ethnographic approach: Rigour & Ethics
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 7: Realist evaluation
Module 8: Systems thinking
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Preparing a Research Plan
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
Involucrar a los responsables políticos para priorizar proyectos de investiga...investenisciii
XVI Encuentro Internacional de Investigación en Cuidados
CONFERENCIA CLAUSURA:
Alba DiCenso: Involucrar a los responsables políticos para priorizar proyectos de investigación que influyan en las políticas de salud
A document prepared by Dr. Mustafa Salih, the former director of the Directorate General of Health Policy, planning and research at the Federal ministry of Health in Sudan.
2017.04.06 Back to Hume: Behavioural Science and Public PolicyNUI Galway
Professor Liam Delaney, UCD, gave the plenary lecture at the 2017 Whitaker Institute Research Day entitled "Back to Hume: Behavioural Science and Public Policy" on the 6th of April at NUI Galway.
PhD private defence: Realist evaluation of a capacity building programme for ...Prashanth N S
My PhD private defence on realist evaluation of health managers capacity building programme examining scope for organisational change in public health services in a district setting in southern India. A less technical version from the public defence is here: http://www.slideshare.net/PrashanthSrinivas/public-defence-realist-evaluation-of-capacity-building-programme-of-health-managers-in-tumkur-india
More details at http://www.daktre.com/2015/05/studying-organisational-change-in-indian-district-health-systems
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Supporting paper for Collaborating for Better Care Partnership Master Class 23rd October 2014: Executive summary 'From Evidence to Practice: Addressing the Second Translational Gap for Complex Interventions in Primary Care'
HFG Health Governance Presentation at 2015 USAID Global Health Mini-UniversityHFG Project
Presentation titled "Governance in the Third Dimension: Science Fiction or Science Fact," given by HFG at 2015 USAID Global Health Mini-University on March 2, 2015.
Session Description: Strengthening health governance can significantly improve the effectiveness and sustainability of reforms and, in turn, achieve better health system performance. Yet despite its importance, health governance investments are often overlooked. Health governance is frequently misunderstood by governments and the global health community, because governance in practice (vs. theory) is poorly defined and difficult to operationalize.
In this session, participants will learn how Haiti has defined and is addressing dimensions of governance for health financing and human resource reforms. Participants will apply these dimensions of health governance to work/activities that they are involved in, and consider how addressing these dimensions can strengthen health governance in their countries and enhance the impact of health financing, human resource, and service delivery reforms.
Involucrar a los responsables políticos para priorizar proyectos de investiga...investenisciii
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A document prepared by Dr. Mustafa Salih, the former director of the Directorate General of Health Policy, planning and research at the Federal ministry of Health in Sudan.
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Professor Liam Delaney, UCD, gave the plenary lecture at the 2017 Whitaker Institute Research Day entitled "Back to Hume: Behavioural Science and Public Policy" on the 6th of April at NUI Galway.
PhD private defence: Realist evaluation of a capacity building programme for ...Prashanth N S
My PhD private defence on realist evaluation of health managers capacity building programme examining scope for organisational change in public health services in a district setting in southern India. A less technical version from the public defence is here: http://www.slideshare.net/PrashanthSrinivas/public-defence-realist-evaluation-of-capacity-building-programme-of-health-managers-in-tumkur-india
More details at http://www.daktre.com/2015/05/studying-organisational-change-in-indian-district-health-systems
Executive summary:From Evidence to Practice: Addressing the Second Translatio...NEQOS
Supporting paper for Collaborating for Better Care Partnership Master Class 23rd October 2014: Executive summary 'From Evidence to Practice: Addressing the Second Translational Gap for Complex Interventions in Primary Care'
HFG Health Governance Presentation at 2015 USAID Global Health Mini-UniversityHFG Project
Presentation titled "Governance in the Third Dimension: Science Fiction or Science Fact," given by HFG at 2015 USAID Global Health Mini-University on March 2, 2015.
Session Description: Strengthening health governance can significantly improve the effectiveness and sustainability of reforms and, in turn, achieve better health system performance. Yet despite its importance, health governance investments are often overlooked. Health governance is frequently misunderstood by governments and the global health community, because governance in practice (vs. theory) is poorly defined and difficult to operationalize.
In this session, participants will learn how Haiti has defined and is addressing dimensions of governance for health financing and human resource reforms. Participants will apply these dimensions of health governance to work/activities that they are involved in, and consider how addressing these dimensions can strengthen health governance in their countries and enhance the impact of health financing, human resource, and service delivery reforms.
Innovative approaches to researching governanceresyst
This presentation was given at the 3rd RESYST annual meeting in Hanoi, Vietnam, 2013, during a workshop on Universal Health Coverage (UHC). It gives a background to RESYST research on Governance issues and how these relate to the UHC debates.
The presentation was given by Professor Lucy Gilson from the Health Economics Unit at the University of Cape Town
Evidence on Improving Health Service Delivery in Developing CountriesIDS
This presentation by David Peters of the Future Health Systems Consortium was given at the Global Symposium on Health Systems Research in November 2010.
Presentation is about the uniqueness of Implementation Research and Role of the Government, specially in Indian context of health programme implementation.
A Health Equity Toolkit: Towards Health Care Solutions For AllWellesley Institute
This presentation offers health solutions that will help create a more equitable system.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
What offers more choice? Budgets or human rights?shibley
My talk on how best to deliver choice in English dementia strategy - through the market, e.g. personal budgets, or international law, e.g. human rights.
Christopher p digiulio md - building integrated health service networksChristopherp3
Christopher p digiulio md achieve their goal of managing a healthcare team and ensuring the smooth day-to-day operations of a healthcare facility, Medical Officers perform various tasks.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
4. KEYSTONE
The ‘Actors’ in the System
Policies / environments
Systems
performance
and outcomes
POLITICIANS
POLICY-PLANNERS
ADMINISTRATORS
AND STEWARDS
HEALTH PROVIDERSCITIZENS
CIVIL SOCIETY
MARKET ACTORS
ADVOCATES
6. KEYSTONE
Rational choice approach
• Actions of decision-
makers, in response to
estimable constraints, can
be modelled and predicted
• Has predictive value and is
open to empirical testing
• Regards human beings as
being “instrumental and
not expressive” (John 1995)
• Has limited value as a
descriptive device
Predicts the behaviour of individuals, based on economic
theories of maximisation of self-interest (Sabatier 1999)
7. KEYSTONE
Bounded Rationality
• Rationality as the ideal, and
actual behaviour as divergence
from ideal
• Organizations should function
by maximising rationality in a
step-wise process: intelligence,
design and choice
• What constitutes rational
action in unjust institutions?
• What does bounded rationality
signify in the context of health,
where empathy is a core value?
INTELLECT
Reason,
rationality
AFFECT
Passion, instincts
(Simon 1957)
8. KEYSTONE
Discourse Theory
• ‘Systems of meaning’, ‘Frames’: actors’ ways of understanding the
world
• How “facts, values, theories and interests are integrated” by actors to
construct their realities, define problems, identify solutions
• “Communities of meaning”: actors belonging to the same group share
cognitive mechanisms, engage in similar acts and use similar
language to discuss policy problems
(Yanow 2000, Rein and Schön 1993, Geertz 1983)
REASONS FOR POLICY / SYSTEMS FAILURE
Discordances in systems of meaning
Dominance of particular systems / submission of valuable systems
Difficulties in communicating across systems
9. KEYSTONE
Policy Learning Cycle (Vickers 1965)
Reality judgements
‘What is’
Appreciation
Value judgements`
‘What ought’
Action
judgements
‘What to do’
‘How to do it’
10. KEYSTONE
Why health regulators in India
don’t actually regulate…
• Delicate relationships with the regulated
• Lack of support from senior authorities
• Lack of regulatory capacity
• Empathy with ‘rights’ of the regulated
• ‘Development’ ethic favoured
• Disengagement with / antipathy to regulatory principles
• Focus on developmental tasks
• Neglect of regulatory tasks
(Sheikh and Porter 2010)
11. KEYSTONE
Roles and Rationales
O1
P1
P2
P3
O2 O3
Multiple organizations
implement programmes
Organizations participate in
several programmes
Conflicts between
organizational and
programme
rationales are
common
I must
perform
I have to
conform
13. KEYSTONE
Defining challenges for our time
HOW CAN WE…
• Make affordable, high quality health goods and services accessible to all?
• Get quality health services to underserved areas?
– Doctor retention or replacement?
• Best engage the private health sector?
– Government as provider, steward, purchaser?
• Effectively govern existing services, make them accountable?
– Build government capacity, efficiency, transparency
– Integrate multiple systems, sectors
• Mobilize communities for health in context of massive social inequality?
14. KEYSTONE
• Health governance in many LMIC may mirror mixed
health systems syndrome in its combination of
declining capabilities of public organizations and
infiltration and dominance of private interests (Sheikh et al
2012)
• Little research on health governance in LMIC
– Poor financial, HR and leadership capacities
– Poor organizational coherence
– Elite capture, corruption
– Little community oversight, low transparency
Health Governance in LMIC
15. KEYSTONE
What is (Health) Governance?
• How institutions, rules and systems of the state –
executive, legislature, judiciary, and military – operate at
central and local level and how the state relates to
individual citizens, civil society and the private sector
(DfID 2001)
• The exercise of economic, political and administrative
authority to manage a country's affairs at all
levels(UNDP)
• Leader selection, formulation and implementation of
policies, citizen-state interaction (World Bank)
16. KEYSTONE
WHO Views
• SYSTEMS FUNCTION: macro-level function involving guidance of
the health system through six sub-functions of policy guidance,
system design, stakeholder management and regulation and
system-level accountability (WHO health systems)
• COMPONENTS: Intelligence, policy formulation, organizational
‘fit’, implementation, partnership, accountability (WHO –
stewardship)
• POLITICAL: The exercise of authority at all levels, comprising
mechanisms, processes, relationships and institutions through
which citizens and groups articulate their interests, exercise
their rights and obligations and mediate their differences (WHO)
17. KEYSTONE
Institutions and Rules
(Brinkerhoff & Bossert)
Arena Functions
CIVIL SOCIETY Socializing, Enabling
POLITICS Aggregating, Representing, Legitimizing
POLICY Distributive, Redistributive, Regulatory, Constitutive,
Adjudicatory
PUBLIC ADMINISTRATION Implementing, Managing
Governance signifies the formal and informal rules that define roles of actors
and shape their respective interactions, within these institutional arenas…
18. KEYSTONE
Relationship with Health Systems
Health
sector
Allied
sectors
Governance of Health
Leadership
and
Governance
HR, Finance, etc
Other
Building
blocks
Health Systems Governance
Health
Sector
Food, water,
environment,
rural and urban
All other
Sectors
Governance for Health
19. KEYSTONE
What is good governance?
Governance works well if these are assured (Brinkerhoff and Bossert 2010)
• Accountability of key system actors to beneficiaries and public
• Fairness: engaging competing interest groups on equal terms
and allowing negotiation and compromise
• Capacities, power and legitimacy to manage policy making
and implementation processes effectively
• Engagement of non-state actors in policy processes, service
delivery partnerships, oversight and accountability
20. KEYSTONE
What makes governance good? (DfID 2007)
• State Capability
• Accountability
• Responsiveness
Some neglected norms that are relevant for
health governance in India and other LMIC
• Self reliance
• Equity
• Socially realized justice
21. KEYSTONE
Health governance research:
• Empirical research on decision-making at all levels of the health
system and in communities
• Investigates policy processes and systems performance as well as the
interface of health systems with citizens
• Questions focus on systems hardware (finance, HR, medicines) as well
as software (ideas, interests, values, norms, relationships, power)
• Uses a range of “HPSR” methods: policy analysis, mapping and
landscaping, ethnographies, realist evaluation
22. KEYSTONE
Mapping study: Regulatory Failure in
LMIC Mixed Systems
Regulatory failure is a pre-
eminent challenge for health
policy in LMIC; yet institutional
contexts for these failures
remain poorly explored
STUDY AIMS
Develop and field-test a research tool to:
1. Empirically map architecture of
health regulatory institutions in a
geo-political unit (state or country)
2. Identify gaps in design and
implementation of regulatory
policies
(Oxfam 2009, Nishtar 2010)
23. KEYSTONE
Steps in Research
METHODS
• In-depth interviews with
health systems officials
• Discussions with policy
elites and key informants
• Policy document review
STEP 6 Data synthesis
STEP 5 Describing regulatory activities
STEP 4 Charting putative functions
STEP 3 Listing relevant policy documents
STEP 2 Listing groups with regulatory functions
STEP 1 Detailing policy context
24. KEYSTONE
Design Gaps
Delhi
• RSBY and government subsidies to
private hospitals both aimed at
reducing costs of private care for EWS,
do not address the high incident costs
in public facilities, or financial
protection of non-EWS. No direct
control of care costs, no regulation of
competition.
• No credible regulatory mechanism to
limit practice by unqualified providers.
For both quality of care and conduct of
providers, absence of credible
community-based forum for grievance
redress.
• Accessibility of care not addressed
through act or policy
Madhya Pradesh
• No known laws or regulatory policies
for the curtailment of costs for users of
health care, other than recently
introduced Janani Sahayogi Yojana
(Scheme)
• For quality of care and conduct of
providers: absence of credible
community-based forum for grievance
redress
• Variable accessibility of care (workforce
distribution): only mandatory rural
service, no incentive based policies
25. KEYSTONE
Implementation Gaps
Delhi
• Cost of Care: Information asymmetries impede
uptake of social insurance scheme, also lack of
stringent regulatory component. Reduced
investment in regulatory capacity of relevant
departments impedes enforcement of EWS free-
bed condition for hospital subsidy
• Quality of care: multiple contestations of NHRA
have diluted content. Partial implementation due
to personnel constraints and organizational
inertia, active resistance of medical fraternity
• Provider conduct: Councils role transformation to
less of disciplinary function, more on protecting
professionals’ rights, medical sanctity
• Accessibility of care: health authority
subordinated to urban development authority in
determining location of new hospitals
Madhya Pradesh
• Quality of care Clinical Establishments Act,
PNDT, MTP: Implementation is partial due to
personnel constraints problems of inter-
departmental coordination, affects
relationships with hospital owners
• Provider conduct: self-regulatory council’s
commitment to disciplinary functions, made
problematic by closeness to associations who
oppose regulation. Engagement with
additional tasks such as reducing quackery
greater than performance of disciplinary
roles.
• Accessibility of care: implementation of rural
medical bonds hampered by extensive
contestation by doctors’ groups, problems in
coordination between government
departments involved in placements
26. KEYSTONE
Key factors underlying governance failure
1. Influence of medical political interests (regulatory agencies
are largely constituted of medical professionals, or reliant on
their cooperation)
2. Discordance in inter-departmental relationships and
coordination within the State regulatory machinery
3. Severe constraints in numbers and capacities of personnel
for regulation
28. KEYSTONE
How it helps…
Provides multi-layered explanations and solutions for
problems of implementation: often a pre-eminent concern
in LMIC health policy
Helps in systematically investigating the functioning of
complex and poorly understood systems and institutions
29. KEYSTONE
Uses of implementation analysis
• Diagnostic: explaining why a policy is ineffective or
partially effective
• Strategic: identifying factors which influence the viability
and effectiveness of a policy or policy process
• Prospective: generating knowledge to inform the future
trajectory of policy processes
30. KEYSTONE
Implementation: the classical view
Policy
Execution
Implementation
on front-lines
• A managerial function,
succeeding and separate
from policy-making
• Not integral to an
understanding of policy
“a series of mundane
decisions and interactions”
(Van Meter and Van Horn 1975)
ExternalFactors
(Hogwood and Gunn 1984)
31. KEYSTONE
Action-centred approaches
• Implementation central to understanding of policy
• Seek to understand what “actually happens or gets done,
how and why?” (Barrett and Fudge 1981)
• Investigating actors (as individuals and as members of
groups), processes and contexts (Walt and Gilson 1994)
32. KEYSTONE
Written and living constitutions
“confronting the manifestations of the living constitution with
the prescriptions of the written” (Hjern and Hull 1982)
• Written constitutions: policy problems as defined and
addressed by the ‘political system’
• Living constitution: policy problems as defined and addressed
by relevant actors (engaged in implementation)
33. KEYSTONE
Methods commonly used…
• Interviews
– With representatives of implementing groups
– With stakeholders and users
– With policy elites and key informants
• Review of documentation
– Public: constitutions, reports, outputs
– Internal: circulars, memos
• Thematic case studies (Yin 2003)
• Units of analysis: individuals, organizations, “groups”, “networks”
35. KEYSTONE
Implementing national guidelines
• Problem: non implementation of national public health policy
guidelines (HIV, TB, diarrhoea, RI, etc.) by medical providers in
India
• Objective: diagnosing the problem of policy-practice gaps
• Methods: in-depth interviews with implementers and other
key actors, ‘framework’ analysis
37. KEYSTONE
Diverging from putative roles
• Frontline practitioners don’t follow guidelines
• Administrators don’t enforce implementation
• Health programmes don’t enforce guidelines
• Professional regulatory bodies demonstrate no role in the
enforcement of guidelines
38. KEYSTONE
Diagnosis: resources, capacity
• Human resource capacity
– E.g. not enough inspectors to regulate the private medical
sector
• Material resources
– E.g. shortage of protective equipment, to protect health workers
from cross-infection
• Access to, and utilization of finances at different levels
39. KEYSTONE
Diagnosis: inter-organizational relations
Employment
(contractual)
and answerabilityAnswerability
for HIV tasks
Employment,
answerability for
other tasks
Poor
communication
GOVT.
HOSPITAL
State health
department
State AIDS
Control Society
Hospital practitioners
Programme staff
(technicians,
counsellors)
Hospital administrators
GENERAL HEALTH SERVICES & HIV/AIDS PROGRAMME
PERFORMANCE VS. CONFORMANCE
(Sheikh ‘08)
‘PERFORMANCE LOGIC’ ‘CONFORMANCE LOGIC’
Some shared
posts
40. KEYSTONE
Diagnosis: uncertainties of affiliation,
legitimacy, role
Affiliation Formal affiliation to Ministry of Science and Technology,
not Ministry of Health
Multiple authorities 26 states , “each with its own authority, its own setup…
each with their own rules…”
Defining legal basis for
work
“there is no licensing mechanism for medical labs... We
had to ask lawyers what we should accept as a proof of
legal identity.”
Defending “non-profit”
identity
“We had to fight with the Revenue department; they
wanted us to pay service tax. We convinced them that
accreditation is like an educational service ...”
NATIONAL ACCREDITATION BOARD FOR LABORATORIES:
PROMOTING RATIONAL PRACTICES
(Sheikh ‘08)
41. KEYSTONE
STATE MEDICAL COUNCILS: UPHOLDING
PROFESSIONAL STANDARDS
Diagnosis: distortion, subversion of
institutional functions
‘Written constitution’
• Enforcing code of ethics
• Regulating practitioners’
professional conduct (including
adherence to prescribed practice
norms)
‘Living constitution’
• Role perceptions focused on
sanctity of profession
• Negation of disciplinary functions
• Instances of provision of legal
protection for doctors in
negligence cases
(Sheikh ‘08)
43. KEYSTONE
Implementing national guidelines
State Medical
Councils
Administration /
Management
Departmental
Authorities
Staff (Medical
Practitioners)
Clients
Courts and
Consumer
Forums
Medical
Council of India
State health
programme
National Health
programme
Civil Society
Organizations
Medical
Associations
Accreditation
agencies
International
Organizations
Facilitation
LitigationProfessional
Regulation
EducationSupervisionSupervision* EducationInstituting
VCTCs*
HOSPITALS
Education
Supervision
Legislature
Technical and
Financial
Support
Attempted
Legal Reform
(HIV Laws)
Supervision
Grievance Redress
Supervision
Grievances
Grievances
Government
Health
Authorities*
Implementing relevant laws
FORMAL IMPLEMENTATION CHANNELS
* Not applicable in the case of
private and charitable hospitals
Putative Roles of Various Groups and Institutions in Implementation (Sheikh ‘08)
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Editor's Notes
I will talk about a type of policy research – implementation research, which I believe is a useful and neglected way of studying health institutions and systems. It also has relevance for some of the areas of work which we have been talking about.
These are some of the defining questions for analysis, research and action. Decision-makers, analysts and researchers across the country, and many at PHFI, are grappling with these issues
The previous definitions and characterizations, particularly on the importance of citizens in governance
Implementation research is particularly important in LMIC because it deals with the commonly stated concern – there are lots of policies, but they are not implemented.
A lot of it is “stating the obvious” – consolidating common knowledge and piecing it together.
However, common knowledge within particular groups and systems is often not available to people outside that system – so there is a strong communicative function
Action-centred approaches view implementation as a social and political process
This is another example of the kind of rationales used in doing implementation research
Resources, capacity, access to finances, are important. But redressing them is a long-term option. How do we deal with present concerns, particularly in developing polities and societies?
“Whenever there is a need, we provide them [practitioners] with protection. We take up their issues with the concerned authorities, within the ambit of existing rules and norms... The doctor informs us. Or we may take suo motu action if we come to know about some oddity.”
Care in discussing these issues
Complex network of institutional structures, programmes and otherwise involved groups