Policy Analysis and Decision Making Key points, Assignments of Policy analysis

Download Policy Analysis and Decision Making Key points and more Assignments Policy analysis in PDF only on Docsity! 1 Policy Analysis and Decision Making with Emphasis on Chronic Non-communicable Diseases Bridgetown, Barbados October 15-17, 2007 The Analysis of Public Problems Cristina Puentes-Markides Health Policies and Systems Strategic Health Development Area PAHO/WHO PAHO-CPM/HSS/HP/07 2 Key points Types of inquiry Analysis of public problems. Policy analysis: overview, advantages, disadvantages General features Styles and products of the analysis Problem definition 2 PAHO-CPM/HSS/HP/07 3 Different Types of Inquiries; Different Objectives Disciplinary Research Health services research Health policy analysis Health program evaluation PAHO-CPM/HSS/HP/07 4Lu Ann Aday , et al. Evaluating the Medical Care System: Effectiveness, Efficiency and Equity. Ann Arbor, Michigan: Health Administration Press, 1993. 5 PAHO-CPM/HSS/HP/07 9 What is policy analysis? Several definitions… The use of reason and evidence to select the best policy among a number of alternatives to address a particular policy problem. (MacRae and Wilde). “An applied social science that utilizes multiple research methods, in argumentation and debate contexts, to create, estimate critically, and communicate knowledge that is relevant to the policies.” (Dunn) “A way of speaking truth to power”. (Wildavsky) “A process through which one identifies and evaluates “alternative policies or programs that are intended to lessen or resolve social, economic or physical problems” (Patton & Sawicki). PAHO-CPM/HSS/HP/07 10 A good analysis (or even a good decision) does not guarantee that the optimal solution will be selected and/or implemented. 6 PAHO-CPM/HSS/HP/07 11 A practical definition… “Policy analysis is client oriented advice relevant to public, or private, decisions and informed by social values.” Weiner & Vining, p. 27 PAHO-CPM/HSS/HP/07 12 Advantages Identifies, verifies complex problems. Compares alternative ways to address an issue. Frames information in a useful format for decision-makers. Informs the political debate. Can improve the quality of decisions. Provides a bargaining chip. Suggests how to translate ideas into viable policies. Disadvantages Inability to choose its own problems. Problems and the context in which they occur are highly complex. Perceptions and values are subjective and often in conflict. Uncertainty about the future. Use is limited for believers of bargaining or muddling. The capacity of any instrument is always limited. 7 PAHO-CPM/HSS/HP/07 13 What policy analysis can and cannot do… Policy analysis can assist decision makers in choosing a preferred course of action from complex alternatives and under uncertain conditions. Policy analysis is nota panacea or a substitute for inadequate policymaking processes, defects of public decisions, bad judgment on the part of analysts or policymakers, an exact science or a tool for advocacy by the analyst for his/her own views. PAHO-CPM/HSS/HP/07 14 Types of Policy Analysis Descriptive (also interpretative), to describe the effects of a policy already implemented Evaluative (were the policy objectives achieved?) Assess whether policy satisfies established policy outputs and outcomes. After policy adoption, and implementation has began. Ex post (a posteriori, post hoc, retrospective); also known as program evaluation. Predictive (To anticipate likely effects that might result from the adoption of a particular policy) Prescriptive (recommendations to achieve a particular result), to inform process of decision making and deliberation Before selection, recommendation and implementation Ex ante (a priori, pre hoc, prospective) PurposeWhen 10 19 The Policy Analysis Process Source: Weimer and Vining, pp. 257 Problem Analysis 1. Understanding the problem [Receiving, Framing, Modeling the problem] 2. Choosing & explaining relevant goals & constraints 3. Selecting a Solution method Solution Analysis 1. Choosing evaluation criteria 2. Specifying policy alternatives 3. Evaluating: Predicting impacts of alternatives and valuing them in terms of criteria 4. Recommending actions Information Gathering Identifying and organizing relevant data, theories, and facts for assessing problem and predicting consequences of current and alternative policies Communication Conveying useful advice to clients PAHO-CPM/HSS/HP/07 20 Determine whether a new policy is required to address the proble m If a policy already exists, determine whether it needs to be modified or terminated. Analyze one policy (retrospectively or prospectively) Compare two or more policies that address a similar problem. Assess future implications of current or new policies Explore stages in the development of particular policies. Not all public problems are amenable to policy analysis, but when they are, the analysis can support decision making to: 11 Source: 21 The Policy Analysis Process: the Classic Policy Analytic Format PROBLEM ANALYSIS I. Problem Definition/Formulation: Analyst’s statement of the policy problem to be addressed. a) why the problem is a concern that needs to be addressed through public policy? b) potential cause (s) of the problem. SOLUTION ANALYSIS II. Selection of Criteria:. Criteria connote measurement; yard stick by which to assess the efficacy of policy alternatives. (e.g. social values of efficiency and equity, political feasibility, effectiveness. III. Construction of Alternatives: The development of feasible alternatives to solve or mitigate the problem is a frequently underestimated, and creative phase. Alternatives should include policy options that key political actors are proposing or seem to have on their mind, but should also propose or identify alternatives that may be superior to those under political discussion. IV. Comparison of the Alternatives: An analysis of possible policy alternatives based on their satisfaction of the various criteria, and regarding the projected outcomes or impacts of each alternative. The recommendation should be treated as a useful but not overriding element in the analysis; it is often the least valuable element to the policymaker. COMMUNICATE RESULTS V. Consideration of Organizational Constraints (Implementation Analysis): An analysis of whether the organization's) charged with responsibility for operating the policy or program can put it in place successfully. (e.g. bureaucratic will (commitment) and the technical and institutional capacity) VI. Implementation and evaluation of the program : expert analysis (evaluation research use of objective, scientific criteria), market accountability (relying on aggregate consumer tastes), and political accountability (citizen support/opposition through democratic processes). Source: William Dunn. 22 Dunn’s Integrated Framework: Process of Policy Analysis POLICY PROBLEMS ForecastingPractical Inference Problem Structuring Evaluation RecommendationMonitoring POLICY PERFORMANCE POLICY ALTERNATIVES POLICY OUTCOMES POLICY ACTIONS 12 PAHO-CPM/HSS/HP/07 23 Defining the policy problem is easier said than done… PAHO-CPM/HSS/HP/07 24 What's the Problem? What if pigs could fly? 15 PAHO-CPM/HSS/HP/07 29 Importance of problem definition in decision-making “There is a difference between a condition and a problem … conditions become defined as problems when we come to believe that we should do something about them .. the problem doesn’t have to get any worse or better”. Kingdon (1984: 103-4): PAHO-CPM/HSS/HP/07 30 Importance of problem definition in decision-making Problem definition depends on: How issues are framed, portrayed. How obvious is the crisis that the problem evokes. How it is measured. Endless ways to look at a particular problem, yet limited time, money and energy. Therefore, highly complex issues are simplified; focus on certain aspects happens at the expense of other aspects/elements. 16 PAHO-CPM/HSS/HP/07 31 Problem Definition Translation of a situation that is perceived as important into a problem that can be solved § Indicators reveal its existence, magnitude, severity § Events or crisis call attention on a problem § The results of evaluations (or monitoring/surveillance) show troublesome conditions, etc. Challenges: Public policy problems, particularly social problems § May show up in ways that are difficult to address § “Inherently multidimensional”, overlap, intersect, contradict § They are ill defined, that is, they are “wicked problems” § The consensus over social goals may be illusory. § Decision-makers have different preferences and values, often conflicting § The definition of a policy problem is not completely scientific or systematic: creativity, sagacity, socially constructed. PAHO-CPM/HSS/HP/07 32 Therefore, let’s discuss.. How would I go about structuring the problem? Do we already have a policy? Do we need a new one or tweak the old one? Does the metaphor seem to obviate the need for evidence, or does it bias the kind of information opponents might bring to bear on a conflict/the issue?” (D. Stone) Who are the stakeholders? What are the levers inside and outside the health sector? What are the preferences, motivations, interests of decision- makers? Etc. 17 PAHO-CPM/HSS/HP/07 33 Suggested Reading(s) Aday , L. A et al. (2005) Evaluating the Healthcare System. Effectiveness. Efficiency and Equity. Ann Arbor, MI: Health Administration Press. Third edition. Pp. 1-56. (Introduction to Health Services Research and Policy Analysis)) PAHO. Regional Strategy and Plan of Action on an Integrated Approach to the Prevention and Control of Chronic Diseases. (2006) Pan American Health Organization, Washington DC. August 31, 2006. http://www.paho.org/english/gov/cd/CD47-17rv-e.pdf Polidano, C Measuring Public Sector Capacity. (2002) World Development 28 (5): 805- 822.(Earlier version available from Institute for Development Policy and Management. University of Manchester. http://www.sed.manchester.ac.uk/idpm/research/publications/archive/ppm/ppm_wp12.htm Walt, G. and L. Wilson. (1994). Reforming the health systems in developing countries. The Central Role of Policy Analysis. Health Policy and Planning 9(4) : 353-370. (Handout) Patton, C. y D. Sawicki. (1993) Basic Methods of Policy Analysis and Planning. Englewood Cliffs, NJ: Prentice Hall. Second edition. Pp. 1-39 (The Need for Simple Methods of Policy Analysis and Planning, The Policy Analysis Process).