Policy Making Process in Health Systems
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WHO AFRO REGIONAL WORKSHOP ON IMPLEMENTATION OF HEALTH IN ALL POLICIES,
01-04 DEC 2015, WITS UNIVERSITY, JOHANNESBERG, SOUTH AFRICA.
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Define Policy and describe the stages of policy making
Recognize the complex and political nature of policy making
Identify the “windows of opportunity” for policy change
Define & Identify the policy champions
Frame a complex health issue and identify its policy changes and
opportunities
Introduction to National Health Systems Resource Centre, Min of
Health & FW, Govt of India
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NHSRC Objectives & Structure
Health Systems Framework: WHO
Health Systems Framework: NHSRC
Linkages with Community
NHSRC main activities
NHSRC Broad Objectives
4
NHSRC works closely with MOHFW
NHSRC: A SYSTEMS APPROACH
TEN DIVISIONS
NHSRC Health System Framework
Why understand Policy Making Process?
An approach to public policies across sectors that systematically
takes into account the health implications of decisions, seeks
synergies, and avoids harmful health impacts in order to improve
population health and health equity.
Helsinki Statement on Health in All Policies 2013
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A principle or a plan to guide decisions, actions & outcome, Laws,
documents, procedures, guiding principles, statements of intent or
working framework
A way of working, a vision, a programme of action, duties
responsibility, accountability or an unwritten cultural or ethical code
Public policy refers to policy of government
Developed through negotiation, repeated practice, decree/order or
convention
Often a discrepancy between policy intent and policy practice
Four Stages of Policy Cycle
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Need for HiAP
Fact:
Sectors outside health
account for 80-90% of
health.
An example: 1 in 8 deaths
due to air pollution
Action in following sectors
1.
Household Energy
2.
Energy
3.
Transport
4.
Urban Planning
5.
Housing
6.
Waste Management
7.
Industry
8.
International agencies
9.
Local Self Government
NGOs, Civil Society
10.
Min of Health
What is “Window of Opportunity”
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National Health
Policy 2015 Draft
Public Health Act
Four Task Forces
on National
Health Assurance
Mission
Policy Champions
Person or team willing and able to lead and manage the policy
process.
Proactively promote policy reforms, publicly support the
policies and foster the support of others.
Frame discussion of the issue, build consensus, attract
resources, and seize and create opportunities to move the reform
forward.
Policy development in related sectors
All sectors that impact health, health systems, health determinants, health equity, cost of
health care
Recognize, own the problems, define and frame the issues
Identify the role of each sector- clearly identified as causes of causes and what action can be
taken
If not done ownership of health problems falls by default on health actors (ministry and
health institutions)
Inform the stake holders (public institutions, academic institutions, think tanks, private
sector, CSOs) through policy briefs giving policy options
Technically sound, culturally and ethnically acceptable and financially reasonable
Negotiations between various stakeholders
Health Policy 2015 - Goal
The attainment of the highest possible level of health and well-
being for all at all ages, through a preventive and promotive
health
care orientation in all developmental policies
, and universal
access to good quality health care services without anyone having
to face financial hardship as a consequence.
Cross Sectoral Goals
Seven Priority Areas in NHP
1. Clean India Campaign
2. Balanced and Healthy Diet
3. Addressing Tobacco, Alcohol and Substance Abuse
4. Travellers Safety (Yatri Suraksha)
5. Women Safety (Nirbhaya Nari)
6. Occupational Diseases
7. Air Pollution
Proposed Role of Health Sector
1.
A strengthened Comprehensive Primary Care approach.
2. Recognizing two way continuity of Preventive and Promotive
Care with Curative care.
3. Extending
the coverage and quality of existing package of
services and focus on School Health interventions.
4. Developing capacities and processes for ‘Health Impact
Assessment’ of existing and emerging policies of key non-health
departments.
Contd.
5. Setting up of seven Task Forces for formulation of a detailed
‘Preventive and Promotive Care Strategy’ in each of the seven
priority areas.
6. Promoting prevention strategies from AYUSH systems, Yoga
at workplaces.
7. Wider involvement of stakeholders including elected local
governments, local communities and community based
organizations to create a Social Movement for Health.
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Defined Policy and the stages of policy making
Looked at the complex and political nature of policy making
How to look for and identify the “windows of opportunity” for
policy change
Identify & work with the policy champions
Frame a complex health issue and identify its policy changes and
opportunities
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DR SANJIV KUMAR ROLE OF GOVERNMENT IN HIAP WHO AFRO MEETING 01 – 04 DEC 2015
Blog:
drsanjivkumar.wordpress.com/
Explore the stages of policy making, the role of policy champions, and opportunities for policy change in the health sector. Learn about the National Health Systems Resource Centre in India and its objectives in supporting policy development and implementation. Gain insights into the frameworks, divisions, and activities of the NHSRC in promoting effective health systems.
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Presentation Transcript
Policy making Process: Module 4 Policy making Process: Module 4 DR DR SANJIV SANJIV KUMAR RESOURCE CENTRE (NHSRC) RESOURCE CENTRE (NHSRC), NATIONAL HEALTH MISSION, MINISTRY OF HEALTH & FAMILY WELFARE, GOVERNMENT OF INDIA, NEW DELHI KUMAR, EXECUTIVE DIRECTOR, NATIONAL HEALTH SYSTEMS NATIONAL HEALTH SYSTEMS WHO AFRO REGIONAL WORKSHOP ON IMPLEMENTATION OF HEALTH IN ALL POLICIES, 01-04 DEC 2015, WITS UNIVERSITY, JOHANNESBERG, SOUTH AFRICA.
Learning Objectives Learning Objectives Define Policy and describe the stages of policy making Recognize the complex and political nature of policy making Identify the windows of opportunity for policy change Define & Identify the policy champions Frame a complex health issue and identify its policy changes and opportunities Introduction to National Health Systems Resource Centre, Min of Health & FW, Govt of India
NHSRC Presentation NHSRC Presentation NHSRC Objectives & Structure Health Systems Framework: WHO Health Systems Framework: NHSRC Linkages with Community NHSRC main activities
NHSRC Broad Objectives Respond to technical assistance needs of MOHFW and States 1 Inputs to Policy, Strategy & Plan Development 2 Coordinate technical assistance to MoHFW and States 3 NHSRC works closely with MOHFW 4
NHSRC: A SYSTEMS APPROACH TEN DIVISIONS Public Health Planning Regional Resource Centre-North East (8 states) Community Processes Human Resources for Health Health Informatics Admin, HR & Accounts Quality Improvement PH Administration Healthcare Technologies Healthcare Financing
NHSRC Health System Framework Leadership & Governance Health Information Systems Service Delivery Community Human Resources for Health Healthcare Financing Essential medical products and technologie s
What is policy? What is policy? A principle or a plan to guide decisions, actions & outcome, Laws, documents, procedures, guiding principles, statements of intent or working framework A way of working, a vision, a programme of action, duties responsibility, accountability or an unwritten cultural or ethical code Public policy refers to policy of government Developed through negotiation, repeated practice, decree/order or convention Often a discrepancy between policy intent and policy practice
Types of Health Problems Types of Health Problems Type of Problem Cause and effect Response Simple predictable appropriate response to definable situations can be codified in standard Operating Procedures which then drive interventions Example Acute Gastroenteritis in an individual Complicated unclear at the time, but can be inferred using data, analysis and expert knowledge Once understood, rules for intervention can be defined and followed. Example: Salmonella Outbreak in an institution Complex may be identifiable in retrospect. Interventions go beyond one sector unlikely to conform with prior expectations how things work. Interventions must be flexible as outcomes may be unforeseen. Example Arsenic poisoning varied symptoms Chaotic may be speculated in retrospect, but cannot be validated Interventions must be approached as a learning exercise: act, sense, then revise if necessary Example: Nodding Syndrome (Since 1990 in Uganda, Sudan & Tanzania) https://www.youtube.com/watch?v=fsrV395S-2I
Windows of Opportunity: Examples from India Windows of Opportunity: Examples from India National Health Policy 2015 Draft Public Health Act Four Task Forces on National Health Assurance Mission
Policy development in related sectors All sectors that impact health, health systems, health determinants, health equity, cost of health care Recognize, own the problems, define and frame the issues Identify the role of each sector- clearly identified as causes of causes and what action can be taken If not done ownership of health problems falls by default on health actors (ministry and health institutions) Inform the stake holders (public institutions, academic institutions, think tanks, private sector, CSOs) through policy briefs giving policy options Technically sound, culturally and ethnically acceptable and financially reasonable Negotiations between various stakeholders
Sum up Sum up Defined Policy and the stages of policy making Looked at the complex and political nature of policy making How to look for and identify the windows of opportunity for policy change Identify & work with the policy champions Frame a complex health issue and identify its policy changes and opportunities
Thank You & Best wishes for your leadership role Thank You & Best wishes for your leadership role Blog: drsanjivkumar.wordpress.com/ DR SANJIV KUMAR ROLE OF GOVERNMENT IN HIAP WHO AFRO MEETING 01 04 DEC 2015
