POLICY ARENA OF HEALTH POLICY-MAKING PROCESS IN DEVELOPING COUNTRIES

Abstract

ABSTRACT

Background: Making a policy, which is a set of actions, decisions or statements of intent, involnes the processes of initiation, creation, implementation and evaluation. Health policies include actions or inactions by public, private and voluntary organizations having impacts on health. The sites or platform where policy processes take place are defined as the policy arenas and include legislatures, executives, courts, regulatory agencies or semi-public bodies. This paper aims to identify the different policy arenas providing a platform for each phase of the policy-making process; problem identification, policy formulation, policy implementation and policy evaluation.

Materials and Methods: A scoping systematic review method was used. Articles were identified using the Scopus, Science Direct, Google Scholar and PubMed database. The keywords “Policy Arena”, “Health Policy Process” and “developing countries” were used. Only articles written in English, published within the last 15 years, and about developing countries were included. Initial searching yielded 100 articles. After reading the titles and abstracts, 60 articles were excluded. Subsequently, three articles were excluded after checking for duplicates. Finally, only 19 articles were included after reading the full texts of the articles.

Result: The policy arenas for health policy development are classified as state and government arena. The executive branch refers to the highest administration making decisions regarding national policies. Under this executive branch is bureaucracy, referring to all the systems and processes of an organization.  The legislative branch enacts the laws or policies through the parliament. Subsequently, the judiciary interprets and applies the laws. The international arena includes the World Health Organization, who may come out with policies to be adopted by member countries. Based on the review, for agenda setting, the policy arenas are the bureaucratic and international arena. For policy formulation, the bureaucratic, executive and legislative arenas are involved. The subsequent stage, policy implementation, involves the legislative and judiciary arenas. Finally, the evaluation stage, the bureaucratic and the international arenas are involved.

Conclusion: Each stage in policy-making involves different policy arenas. For a particular policy arena, the role it plays differs according to the stage of the policy cycle. The type of policy would also influence the type of arena as well as the mix of actors within the arena. Therefore, it is essential to fully understand the role of each arena and their main actors in order to ensure the success of the policy-making process.

Keywords: policy arena, health policy process, developing countries