T17P10. Why Health Reforms Fail (and Sometimes Succeed): Applying Public Administration Theory to Policy Implementation of Health Reforms with a focus on Low and Middle-Income Countries
Health PolicyCATEGORISATION
KEYWORDS
GENERAL OBJECTIVES, RESEARCH QUESTIONS AND SCIENTIFIC RELEVANCE
Policy studies are replete with examples of unintended consequences and policy failure and yet the causes of implementation failure have been under-researched. Why do good ideas fail in practice? While the topic of policy change is a widely researched area in public policy and political science, the literature on what happens next, in other words on implementation, is more sparse. Once a policy is adopted, it becomes the domain of public administrators and of less potential interest to public policy. Yet, literature on bureaucratic politics suggests that policymaking continues during policy implementation and that policies continue to evolve as they are put into practice. Meanwhile, in the field of health policy, literature on “implementation science” is rising in prominence. However, this literature is more focused on program implementation and the dissemination and scalability of effective interventions at a community level than on policy implementation and the diffusion of effective policies to populations and representative bodies. For instance, how do we scale universal health coverage and effectively regulate drug companies as opposed to how do we replicate this community-based intervention to promote weight loss and reduce pre-diabetes? Whereas program implementation requires knowledge of management and organization theory, policy implementation necessarily requires knowledge of public administration theories.
CALL FOR PAPERS
This panel aims to bring together scholars working on questions of relevance to the global health field, but with a particular focus on how theories, methods and approaches from public administration can be applied to understand policy implementation in the context of less developed countries. The panel welcomes submissions that apply existing public administration theories to cases of health reform that have either succeeded or failed. Alternatively, papers may develop new theories or address the question of why public administration theories have not been more integrated into the field of health services and policy research in spite of their clear relevance to pertinent, real-world questions. While the main focus is on policy implementation in low- and middle-income countries, we will also consider papers that advance and apply public administration theories to health policy questions in a high-income country context if their focus is sufficiently pertinent to policy learning in other contexts.
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