POLICY DEVELOPMENT Public Policy and Policy Process

1. Problem: Patients wait for an hour to be seen by the HC doctor. Not all services are available; supplies, like drugs, are often lacking. Patients do not know where to go for complicated diseases; when they are discharged from a hospital, they are not followed-up.  Parts: Agenda Setting Policy Formulation Implementation Evaluation Don’t forget about PUBLIC HEALTH!

2. POLICY DEVELOPMENTPublic Policy and Policy Process EXTERNAL (GENERAL) ENVIRONMENTAL FACTORS [ Political, Economic, Social, Technological, Legal & Environmental (PESTLE) ] OUTCOMES SUPPORTS OUTPUTS INPUTS Agencies DECISION Data Issues Gaps Improved State of People Enacted Policies / Programs Decision Areas DEMANDS Need for Policies THE POLICY SYSTEM INTERNAL (SPECIFIC) ENVIRONMENTAL FACTORS Competition, Cooperation & Linkages

3. Agenda Setting • Statement of the Problem • Define scope (RHU, who else is involved?) and target population – we’ll be focusing on rural • Efficiency (triage, SOP, reasons for the long wait? Doctors? Nurses? # of patients? BHW? [what factors contribute individually to the stakeholders]) • Services – training of staff, increase awareness, continuing medical education • Focus on BHWs? Since there are more BHWs BUT there are a lot of BHWs and there is not enough budget for that many people. Would it be better to just focus on few doctors that will be more efficient? • Prioritization of diseases per region – just so focused programs/policies • Available Supplies (LGU, # of people taking part of the supplies, percentage of supplies provided by the government, location like if area is prone to floods, etc.) – we could suggest communication/partnership of gov’t departments with private sectors • Sustainability/continuity of health care –

4. POLICY DEVELOPMENTPolicy Analysis • Agenda Setting • Lists of subjects or problems to which government officials are paying some serious attention to any given time (John Kingdon) • Viewed to result from three mostly independent streams of activity (problems, policies, politics) which converge into a policy window and permitting a policy agenda • research fora, round table discussions, national health sector meetings

5. Policy Formulation • Past Policies (RRL) • Data Issues • Gaps • POLICY DOCUMENT • Continuous training of BHWs • How? Regional competition, top to bottom improvement on service delivery (like a DOH representative should be checking up on them so as to create a more holistic approach), training and evaluation should go hand in hand • Competition helps promote unity and communication among BHUs • Continuity of care/ sustainability can be assessed by monitoring of BHWs to get census of disease prevalence; Mobile clinic that can monitor patients 2x/month within regions • Standard Evaluation Sheet for every health worker • Levels of Policy-Making • National • Local • Institutions/Agencies • Policy Adoption • Benefits • Supports • Agencies • Demands • Need for policies • Limitations • INTERNAL (SPECIFIC) ENVIRONMENTAL FACTORS • Competition, Cooperation & Linkages • EXTERNAL (GENERAL) ENVIRONMENTAL FACTORS • [ Political, Economic, Social, Technological, Legal & Environmental (PESTLE) ] • Ethics

6. POLICY DEVELOPMENTPolicy Analysis • Policy Formulation • Pertains to the development of pertinent and acceptable proposed courses of action for dealing with public problem • Passage of legislation designed to remedy some past problem or prevent some future public policy problem • Research undertakings, augmented by special studies, review of policies developed by technical units

7. Implementation • Policy Instruments, Allies in civil society, • Anticipated future challenges • Managerial • Financial • Formal Instruments • Legislation • Executive Fiat • Department Issuances • Informal Instruments • Policy Statements / Pronouncements / Directives • Mass Media • Ethics and Norms

8. POLICY DEVELOPMENTPolicy Analysis • Policy Implementation • Often described as “what happens after a bill becomes a law” • Application of the policy by the government’s administrative machinery. • Takes the form of organizational performance indicators framework, health sector expenditure framework, planning guidelines, contracts, etc

9. Policy Evaluation • Outcomes • Improved state of the people • Policy Analysis • Policy Change • Policy Termination

10. POLICY DEVELOPMENTPolicy Analysis • Policy Evaluation • Efforts to determine whether the policy was effective… why or why not • What happens as a result of the public policy • Concerned with the extent to which policy actually achieves its intended results • MDG tracking, ME3, general audits

11. POLICY DEVELOPMENTPolicy Analysis • Policy Change • Newest conceptual development in the policy cycle • Absorbs several stages of the policy cycle – formulation, implementation, evaluation, termination • Refers to the point at which a policy is evaluated and redesigned so that the entire policy process begins anew

12. POLICY DEVELOPMENTPolicy Analysis • Policy Termination • End point of the policy cycle • Ending outdated or inadequate policies • Means many things e.g. policy redirection, project elimination, agency termination, fiscal retrenchment, etc • Termination may occur through a sudden authoritative decision or through a long term decline in resources necessary to run a program.

13. Practical Principles for Policy Analysts Learn to focus quickly on the central decision criteria of the problem. Avoid the tool box approach to analyzing policy. Learn to deal with uncertainty. Say it with numbers and/or figures. Make the analysis simple and transparent. Check the facts. Learn to advocate the position of others. Give client analysis, not decisions. 9. Push boundaries beyond analysis of policy envelope. 10. Be aware that there is no such thing as an absolutely correct, rational and complete analysis. For Everyone: POLICY DEVELOPMENTPolicy Analysis