Future directions for health policy analysis: a tribute to the work of Professor Gill Walt

Abstract

This edition of Health Policy and Planning comprises a set of seven papers that focus on the field of health policy analysis. Such analysis shares an understanding that policy making is a process of continuing interaction among institutions (the structures and rules which shape how decisions are made), interests (groups and individuals who stand to gain or lose from change) and ideas (including arguments and evidence) (John 1998). This area of multi-disciplinary inquiry is, in higher income countries, a recognized academic field of practical relevance, but in low and middle income settings it remains an underdeveloped area of work. Yet, in the year we celebrate the 30-year anniversary of the Alma Ata Declaration on Primary Health Care, it is clear that better understanding of the challenges to health policy implementation and renewed action to achieve the Millennium Development Goals are vital in these settings. Health policy analysis is important to both tasks. It can help explain why certain health issues receive political attention, and others do not, such as by enabling identification of which stakeholders may support or resist policy reforms, and why. It can also identify the perverse and unintended consequences of policy decisions, as well as the obstacles that undermine policy implementation and so jeopardize national and global goals for improved health. In these ways, policy analysis supports more realistic expectations about the timeframes and nature of policy reform, can assist in enabling successful policy development and implementation, and can support the use of technical evidence in these processes (Buse et al. 2007). The papers presented here derive from a workshop held in London in May 2007 which brought together 25 practicing health policy analysts from around the world. The workshop sought to take stock of the current state of health policy analysis inquiry in low and middle income countries (LMICs). Participants reflected not just on the content of this body of work but also, and equally importantly, on how this work is undertaken. The workshop specifically allowed an exchange of ideas about the use of theoretical and conceptual frameworks, and methods and approaches, in investigating and understanding policy processes; and it sought to identify how such analysis could be strengthened in the future. The workshop and this set of papers pay tribute to the work of Gill Walt, a co-founder of this journal, Professor Emeritus in Health Policy at the London School of Hygiene and Tropical Medicine, and a key intellectual influence in the field of health policy analysis. Gill established Health Policy and Planning with Patrick Vaughan in 1986 and has played an important role in the journal’s subsequent development. The hallmarks of their approach to health policy are reflected in the very first editorial [1(1): 3–4, 1986], which established that the journal would: