Policy Actor Groups Research Articles

From local networks to national reform? Programmatic groups in the regionalization of German health policy

AbstractBefore policy reform initiatives reach the agenda of national decision makers, such initiatives often start at a small‐scale, local level. The Programmatic Action Framework (PAF) emphasizes the importance of biographical connections to understand how a group of policy actors forms, and how it develops programs that may lead to decade‐long policy change. This article applies the PAF to study the emergence of a programmatic group behind initiatives on regionalization in German health policy through discourse analysis and expert interviews. The study contributes to understanding social networks behind policy programs and social‐psychological, partly informal drivers of policy change. The results show that many PAF conditions have already been met in the German health policy subsystem. We describe a network of policy actors with local and organizational drivers that has led to nationwide cooperation on regionalization.Related ArticlesCaliskan, Cantay. 2020. “The Influence of Elite Networks on Green Policy Making.” Politics & Policy 48(6): 1104–37. https://doi.org/10.1111/polp.12382.Petridou, Evangelia, Per Becker, and Jörgen Sparf. “Policy Entrepreneurs in Public Administration: A Social Network Analysis.” Politics & Policy 49(2): 414–45. https://doi.org/10.1111/polp.12400.Svallfors, Stefan, Erica Falkenström, Corrie Hammar, and Anna T. Höglund. 2022. “Networked Reports: Commissioning and Production of Expert Reports on Swedish Health Care Governance.” Politics & Policy 50(3): 580–97. https://doi.org/10.1111/polp.12462.

Imagining educational futures? SDG4 enactment for ethnic minorities in Laos

ABSTRACT Sustainable Development Goal 4 (SDG4) began with the ambition of reducing inequalities in education. This paper unpacks the enactment of SDG4 in Laos in relation to ethnic minority students by three groups of policy actors: policymakers, donor agencies, and teachers in an ethnic minority boarding school. Informed by Nancy Fraser’s three dimensions of social justice (distribution, recognition, and representation), the findings show that SDG4 targets as well as subsequent national policy documents were restricted to the distributive dimension. Even distributive justice for ethnic minorities was limited to basic education and technical and vocational training, with decreased access to university scholarships – a potential pathway out of poverty. Combined with meritocratic approaches and the absence of policy support to alleviate cultural and political disenfranchisement, SDG4 enactment in the Lao context appears to contribute to further difficulties for ethnic minority students’ upward mobility and their capacity to imagine enhanced educational futures.

Science, Technology and Innovation (STI) and Startup Ecosystem in Vietnam

Research on science, technology and innovation policy (STI policy) in Vietnam has mainly focused on the role of government and business—the two main groups of social actors shaping the development of the Government. From the cultural perspective of STI policy, the article analyses the interactions between four policy cultures representing four groups of social actors (academic, state, business and civil society) that affect the formation and development of STI policy in Vietnam through four stages of development. From there, the article provides a general picture of the role of four groups of policy actors involved in the policymaking process, considering aspects including: (a) the nature of the policy; (b) policy objectives; (c) policy makers; (d) policy instruments; (e) policy specificity and (f) group of agents representing policy culture. Next, the article analyses the formation and development of an innovation-based startup ecosystem that represents the concerns of a third policy culture—an economic policy culture. Finally, the article proposes some initial recommendations to promote the interaction between the components of the STI ecosystem, especially those related to the innovation-based startup ecosystem.

The Barriers to Universal Health Coverage in India and the Strategies to Address Them: A Key Informant Study.

India has adopted several policies toward improving access to healthcare and has been an enthusiastic signatory to several global health policies to achieve Universal Health Coverage (UHC). However, despite these policy commitments, there has been limited success in realizing these goals. The COVID-19 pandemic has highlighted the urgent need for health system re-design and amplified the calls for such reforms. We seek to understand the views of a diverse group of policy actors in India to address the following research questions: what are the (i) conceptualizations of UHC, (ii) main barriers to realizing UHC, and (iii) policy strategies to address these barriers. We collected data through in-depth interviews with 38 policy actors from diverse backgrounds and analyzed using the Framework Method to develop themes both inductively and deductively using the Control Knob Framework of health systems. There was congruence in the conceptualization of UHC by policy actors. Quality of care, equity, financial risk protection, and a comprehensive set of services were the most commonly cited features. The lack of a comprehensive systems approach to health policies, inadequate and inefficient health financing mechanisms, and fragmentation between public and private sectors were identified as the main barriers to UHC. Contrasting views about specific strategies, health financing, provider payments, organization of the delivery system, and regulation emerged as the key policy interventions to address these barriers. This is the first systematic examination of a diverse set of policy actors' problem analyses and suggestions to advance UHC goals in India. The study underscores the need to recognize the complex and interlinked nature of health system reforms and initiate a departure from path-dependent vertical interventions to bring about transformative change.

Editorial Introduction: Contributing to the policy process literatures

Editorial Introduction: Contributing to the policy process literatures

Smartphones in the Swedish upper-secondary classroom: A policy enactment perspective

ABSTRACT This study addresses normative orientations to smartphone use in Swedish upper-secondary classrooms. We present a Nexus Analysis from a policy enactment perspective of a material comprising ethnographic interviews, classroom video observations, and smartphone screen capture, investigating how a cultural conception of the smartphone as a source of disturbance is negotiated in discursive and embodied social action. Three groups of policy actors – head teachers, teachers, and students – balance competing agendas such as digitalization strategies, popular media narratives, and student autonomy and peer relationship maintenance. There is a tension between orientations to the smartphone as a legitimate resource for socialization and learning in the digitalized classroom, but also as an exception to desired digitalization – a potential threat to the social and disciplinary order of the classroom. Notably, the students display considerable awareness of such tensions, in reflective comments made in interviews and in displayed strategies for managing their smartphones in class.

All opinions are not equal: Toward a consensual approach to the development of drug policy

AbstractDrug policy has been subjected to much scrutiny from different stakeholder groups who present sometimes very different opinions on solutions to address a problem. Reconciling such differences, that are underpinned by both anecdotal and empirical evidence, is a priority yet to be fully achieved. In this study, we examine: (i) whether differences exist among actor groups regarding their perceived importance in policymaking; (ii) whether those who dominate the decision process value the input of laypeople or minority actors; and (iii) whether differences exist, with regard to i and ii, between study sites (i.e. Australia and Hong Kong) that have markedly different drug strategies. Overall, differential preference weightings between dominant groups reveal a strong influence of political orientation. Results suggest that decisions made by health professionals were regarded as the most important, while most of the respondent groups gave a low preference toward policy decisions made by law enforcers. Dominant groups also tend to discount the inputs of laypeople and other minority groups. Our study highlights the importance for policy actor groups to consider such a differential weighting of inputs when synthesising knowledge and gathering opinions for the development of drug policy.

Imagining language policy enactment in a context of secrecy: SDG4 and ethnic minorities in Laos

ABSTRACT This article explores policy enactment processes in relation to the United Nations’ Sustainable Development Goal 4 (SDG4), particularly its emphasis upon ensuring inclusive and equitable quality education. Specifically, as part of SDG4 in Laos, the research reveals how medium-of-instruction policy was enacted in relation to ethnic minorities, focusing upon three groups of policy actors in the Lao context – policymakers involved in developing education language policy; donor agencies that provided funds to support education reform in Laos, and; school teachers in an ethnic minority boarding school who were charged with enacting the policy. The findings, informed by relevant theorising about imagined communities and secrecy, including in the Lao context, revealed the central role of secrecy in this enactment process. The findings showed three types of secrecy at play which influenced policy actors’ imaginations and enactments of ethnic minority education in response to SDG4 in Laos: secrecy to create the image of national unity; secrecy arising from fear of reprisal, and; secrecy to safely resist dominant policy discourses. The research has implications for how global policy reforms, such as SDG4, are actually made sense of in low-income country contexts where such reforms are enacted.

Tensions and coalitions: A new trade agreement affects the policy space for nutrition in Vietnam

Global trade has shaped food systems over centuries, but modern trade agreements are hastening these changes and making them more complex, with implications for public health and nutrition transition. This study aimed to understand the impact of the 2018 Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) on the policy space for public health nutrition in Vietnam. We conducted comparative document review and key informant interviews, and our analysis drew on a framework of policy space and the theory of advocacy coalitions. We identified 10 CPTPP sections with potential public health nutrition implications; and 50 Vietnamese policies relevant to nutrition having one or more tensions with one or more CPTPP sections. A majority of policy tensions were in sections of the CPTPP relating to technical barriers to trade and government procurement; most tensions related to protecting policy-making from vested interests. Different groups of policy actors hold different beliefs and interests on these issues, and therefore promote different framings and policy approaches. We identified two advocacy coalitions working very separately on issues affecting nutrition policy space: a trade coalition holding the policy position that free trade improves nutrition by default; and a nutrition coalition holding the policy position that nutrition should be explicitly considered in trade policy. The policy space for nutrition in Vietnam has important potential constraints through written policy, and the trade and nutrition coalitions will need to interact more regularly and constructively in order to foresee where these tensions will arise in practice, and create plans for their mitigation. This study adds to global evidence of free trade agreement impacts on nutrition policy space, and we extend previous work by explaining these actor groupings in the policy space through the theory of advocacy coalitions.

Introduction—Stories of the old world: The Narrative Policy Framework in the European context

Introduction—Stories of the old world: The Narrative Policy Framework in the European context

Reimagining instrument constituencies: the case of conservation policy in Mexico

Throughout the developing world, payments for ecosystem services (PES) programs are popular policy instruments that allow those who rely on such amenities as drinking water and clean air to pay the landowners who, in turn, provide and care for those services so the resources are protected and sustainably available in the future. Despite the popularity of PES programs as policy instruments, they have been proven largely ineffective in achieving their long-term goals. Specifically, they have failed to conserve the targeted ecosystem services. We examine Mexican instrument constituencies that have promoted use of a PES program, the payments for hydrological services (PHS) program. Instrument constituencies are groups of policy actors who are bound by an interest in a particular policy instrument or solution. Although the PHS program has been in existence for nearly 20 years, the evidence points to policy drift and overall policy failure. The path-dependent nature of the instrument constituency and resulting feedbacks have crowded out any chance of more effective forest or water conservation programs from being established. A case-based counterfactual analysis is employed to consider alternative program choices that could exist in the absence of a PHS instrument constituency.

Europe as spatial imaginary? Narratives from higher education ‘policy influencers’ across the continent

ABSTRACT Europe is, in many ways, of central importance to discussions about higher education. Various European initiatives, such as the Bologna Process and the Erasmus mobility programme, have had a direct and material impact on the shape and nature of higher education across the continent. They have also been linked to wider political objectives, such as the inculcation of a European political identity, and the strengthening of the European political and economic space relative to other parts of the world. Nevertheless, the relationship between Europe and education has tended to remain rather marginalised within research. We know relatively little, for example, about how policymakers think about Europe and the extent to which it constitutes an important frame of reference for them. To start to redress this gap, we draw on an analysis of policy documents and interviews with key policy stakeholders to argue that the idea of Europe constitutes an important ‘spatial imaginary’ for higher education within the continent, and helps to frame the ways in which students are conceptualised. However, we also suggest that this is not played out in uniform ways; there are significant differences between both countries and different groups of policy actors within them.

McKinsey and the 'Tripartite Monster': The Role of Management Consultants in the 1974 NHS Reorganisation.

The first major reorganisation of the National Health Service took place in 1974, twenty-six years after the service had been established. It has long been perceived as a failure. This article draws on archival records and a witness seminar held in November 2016 to provide a more nuanced assessment of the 1974 reorganisation and understand more fully why it took the form that it did. In particular it identifies the reorganisation as an important moment in the ongoing story of management consultants engaging with health policymakers, and explores the role of McKinsey and Co. in detail for the first time. Key explanatory factors for their involvement are identified, including the perceived lack of expertise and manpower inside the civil service and the NHS, and perceptions of their impact and effectiveness are discussed. Many debates about the use of management consultants today were directly foreshadowed during the early 1970s. Alongside this, the role of other groups of policy actors, including civil servants, politicians and medical professionals, are established and the extent to which British health policymakers have had to work within existing cultural, political, legislative and practical constraints when trying to initiate change is demonstrated. The fact that many of the 'mistakes' that were made have been repeated in the course of subsequent reforms, speaks to the poor institutional memory of Whitehall, and the Department of Health and Social Care in particular. In the run up to 1974 management consultants could make only a limited contribution to an imperfect compromise.

Navigating the politics of evidence-informed policymaking: strategies of influential policy actors in Ontario

Policy studies suggest that evidence-informed policymaking (EIPM) requires framing and persuasion strategies, and an investment of time to form alliances and identify the most important venue. However, this advice is very broad and often too abstract. In-depth case studies help make this advice more concrete. To understand the engagement strategies of influential policy actors, this case study examines the Ontario Poverty Reduction Strategy, a large-scale provincial policy touted as “evidence-based.” The study is based on interviews with elite policy advisors (n = 19) serving in different stages of the policymaking process. It shows that the elite advisors effectively used persuasion tactics, networking and longevity strategies to counteract a volatile political context and competing policy priorities. In light of the findings, this paper provides practical recommendations on how evidence producers can emulate such success in different contexts: understand formal and informal processes, master and exercise political acuity, and strategically establish networks with a diverse group of policy actors in order to effectively frame and communicate evidence.

Citizens’ self-mobilization, motivational factors, and the group of most engaged citizens: The case of a radioactive waste repository in Denmark

Citizens’ self-mobilization has received considerable attention in literature on land use policy and environmental politics. Involved in this mobilization process is a group of highly engaged citizens, which are known by a variety of names in literature and acknowledged for their role in policymaking. To better understand this group of policy actors, the paper investigates the motivational factors that lead this group of citizens to invest numerous hours in policymaking. The case of the planning process of a radioactive waste repository in Denmark is used, since this topic is a well-known policy struggle in many countries. Bringing together theoretical insight into motivational factors, empirical data from a nationwide questionnaire, and interviews with a selected group of highly engaged citizens, the study shows that the most engaged citizens have a distinct set of motivational factors dominated by their perception of unfairness, collective identity, and knowledge of the case.

A media framing analysis of urban flooding in Nigeria: current narratives and implications for policy

A critical element of current flood management is the importance of engaging key policy actors when policy decisions are to be made. However, there is still only limited understanding of how narratives of flood management actors may influence flood management policies, even though there is a suggestion that actors can strategically use their narratives to influence policy directions. In a developing country like Nigeria, there are still questions around lessons that can be learnt from understanding the narratives of policy actors, to unravel the complex nature of strategies and policy directions in managing urban floods. To help fill these gaps, this paper uses quantitative content analysis to explore the frame of five policy actor groups (government, local communities, business, multilateral organisations and non-governmental organisations (NGOs)) as expressed in local and national newspapers between 2012 and 2016 to understand their narratives of causes and strategies to solve the problem of urban flooding in Nigeria. The narratives of government, local communities and businesses align with the premise that flooding can and should be prevented whilst that of multilateral and business actors champion adaptation strategies on the basis that flooding is inevitable and hence more energy should be directed at ‘living with water’—emergency response, damage reduction and the aftermath. The study also identified areas of potential consensus and conflict between direct actors such as government and local communities on the one hand and funders on the other. Better discussion among actors aiding understanding of contemporary thinking and local realities will aid policy-making and policy implementation in the Nigerian context. An important step will be in the collaborative design of an urgently needed ‘Nigerian policy on flooding’ which currently does not exist.

Non-implementation of road pricing policy in the Netherlands: An application of the ‘Advocacy Coalition Framework’

The implementation of road pricing policies is dependent on political support for the policy. It is frequently argued that many pricing proposals fail to be implemented due to the opposition of one or a group of policy actors (e.g. political parties, interest groups). This study considers this issue and examines the reasons for non-implementation of proposals for Dutch road pricing policies by analysing the policy position changes of 26 major policy actors and the changes in consensus and conflict among these actors over a policy process of 16 years. The “Advocacy Coalition Framework” (ACF) is used as the theoretical lens. Our findings show that in the Netherlands non-implementation cannot be ascribed to only the opposition of one policy actor or to one group of policy actors, but rather to features of the Dutch political system/culture and complications peculiar to the road pricing subsystem (socio-cultural values related to mobility, complex design issues). We found that internal and external shocks, and policy-oriented learning affected the subsystem and alerted the power balance between pro-and anti-road pricing coalitions. However, these factors did not produce a major policy change, namely, the introduction of a road pricing scheme.

Conceptualizing the outcomes of involving people who use mental health services in policy development

Inclusion of people who use mental health services in policymaking is a goal of many mental health systems. However, the outcomes of such involvement have not been well articulated or researched. The objectives of this research were to explore how the social and personal outcomes of citizen-user involvement in mental health policymaking were conceptualized by policy actors and to create a conceptual framework to guide the development and evaluation of citizen-user involvement. This qualitative instrumental case study explored the phenomenon of citizen-user involvement using the policy field of mental health and social housing policy in the Province of Manitoba, Canada, as the focal case. A total of 21 informants from four policy actor groups, citizen-users, representatives of advocacy organizations, government officials and service providers, participated in key informant interviews. Data also included policy documents relevant to the policy field. Data collected from interviews and policy documents were analysed using an inductive qualitative paradigm. Participants identified multiple outcomes of citizen-user involvement in policymaking. The resulting conceptual framework illustrated how outcomes in personal, substantive, instrumental and normative dimensions influence micro-, meso- and macrosocial structures. The results also provided a cautionary tale by suggesting how attention needs to be paid to managing the risks as well as optimizing the rewards of involvement. The framework has application in guiding the development and evaluation of mechanisms that aim to involve citizen-users in policymaking. The framework encourages an approach that takes into account the complexity and multidimensional nature of engaging citizen-users.

Policies and practices in supporting scientists' public communication through training

Scientists are increasingly expected to engage in public communication, though they frequently report that they feel inadequately prepared for such activity. The necessary training for such activity has barely been discussed in the science communication literature. Drawing on country reports from the Monitoring Policy and Research Activities on Science in Society in Europe (MASIS) report, this paper reviews initiatives across Europe to support scientists’ public communication. It examines these within a framework that distinguishes between training oriented to dissemination or dialogue, and to capacity-building of scientists or professionalisation of science communicators. It traces the uneven spread and diverse character of such supports and identifies the four principal groups of policy actors who play distinct roles and, in the case of higher education institutions, sometimes internally contradictory roles. The paper draws on the authors’ own experiences to underline the value of communication training that is oriented to dialogue and stimulates reflexivity.

Understanding How Context Shapes Citizen-User Involvement in Policy Making

As governments grapple with meeting expectations of citizens and including their voices in policy making, greater understanding of how context influences involvement can help identify ways to involve those citizens who face substantial barriers to inclusion in policy development. This qualitative, instrumental case study focused on the involvement of people who use and need mental health and housing services in policy development in Manitoba. Data were collected from 21 key informants purposively selected from four policy actor groups as well as from relevant documents. Data were analyzed using inductive qualitative methods. Results identified five themes related to contextual influences on involvement: (a) the social environment, (b) institutional characteristics, (c) participant characteristics, (d) opportunities for involvement and (e) ideas and formal policy structures. The findings suggest that policy makers should look to contextual factors to identify ways to reduce the barriers to the inclusion of people with mental health and housing needs in health policy making.