Kingdon's Multiple Streams Research Articles

The Health Policy Process in Vietnam: Going Beyond Kingdon's Multiple Streams TheoryComment on "Shaping the Health Policy Agenda: The Case of Safe Motherhood Policy in Vietnam".

This commentary reflects upon the article along three broad lines. It reflects on the theoretical choices and omissions, particularly highlighting why it is important to adapt the multiple streams framework (MSF) when applying it in a socio-political context like Vietnam's. The commentary also reflects upon the analytical threads tackled by Ha et al; for instance, it highlights the opportunities offered by, and raises questions about the centrality of the Policy Entrepreneur in getting the policy onto the political agenda and in pushing it through. The commentary also dwells on the implications of the article for development aid policies and practices. Throughout, the commentary signposts possible themes for Ha et al to consider for further analysis, and more generally, for future research using Kingdon's multiple streams theory.

To what Extent do Australian Health Policy Documents address Social Determinants of Health and Health Equity?

AbstractEvidence on social determinants of health and health equity (SDH/HE) is abundant but often not translated into effective policy action by governments. Governments’ health policies have continued to privilege medical care and individualised behaviour-change strategies. In the light of these limitations, the 2008 Commission on the Social Determinants of Health called on health agencies to adopt a stewardship role; to take action themselves and engage other government sectors in addressing SDH/HE. This article reports on research using analysis of health policy documents – published by nine Australian national or regional governments – to examine the extent to which the Australian health sector has taken up such a role.We found policies across all jurisdictions commonly recognised evidence on SDH/HE and expressed goals to improve health equity. However, these goals were predominantly operationalised in health care and other individualised strategies. Relatively few strategies addressed SDH/HE outside of access to health care, and often they were limited in scope. National policies on Aboriginal health did most to systemically address SDH/HE.We used Kingdon's (2011) multiple streams theory to examine how problems, policies and politics combine to enable, partially allow, or prevent action on SDH/HE in Australian health policy.

Getting to the Roots of Evaluation Capacity Building in the Global South: Multiple Streams Model to Frame the Agenda Status of Evaluation in Turkey

Abstract: A growing body of research is investigating the mechanisms to develop evaluation capacity in the Global South, but relatively little attention has been given to an equally important question: Under what conditions does the need to conduct and use evaluations for national decision making become a high priority on the governmental agenda? This article utilizes Kingdon's (2003) Multiple Streams Model to understand when and how evaluation is pushed higher on the public policy agenda in the Global South by using Turkey as a country case. This article argues that evaluation capacity building in the developing world may not be successful unless evaluation is indigenously elevated as a prominent item on the government's agenda. Turkey's case demonstrates evaluation's fleeting agenda status because evaluation as a policy solution has not yet become joined to a real problem despite the opening of a brief window of opportunity.

Policy Streams and Immigration to Russia: Competing and Complementary Interests at the Federal and Local Levels

This article uses Kingdon's Multiple Streams Framework to explain forms of national- and region-level governance used in the Russian Federation to manage unprecedented levels of international immigration. First, we identify the ways that the Russian federal government has legislated and governed international migration from 1991 through 2010. We then compare the federal level to the case of the Krasnodar region, an ethnically diverse region in the North Caucasus. We find that that migration policy adoption in Russia at the federal level is relatively immune to economic trends or labour needs but more sensitive to foreign and domestic political objectives. At the regional level, local socio-political and economic concerns predominate and political objectives are secondary. Finally, we argue that migration policy changes or adopted policy at the regional level may be explained by an interaction effect between changes in political leadership, federal level policy adoption, and regional level context.

The sea is rising… but not onto the policy agenda: A multiple streams approach to understanding sea level rise policies

There has been little policy effort to address sea level rise in coastal states in the US. It is important to examine, at the state level, how the multitude of different (and changing) actors with different preferences and perspectives contribute to such inertia. This study examines state-level legislative inaction with regards to sea level rise. Using Kingdon's multiple streams framework, we draw a picture of the policy landscape in Virginia as one where the problem of sea level rise is perceived as a low priority, with little consensus on achievable policy solutions, and is politically controversial. We find that policy inertia in Virginia is a result of (1) fractious viewpoints regarding sea level rise as a problem, (2) a lack of clear consensus on policy solutions, and (3) conflicting perspectives of the role of the state.

Why were upscaled incentive programs for forest conservation adopted? Comparing policy choices in Brazil, Ecuador, and Peru

Forest conservation policies could potentially become a centerpiece for climate change mitigation. Incentive-based conservation policies, such as payments for environmental services (PES), are seen as promising approaches to reduce deforestation. Yet, arguably the adoption of upscaled PES programs has remained slow, and when implemented their design often diverges from the principles laid out in the theory-based PES literature. In this article, we concentrate on some political economy forces that could help explaining the gap between PES theory and practice, with respect to policy adoption, including opportunities and challenges in this process. Public policy theories grasp the adoption determinants of three large, government-led incentive programs for forest conservation in the Amazon, in Peru, Ecuador, and Brazil. We use Kingdon's Multiple Streams Framework to analyze decision-making regarding program initiation, including key stakeholder interviews, to understand policy choices. We find that environmental concerns are not always the prime motives for PES programs, as political and institutional contexts limit environmental policy-makers' actions. Yet, policy choice processes become less constrained when environmental issues are closer to a government's priorities.

THE MUDDLING CROWN: VIA RAIL AND THE FEDERAL GOVERNMENT

ABSTRACTThis article is an analysis of VIA Rail and its relationship with the federal government. Canada's publicly‐owned intercity passenger rail service is in a state of slow and steady decline, best illustrated by its small and falling user rates, and despite receiving significant subsidies, the federal government is indifferent to the needs of this transportation provider. Unlike other Canadian state‐owned enterprises, or Crown corporations, VIA Rail has been neither privatized nor modernized and, instead, is languishing as a publicly‐owned firm. While the current Conservative government of Stephen Harper favors a smaller role for the state, and it has both set about modernizing and eliminating other Crowns, it has not followed such a course with VIA Rail. Drawing on John Kingdon's (1984) multiple streams model to outline the empirical data as well as to illustrate how this firm interacts with its political superior, it will argue that the indifference towards this firm is due to both the specific characteristics of VIA Rail and the highly centralized decision‐making structure of Canada's Westminster Parliamentary system. Unless the federal government decides to implement fundamental organizational and governance changes at this firm, Canadians will continue to be served by a marginal rail service provider.

Introducing New Priority Setting and Resource Allocation Processes in a Canadian Healthcare Organization: A Case Study Analysis Informed by Multiple Streams Theory.

In this article, we analyze one case instance of how proposals for change to the priority setting and resource allocation (PSRA) processes at a Canadian healthcare institution reached the decision agenda of the organization's senior leadership. We adopt key concepts from an established policy studies framework - Kingdon's multiple streams theory - to inform our analysis. Twenty-six individual interviews were conducted at the IWK Health Centre in Halifax, NS, Canada. Participants were asked to reflect upon the reasons leading up to the implementation of a formal priority setting process - Program Budgeting and Marginal Analysis (PBMA) - in the 2012/2013 fiscal year. Responses were analyzed qualitatively using Kingdon's model as a template. The introduction of PBMA can be understood as the opening of a policy window. A problem stream - defined as lack of broad engagement and information sharing across service lines in past practice - converged with a known policy solution, PBMA, which addressed the identified problems and was perceived as easy to use and with an evidence-base from past applications across Canada and elsewhere. Conditions in the political realm allowed for this intervention to proceed, but also constrained its potential outcomes. Understanding in a theoretically-informed way how change occurs in healthcare management practices can provide useful lessons to researchers and decision-makers whose aim is to help health systems achieve the most effective use of available financial resources.

Kingdon's Multiple Streams Approach: What Is the Empirical Impact of this Universal Theory?

While John Kingdon's Multiple Streams Approach (MSA) remains a key reference point in the public policy literature, few have attempted to assess MSA holistically. To assess its broader impact and trends in usage, we combine in‐depth analysis of representative studies, with comprehensive coverage of MSA‐inspired articles, to categorize its impact. We find that Kingdon's work makes two separate contributions. First, it has contributed to the development of “evolutionary” policy theories such as punctuated equilibrium. Second, it has prompted a large, dedicated, and often empirical, literature. However, most MSA empirical applications only engage with broader policy theory superficially. The two contributions are oddly independent of each other. We argue that these trends in application are due largely to its intuitive appeal and low “barrier to entry.” Drawing on other policy approaches, we offer suggestions to improve the MSA‐inspired literature.

The Multiple Streams Framework and the problem broker

AbstractJohn Kingdon's Multiple Streams Framework (MSF) constitutes a powerful tool for understanding the policy process, and more specifically, agenda‐setting, through three separate streams: problems, policies and politics. This article argues that the MSF would benefit from further development of the problem stream. It introduces a clearer conception of agency into the problem stream by suggesting the inclusion of the problem broker. The problem broker is a role in which actors frame conditions as public problems and work to make policy makers accept these frames. The problem broker makes use of knowledge, values and emotions in the framing of problems. The use of these three elements is seen as a prerequisite for successful problem brokering – that is, for establishing a frame in the policy sphere. Other important factors are: persistence, access to policy makers, credibility and willingness. Problem brokers also need to know who to talk to, how and when in order to make an impact. The context, in terms of, for example, audience and national mood, is also crucial. The inclusion of the problem broker into the MSF strengthens the analytical separation between streams. According to Kingdon, policies can be developed independently from problems. The MSF, therefore, enables a study of policy generation. The inclusion of the problem broker, in the same sense, makes it possible to investigate problem framing as a separate process and enables a study of actors that frame problems without making policy suggestions. The MSF is, in its current form, not able to capture what these actors do. The main argument of this article is that it is crucial to study these actors as problem framing affects the work of policy entrepreneurs and, thereby, agenda‐setting and decision making.

Understanding Policy Reform in Colorado's Domestic Violence Offender Treatment Standards

AbstractThis study examines the perceived conditions leading to Colorado adopting revised Standards for treating domestic violence offenders from the perspective of Kingdon's multiple streams theory. A within‐case analysis of ten semi‐structured interviews explores the Domestic Violence Offender Management Board in Colorado's process for revising Colorado's 2001 Treatment Standards. Findings suggest a benign political stream, supported by technically feasible and value‐accepted policy ideas, feedback and indicators of the problem, promoted a favourable setting for change. At least two policy entrepreneurs championed the decision‐making process. Agenda setting and policy formulation depended on three elements: feedback from existing programmes, indicators of continued difficulty in effectively treating offenders, and the existence of a suitable policy alternative. This study contributes a rare application of multiple streams theory to a criminal justice context in a sub‐national government. Future research should explore whether the presence of a benign political stream influences the development and revision of domestic violence policy in other policy environments.

Resistance and change: a multiple streams approach to understanding health policy making in Ghana.

Although much has been written on health policy making in developed countries, the same cannot be said of less developed countries, especially in Africa. Drawing largely on available historical and government records, newspaper publications, parliamentary Hansards, and published books and articles, this article uses John W. Kingdon's multiple streams framework to explain how the problem, politics, and policy streams converged for Ghana's National Health Insurance Scheme (NHIS) to be passed into law in 2003. The article contends that a change in government in the 2000 general election opened a "policy window" for eventual policy change from "cash-and-carry" to the NHIS.

Kingdon's Multiple Streams Framework and Policy Innovation: the Birth of ‘4 Major Social Hazards’ Policy

Kingdon's Multiple Streams Framework and Policy Innovation: the Birth of ‘4 Major Social Hazards’ Policy

The NIH Public Access Policy and Federally Funded Research: An Analysis of Problem Recognition and Agenda Setting

This interpretive and descriptive study examines the development of the U.S. National Institute of Health's (NIH) public access policy which requires NIH funded research to be made publicly available through an open access depository, the PubMed Central database. Using elements of Kingdon's (2003) multiple streams framework, Stone's (2012) challenges to the theory of free market efficiency, and her rhetorical characterization of “good weak interests” vs. “bad strong interests,” this work explores the rationale behind the development of the NIH open access policy . Based upon this rationale and the current structure of the scholarly publishing system, future implications for other federally or publicly funded research are proposed.

Healthy Families and Gay Rights: A Multiple Streams Analysis of Civil Union Legislation in Illinois

Using Kingdon's (1995) multiple streams framework, this article analyzes the processes of problem definition, policy proposal, and political decision-making in the passage of civil union legislation in Illinois in 2009–2011. Prominent problem definitions emphasized family vulnerability in the health care system, eclipsing the concerns of religious organizations that the existence of civil unions violated their religious liberty. Political factors which permitted both civil unions and same-sex adoption protection included disorganized and detached opponents; a state attorney general who served as a policy entrepreneur for family rights; and postelection, strategic bipartisan negotiation which opened a narrow window for policy change. Implications for family policy issues are discussed.

Lifelong learning in the EU: changing conceptualisations, actors, and policies

This paper explores the changing conceptualisations, actors, and policies of lifelong learning (LLL) in the European Union (EU) from the time the topic first emerged and was promoted by international organisations in the 1960s. The author uses Kingdon's Multiple Streams Framework to analyse how the LLL discourse became an important part of the EU agenda from the mid-1990s onwards, ultimately resulting in numerous policy changes intended to address a wide range of economic and societal issues. The analysis is based on a critical reading of policy documents from the EU, the United Nations Educational, Scientific and Cultural Organization (UNESCO), the Organisation for Economic Co-operation and Development (OECD) and a number of other agenda-setting bodies. The results indicate that the LLL discourse has evolved from one of lifelong education intertwined with humanistic ideals promoted by UNESCO (and partly OECD), to the EU's all-encompassing neo-liberal conception of lifelong learning which has been conceived as a cure for a wide range of maladies, ranging from high unemployment, to low innovation rates and the lack of entrepreneurship.

The Formation of Organ Donation Policy in Germany: Evidence, Politics and Public Opinion

The gap between the demand and supply of organs for transplantation is a worldwide phenomenon that continues to tax policy-makers. We consider recent policy reforms in Germany, drawing on evidence from Spain and Austria for comparison. Our analysis adopts Kingdon's multiple streams model which suggests that windows of opportunity for policy change open when an issue of public concern combines with a plausible solution and favorable political circumstances. Evidence is central to this process, but the type of evidence and the ways it is used, differ from technocratic formulations of evidence based policy-making. Scientific evidence may contribute to the rational appraisal of options, but this and other forms of evidence are also used rhetorically to generate political will and public support for change. We conclude by considering what the formation of organ donation policy in Germany reveals about the processes of policy-making under the competing imperatives of rationalism and democracy.

The Environmental Protection Agency Regulates Greenhouse Gas Emissions: Is Anyone Paying Attention?

AbstractThe promulgation of the Mandatory Reporting of Greenhouse Gases Rule stands as the first step to developing a comprehensive national approach to climate change. However, what role, if any, did interest groups play in the development of this rule? This paper applies Kingdon's multiple streams model as a descriptive framework to analyze interview data for this rule to better understand interest group involvement across all the stages of the rule‐making process (rule development, notice and comment phase, and rule finalization). Our research suggests that interest groups were indeed influential throughout the process, but those involved during rule development were clearly at an advantage.

The application of Kingdon's Multiple Streams Theory for human papillomavirus-related anal intraepithelial neoplasia.

This paper presents a discussion of the advantages and disadvantages of redefining human papillomavirus-related anal intraepithelial neoplasia as a problem of sexually active people by using Kingdon's Multiple Streams Theory to examine possible policy solutions for increasing anal cancer screening. Human papillomavirus is the most common sexually transmitted infection worldwide. Anal cancer associated with human papillomavirus infections is increasing in incidence in both men and women. The prevalence of anal cancer does not decrease with age. Pubmed was searched for articles and internet references from 1995-2012. Although a large body of literature suggests that human papillomavirus-related anal intraepithelial neoplasia is a problem, no effective policy solutions have emerged. However, as almost the entire sexually active population is exposed to human papillomavirus, it should be thought of as every person's problem. This suggests that human papillomavirus-related anal intraepithelial neoplasia calls for different types of problem definitions and policy solutions to address the disease. The issue of anal cancer is typically defined as a problem of HIV-positive individuals. Nurses are focused on improving patient outcomes. We play a key role in helping to identify problems, moving problems onto policymaker's agendas, and influencing the creation of new healthcare policies. Human papillomavirus-related anal intraepithelial neoplasia demands attention and the development of national level policies to ensure public health and safety. Kingdon's Multiple Streams Theory has provided a pragmatic framework to evaluate the problem.

An Idea Whose Time has Come? Explaining the Rise of Well-Being in British Politics

Well-being has recently risen rapidly up the political agenda in Britain and beyond, signalled most clearly by Prime Minister Cameron's announcement in 2010 that well-being measures developed by the Office for National Statistics would be used to guide public policies. Here we seek to explain why well-being has risen up the British political agenda, drawing on Kingdon's multiple streams approach. While this approach has considerable merit, it does not acknowledge the complexity of multi-level governance in which policy, politics and problem streams can operate at different territorial levels. As such, we argue that the match between policy, politics and problem streams has to be not only temporal, but also spatial. The consequence is that, while in relation to measurement a paradigm shift may be taking place, in terms of decisive action there is some way to go before well-being can be described as ‘an idea whose time has come’.