Ministerial Policy Research Articles

Implementing a pilot primary care program: Armenia’s steps toward universal health coverage

Abstract Problem Armenia has struggled to transform its ineffective primary healthcare (PHC) system into one that can address the non-communicable disease burden, which causes 93% of mortality. To address this issue, Armenia aims to establish universal health coverage and invest in high-quality primary care. Description In 2023, the Armenian Ministry of Health signed a multisectoral policy to implement a pilot primary care program to trial a multitude of reforms related to diabetes (DM) and hypertension (HTN). Pilot interventions include pathways for screening/diagnosis, provider training, free medications and diagnostics, and new provider financial incentives. The key question to be answered is if these pilot interventions cause DM and HTN health outcomes to improve. Beginning in 2024, the program is being piloted in a primary care clinic in Dsegh. Results As a result of the 2023 Ministerial policy, multisectoral stakeholders designed and implemented this pilot program. Baseline focus groups found that the pilot addresses the financial barriers that community members noted lead to delays in seeking care and that providers perceive the pilot to be beneficial to their patients. Although final results are not yet available, the pilot has already positively changed features in the national EMR and brought together stakeholders in a way never done before. Lessons The pilot’s innovation comes from it being the first time that hypertension and cholesterol medications are provided by the government for free, provider bonuses are based on outcome indicators, indicator targets are set this high, a point-of-care A1c machine is utilized, and a robust monitoring and evaluation (M&E) plan is implemented, all of which are currently shaping discussions on national policy. For countries similarly working on strengthening primary care, it is recommended to pilot specific reforms and establish mechanisms through M&E systems that allow pilots to inform evidence-based decision making. Key messages • To move towards universal health coverage, pilot programs designed with multi-sectoral stakeholders are needed to trial suggested healthcare reforms. • It is essential to invest in monitoring and evaluations systems to generate the data necessary to develop evidence-based policies.

Ministerial policy roles and mandate letters in the Justin Trudeau government

AbstractThis article examines ministers as policy actors through analysis of tasks in mandate letters. These tasks were coded as involving either policy initiation, supplementation, maintenance, coordination, engagement, or information. The 2021 mandate letters show that policy maintenance tasks are most common, initiation the least, suggesting that most ministers are constrained to passive policy management. Four distinctive ministerial types are also identified. Activists are distinguished by their dominance over policy initiation, advocates are characterized most by policy supplementation and maintenance, managers are mostly tasked with maintaining the policy status quo, and networkers are distinctive in their share of coordination and information tasks.

Framing sexual and gender-based violence: Australia Day, nationalism and conservative prime ministerial policy discourse

ABSTRACT Grace Tame’s 2021 Australian of the Year (AOTY) award directed public attention towards sexual and gender-based violence (SGBV), as did Australia Day award recipients Donna Carson in 2004 and Rosie Battie in 2015. We use mixed-method textual analysis of a corpus of prime minister’s Australia Day speeches between 1990 and 2021 to show how conservative Liberal Party prime ministers have narrated a discourse of idealised national identity to manage activist demands regarding SGBV policy. We quantitatively find that prime ministers promote masculine and heteronormative representations of Australian identity and then develop a qualitative typology of conservative SGBV frames employed by prime ministers that gloss over SGBV as a pressing and chronic policy issue and position idealised Australian femininity to condone and obscure SGBV. This paper builds upon scholarship on public policy and gendered nationalism to explain this pattern of SGBV problem definition and framing by conservative prime ministers.

Improving the quality of Cambodian higher education: Key challenges and suggestions

Higher education is one of the main drivers of economic development. Due to its significant roles, many countries, including Cambodia, have invested in developing their higher education subsector. For over two decades since 1997, Cambodia has experienced a high increase in the number of higher education institutions (HEIs). Despite the rapid institutional expansion, there are many issues impeding the quality of Cambodian higher education. Drawing on secondary sources and the authors’ extensive experience and knowledge of the subsector, this article tries to investigate and explain some of the factors affecting the quality of higher education in Cambodia. The article focuses on several issues, including political interference, fragmented governance structures, ineffective ministerial policy implementation, fragmented institutional management, limited quality of teaching personnel, low academic salaries, business-oriented higher education, and issues concerning curriculum and academic programs. The article offers some suggestions to address these challenges. Key suggestions include (a) limiting political interference in appointing top university leaders, (b) setting up effective and independent higher education quality assurance bodies, (c) creating a term limit for top university leadership roles, (d) establishing a meritocracy-based policy for university leader appointments, (e) making academic salaries comparable to those of other similar professions, (f) developing policies on minimum tuition fees and student loan programs, and (g) introducing mechanisms to improve curricula and promote enrollments in science, technology, engineering, and mathematics (STEM) majors. The article concludes with suggestions for future research.

Colleagues or adversaries: Ministerial coordination across party lines

AbstractIn multiparty governments, policymaking is a collaborative effort among the different incumbent parties. Often hidden by public debates about broader government policy, the necessary coordination routinely happens at the ministerial level, where ministries of different parties jointly devise viable and equitable policy solutions. However, since coordination involves substantial transaction costs, governments must carefully gauge the potential benefits. We study the political rationales that motivate governments to make this investment. We argue that coordination during the process of ministerial policy design hinges on both a conducive ministerial structure and sufficient authority. Once these conditions are met, cross‐party coordination is more likely in policy areas where the implementation of government policy cannot be taken for granted. We investigate these claims, drawing on two new datasets. The first contains information about ministerial collaborations on all legislative projects sponsored by German governments, while the second maps the distribution of policy responsibilities among German ministries from 1976 until 2013, based on data about the policy briefs of all individual working units within the top‐level federal executive. Given that ministries imprint their own perspective on legislation, our results are beyond administrative pedantries, but have substantial implications for the type and content of policies coalition governments formulate.

Keeping tabs through collaboration? Sharing ministerial responsibility in coalition governments

AbstractMoving past the conventional focus on ministerial portfolios, this paper investigates how coalition governments allocate and share ministerial responsibility for individual policy issues. Sharing responsibility induces coalescing parties to collaborate on policy issues, which addresses the problem of ministerial autonomy. Consequently, I argue that incumbent parties in coalition governments share ministerial responsibility for contentious and salient policy issues. This claim is corroborated based on a newly elicited dataset of over 30,000 ministerial policy responsibilities from Denmark, Germany, and the Netherlands. The findings have important implications for scholarship on coalition governments, as they demonstrate that incumbent parties can use the design of ministerial portfolios itself to insulate a coalition compromise from partisan deviations.

Ministerial policy dominance in parliamentary democracies

AbstractTo what extent do ministries dominate a particular policy domain? The policy dictator model and many principle‐agent models of governmental control that followed suit assume that governments create ministries with clear and exclusive policy responsibilities. We test this assertion using data from parliamentary bills from Denmark, Germany, and the Netherlands. For each bill, we observe its substantial policy content and the responsible ministry. The data show that bills on similar issues regularly are drafted by different ministries in parliamentary democracies. About 40 per cent of policy issues cannot be ascribed to one dominant ministry. The regularities elucidate that ministerial division of labour within governments is considerably more complex than commonly assumed. The variegated level of ministerial dominance across policy domains calls for a new research agenda on how governments assign responsibility for legislative action in parliamentary democracies.

Top-Down Implementation and Fragmented Bureaucracy: An Analysis of the Livestock Waste Prevention Regulation in China

Livestock and poultry raising is the largest source of agricultural non-point source pollution and an essential aspect of environmental governance. To resolve the issue, China has introduced a series of policies to promote the recycling of livestock and poultry excrement since 2014. This study uses data from government documents, policy papers, and official husbandry statistics to understand the effects and policy implications of husbandry waste regulations from 2014 to 2019. We examined the planning and implementation guidelines of husbandry waste control programs and supplemented the archival data with 29 in-depth interviews with local environmental protection officers as well as husbandry operators in five provinces from 2015 to 2018. Our findings indicate that the new regulatory regime has three fundamental issues: First, the inconsistency between national and ministerial policy goals; Second, the binding targets of these policies create unforeseen consequences in their implementation, which has hindered the establishment of a national resource recycling system; Third, the regulations provide few incentives to promote the development of sustainable husbandry industry.

LEMBAGA TUNGGAL PENGELOLA REGULASI: DASAR PEMIKIRAN DAN TAWARAN IMPLEMENTASINYA DALAM KETATANEGARAN INDONESIA

In this article the author seeks to answer, within the context of the Indonesia state organizational system, why and how Indonesia should establish a single government authority entrusted with supervising the making of ministerial policy regulations or regional government regulations. To that purpose a comparison with other countries is conducted. It is a fact in Indonesia that regulatory powers or function is shared by and among different ministries and by regional governments. The result of which is the problem of sectoral approach and the existence of numerous overlapping and conflicting regulations. To overcome this problem, in consideration of best practices in other countries, the author suggests the establishment of a single government agency entrusted with, inter alia, previewing ministerial or regional government draft regulations.

Analisis Framing Terhadap Pemberitaan Kebijakan Surat Keputusan Bersama (SKB) 3 Menteri tentang Pemakaian Identitas Agama pada Seragam Sekolah di Media Online Kompas.com dan Republika.com

Online media is a means for various categories to appreciate an event or any aspect that is useful and can provide information for the public. As is the case, the online media Kompas.com and Republika.com distribute their news online, so that it is easier for readers to find the information they want. In online media, Kompas.com and Replubika.com reported the policy of the Joint Decree (SKB) of 3 Ministers under the pretext that it was an attempt to find common ground from various differences in society. With the SKB 3 Ministerial policy, it is intended that each religious community understands religious teachings substantively, and does not force them to be the same. So that the reason, in general, makes researchers feel interested in describing the function of research that is seen directly or indirectly with the Framing Analysis of the William A. Gamson model and using the political economy theory of Vincent Mosco's media. The method used in this research is descriptive qualitative, with data in the form of documents. Data collection using text analysis and online data browsing. The results of the study, which found an interesting fact that the online media Kompas.com builds a good image of the 3 Ministerial SKB Policy issued by the government. The online media Kompas.com emphasizes that this 3 Ministerial Decree was issued for the common good in responding to an existing problem. Meanwhile, Republika.com takes a broader view of the opinion of the top officials in responding to this Decree of 3 Ministers. So that Republika.com gives the impression of being critical of the emergence of this 3 Ministerial SKB rule.

Ministerial Autonomy, Parliamentary Scrutiny and Government Reform Output in Parliamentary Democracies.

One of the most important decisions coalition partners make when forming a government is the division of ministries. Ministerial portfolios provide the party in charge with considerable informational and agenda-setting advantages, which parties can use to shape policies according to their preferences. Oversight mechanisms in parliaments play a central role in mitigating ministerial policy discretion, allowing coalition partners to control each other even though power has been delegated to individual ministers. However, we know relatively little about how such mechanisms influence the agenda-setting and gatekeeping powers of ministers and how much influence minister parties have on policy output relative to the government as a whole in different institutional settings. We fill this gap by analyzing original data on over 2000 important social and economic policy reform measures adopted in nine Western European countries over 20 years, based on a coding of more than 1200 country reports issued by the Economist Intelligence Unit and the Organisation for Economic Co-operation and Development (OECD). We find that parliaments with strong oversight powers constrain the agenda-setting capacity of minister parties but have limited impact on their gatekeeping capacity. Our findings have important implications for our understanding of policy-making and democratic accountability.

Analysis of Klavdii Semyonovich Nemeshaev’s activities as the Minister of Railways of the Russian Empire

The article continues the series of publications devoted to the assessment of activities of the heads of the Ministry of Railways of the Russian Empire. In this article, the authors attempt to systematize and analyze historical data on the activities of Klavdii Semyonovich Nemeshaev as the Minister of Railways of the Russian Empire. There are numerous biographical studies devoted to K. S. Nemeshaev, but little is known about his activities as a minister, and to date the data are scattered and not systematized. The analysis of archival materials, scientific publications, memoirs of Nemeshaev's contemporaries and colleagues allowed us to conduct a detailed assessment of his activities and ministerial policy. It has been found that despite his short term of office, Nemeshaev's consistent policy and extensive managerial experience allowed him to carry out two significant reforms in a short time. The first one involved redistribution of the state-owned railway lines between separate local administrations and merging them into larger groups, which was important in terms of improving their operations and facilitating the cost efficiency, as well as speeding up freight traffic. In opinion of the authors of this article, another important achievement of Nemeshaev as the Minister of Railways was the establishment in 1906 of the central, local and district committees regulating mass transportation of goods. This was the first centralized measure aimed at managing the rolling stock. Nemeshaev's extensive managerial experience, high erudition and energy also led to prominent outcomes in some other areas of the Ministry operation. Attempts were made to create syndicates of shipowners in river transport. Modernization of river and sea vessels was carried out. Works on projects for the development of the Northern Sea Route has begun. The article also assesses the development and construction of railway network in the Russian Empire during Nemeshaev's office, in particular, of the Amur Line and Moscow Encircle Railway, as well as the increase in the capacity of the Trans-Siberian Railway. It has been found out that K. S. Nemeshaev paid great attention to various social aspects of railway employees’ activities. The article also highlights the legislative policy of the Ministry of Railways of that period. Nemeshaev's participation in the preparation of the French scientist’s Paul Pelliot and the Russian officer’s Carl Gustaf Mannerheim joint trip to China has been analyzed. Due to the mass replacement of light and worn-out rails on state-owned railways with heavier ones and the need to discharge a significant number of steam locomotives built in the 1850s and 1860s, an introduction of more powerful steam locomotives was expedient. The article discusses K. S. Nemeshaev's contribution to the development of technology and the introduction of a new type of freight steam locomotive for state-owned railways. Nemeshaev's political views have also been assessed.

KEBIJAKAN SURAT KEPUTUSAN BERSAMA 3 MENTERI (SKB 3 MENTERI) SEBAGAI IMPLEMENTASI PLURALISME DAN MULTIKULTURALISME DI INDONESIA

Indonesia is rich in diversity. The socio-cultural diversity in Indonesia is relatively abundant. This can be a strength, but at the same time it can also create friction ad conflict in the society. Recently, the government issued a Joint Decree of 3 Ministers (SKB 3 Menteri) in response to the friction. This decree organize dress procedures in the learning process at schools. As a result of this implementation, various responses emerged from the Indonesian people, either agreement or disagreement. Part of the society that may be relevant to this policy are students. This article will study the perspectives of undergraduate students of Bandung Institute of Technology (ITB), especially of the School of Architecture, Planning and Policy Development’s (SAPPK) on the Joint Decree. This article uses quantitative and qualitative methods by distributing questionnaires and interviews to SAPPK’s students. From the results of this study, the researchers are able to see the perspectives and the trends of SAPPK ITB Students towards the SKB 3 Ministerial Policy as a solution to social issues related to diversity. It is hoped that these results can be used as a reference for campus policy makers in overcoming the same problem.

The impact of the Country’s health services’ expenditure on the success of MDGs, Goal 4/SDG 3: Reduction of child mortality in Uganda (2000-2016).

Safeguarding access to health services is a serious challenge for poor countries if the Sustainable Development Goals are to (SDGs) are to be achieved. This paper scrutinizes the case of Uganda, a country which is trying to improve its health sector amid a lot of challenges between 2000-2016 to assess how the country has performed in the reduction of child mortality given its expenditure. This study involved analyzing the available data drawn from various sources i.e., time series data on public health expenditure was obtained from Ministry of Health reports and the budget and Ministerial Policy Statements for the period 2000-2016. This data was further demarcated into parameters such as per capita government spending on health in Uganda shillings, health spending as a proportion of Gross Democratic Product (GDP) and private health spending as a proportion of total health spending. Findings revealed that non-significant negative effect of GDP per capita growth on infant mortality rate from 2000 to 2016, a negative effect of GDP per capita on under-five mortality in Uganda from 2000 to 2016, albeit the effect is non-significant (P>0.05), decline in Maternal Mortality Rate (MMR) from 527 death per 100,000 live birth in 1995 to 336 death per 100,000 live birth in 2016, and there is a negative but insignificant effect of health sector budget allocation on the MMR in Uganda since the P-value (0.199). Maternal mortality fell significantly in Uganda due to some interventions in the health sector. The decline is likely to have been cause due to supply and demand situations. There is need to improve funding in the health sector in order to improve quality health services through better coordination, health management, transportation, access, infrastructure at the district level.

Upscaling Virtual Exchange in University Education: Moving From Innovative Classroom Practice to Regional Governmental Policy

Virtual exchange (VE) is an educational practice that involves the engagement of groups of learners in extended periods of online intercultural interaction and collaboration with international peers as an integrated part of their educational programs and under the guidance of educators and/or facilitators. Despite more than 20 years of research and recent large-scale initiatives such as Erasmus+ Virtual Exchange, this approach remains relatively unknown and often misunderstood in international education. Based on the qualitative and quantitative data of an Erasmus+ KA3 European Policy Experiment, which brought together practitioners, researchers, and ministerial policy makers from five European countries and autonomous regions, this article examines the challenges involved in implanting and upscaling an innovative practice such as VE in university internationalization practices. A case study from a Spanish regional autonomy, which took part in the project, is used to highlight barriers to take-up and integration at classroom, institutional, and policy levels. The data also provide a clear illustration of how an international practice such as VE can gain recognition and support though the coordination of bottom-up and top-down initiatives.

What determines senior civil servants’ responsive behaviors to ministers?: Applying mixed-methodology on the relationship between top bureaucrats and ministers in South Korea

ABSTRACTThis study investigates how the relationships between senior civil servants and ministers are formed and how the relationships thus formed shape these civil servants’ responsive behaviors toward ministers. We conducted in-depth interviews and surveys with high-level officials of S. Korean sociocultural ministries, and analyzed the data through mixed methodology to construct a grounded model of the behaviors of the officials vis-à-vis ministers. The results show that the civil servants’ substantive behavior varies from loyalty to tacit resistance, a consequence of the tension between bureaucratic conditions and relations with the minister. In the case of conflicts with ministers, however, senior civil servants tend to become quickly submissive in that they perceive themselves as implementers of ministerial policy and thus as needing to be adaptively accommodative to the political appointees with democratic legitimacy.

Why do Ministers Ask for Policy Evaluation Studies? The Case of the Flemish Government

Policy evaluations can be set up for multiple purposes including accountability, policy learning and policy planning. The question is, however, how these purposes square with politics itself. To date, there is little knowledge on how government ministers present the rationale of evaluations. This article is the first to provide a diachronic study of discourse about evaluation purposes and encompass a wide range of policy fields. We present an analysis of evaluation announcements in so-called ministerial policy notes issued between 1999 and 2019 by the Flemish government in Belgium. The research fine-tunes available evidence on catalysts for conducting evaluations. The Flemish public sector turns out to be a strong case where New Public Management brought policy evaluation onto the agenda, but this has not resulted in a prominent focus on accountability-oriented evaluations. We further show that policy fields display different evaluation cultures, albeit more in terms of the volume of evaluation demand than in terms of preferences for particular evaluation purposes.

Planetary health: from concept to decisive action

Planetary health: from concept to decisive action

Real-time river monitoring supports community management of low-flow periods

Increasing pressure on river catchment water resources has heightened the need for real-time monitoring data for water management agencies and users. This study investigates the capability to develop a technical basis for water co-management at the catchment scale. A web application (dashboard) was created that displayed real-time data for weather, soil water, river flow and water quality at high spatial and temporal resolutions, including streamflow and rainfall forecasts. A method to predict stream water temperature was developed and tested using an interactive table for visualisation of complex data. The dashboard was used to provide information and alerting to water users in an agricultural catchment, through the Ringarooma Water Users Group (RWUG) in NE Tasmania, Australia. The dashboard was updated several times per day using telemetry and data platform services, and accessed by RWUG members mainly during periods of low flow when water extraction restrictions can be applied. Irrigators gained an improved understanding of streamflow behaviour in response to weather variability, and water extractions and releases, and developed abilities to voluntarily manage the water resource as three sub-groups. The Department of Primary Industries, Parks, Water and Environment (DPIPWE) collaborated with the RWUG in this adaptive management approach, as enabled by the Ringarooma River Catchment Water Management Plan, and later informed a new Ministerial Policy for ‘Water Resource Management During Extreme Dry Conditions’. Group management was assisted by using alerts sent through the existing DPIPWE text messaging service. Results showed that stakeholder understanding of technical information and scenario implications using the sensor-based dashboard increased capacity of irrigators to make decisions that improve production and social outcomes, while considering environmental values. This study demonstrates that the information provided through the dashboard enabled a high level of community and inter-agency co-operation, demonstrating potential to apply this management approach in other catchments.

Awareness and use of systematic literature reviews and meta‐analyses by ministerial policy analysts

AbstractSystematic literature reviews and meta‐analyses have been promoted as important types of evidence to inform policy analysis and policy decisions. Little is known, however, about ministerial policy analysts' knowledge of this type of evidence. Drawing from a survey conducted among policy analysts (Québec), we report on the extent to which these research methods and contributions are known and used across policy sectors, and develop a socio‐professional profile of users. We conclude with recommendations for researchers and policy makers to improve the uptake of systematic reviews and meta‐analyses and to more effectively implement evidence‐informed practices.