Policy Design Process Research Articles

Governance and health system reform: a case study of new health regions in Ireland, 2018-2023

Abstract Background While the significance of good governance is recognised within health systems research, its role in health system reform is underexplored. This research focuses on the establishment of new decentralised regional health structures in Ireland in the period 2018-2023, examining how aspects of governance impacted the decentralisation reform process, from policy design through to implementation. Methods The research applied a qualitative, multi-method approach involving analysis of official documents relevant to the regional decentralisation process, and 12 semi-structured interviews with key informants from across the health sector. The research applies the TAPIC framework for health governance as its analytic framework and the data is analysed using thematic analysis. Results Deficiencies in accountability arrangements, poor transparency within the system and vis-à-vis external stakeholders, and a lack of clarity of roles and responsibilities for various process and key decisions related to the reform were identified as undermining progress at various stages of Ireland’s decentralisation reform process. An underlying distrust between key institutional actors was identified. These findings are grounded in complex social, cultural, and political and institutional developments in Ireland’s history. Also of note is the interwovenness of the five TAPIC domains and the importance of engaging with the complexity and relationality intrinsic to health system reform processes to achieve the aim(s) of the reform in question. Conclusions Large scale health system reform is a complex process and its governance presents distinct challenges and opportunities for stakeholders. To understand and address these, critical analysis of the historical context surrounding the policy reform and the institutional relationships at its core are needed. Key messages • Governance plays a crucial if overlooked role in health systems reform. Effective governance arrangements are central to the successful design and implementation of reform initiatives. • Ensuring a strong link between policy design and implementation processes is crucial to the success of health systems reform.

Procedural inclusiveness can mitigate trust challenges in environmental policymaking

ABSTRACT Decreasing political trust poses severe challenges, particularly in policy domains where solutions to societal problems are urgently needed. The reason is that low trust decreases citizens' support for policy interventions. Since trust is difficult to increase in the short to medium term, this study explores how negative trust effects on policy support could be mitigated through policymaking procedures. We connect literature on policy design processes and trust to argue that involving broader actor coalitions when designing a policy is likely to mitigate the negative trust effect on public policy support. We test this argument with an empirical focus on environmental policy, based on data from a survey experiment in Switzerland (N = 6116). Our study design combines a choice experiment with treatment conditions for procedural inclusiveness and various levels of policy stringency with a novel approach to measuring trust. The main finding is that greater inclusiveness in terms of engaging a broader actor coalition in the policy design process reduces otherwise negative effects of low trust on policy support. The main policy implication is that political trust challenges are not a predicament for failure in addressing urgent societal problems but can be offset by including broad actor coalitions in policy design processes.

Explaining low salience of environmental resilience challenges in bioeconomy strategies: A cross-regional comparative analysis

Bioeconomy policies aim at fostering economic growth while solving the sustainability challenges of the fossil-based economy. However, these policies do little to discuss the resilience challenges of bioeconomies and the bio-based production systems on which they rest. Specifically, the environmental stresses that are likely to threaten the delivery of the bioeconomy's desired functions are barely addressed. This paper aims to understand why the salience of environmental resilience challenges is low in bioeconomy strategies. We conduct an exploratory comparative analysis of the policy design processes of six countries - Malaysia, South Africa, the United Kingdom, Ireland, Italy and Germany - building on expert interviews and a conceptual approach that emphasizes the importance of the policy design space. Our findings suggest that key factors in explaining the low salience of environmental resilience challenges are the predominantly economic motivation among leading authorities and the under-representation of environmental actors across policy design spaces.

UK net-zero policy design – from optimisation to robustness

The need to deal with the deep uncertainty and system complexity associated to Net-Zero pathways, especially those relying on emergent greenhouse gas removal (GGR) technologies, has resulted in a growing body of literature on alternative decision-support approaches. Exploratory modelling, and specifically Robust Decision Making (RDM), are potential approaches capable of addressing these challenges: by exploring a wide range of conceivable futures, they explicitly embrace deep uncertainties while seeking to reduce system vulnerabilities. However, though RDM methods have been well documented, there is little insight as to how such approach might be integrated into Net-Zero policy design processes. By means of a workshop (n=17) and interviews (n=13) with the UK climate policy and energy modelling communities, this contribution provides insights into the role and potential of RDM in explicitly dealing with the deep uncertainties that pervade in the establishment of a 60–100 MtCO2 UK GGR sector within three decades. The consultation process revealed that there is an appetite from the decision-making and analytical communities in integrating exploratory modelling concepts into UK policy design processes. It is recommended that to bridge the gap between theoretical RDM constructs and their broader adoption, the analytical process should include a broader set of disciplines and expertise. Specifically for the modelling community, this work suggests that in-use computational models should be adapted, rather than new tools developed. Key challenges also arise from the time and resources required, suggesting small scale place-based pilots could promote the acceptability and foster the adoption of the RDM methodology.

Emerging models of de facto drug policy reforms in the United States

BackgroundHealth and human rights organizations have endorsed drug decriminalization to promote public health-oriented approaches to substance use. In the US, policymakers have begun to pursue this via prosecutorial discretion—or the decision by a prosecutor to decline criminal charges for drug possession in their jurisdiction. This study characterizes drivers of adoption, policy design and implementation processes, and barriers to impact and sustainability of this approach to inform evolving policy efforts promoting the health of people who use drugs (PWUD). MethodsWe conducted n=22 key informant interviews with policymakers and national policy experts representing 13 jurisdictions implementing de facto drug policy reforms. Analyses were informed by the Exploration, Preparation, Implementation and Sustainment (EPIS) framework and analyzed using a hybrid inductive-deductive approach. ResultsDrivers of policy adoption included racial inequities, perceived failures of criminalization, and desires to prioritize violent crime given resource constraints. Three distinct policy typologies are described with varying conditions for eligibility, linkage to services, and policy transparency and dissemination. Public misinformation, police resistance and political opposition were seen as threats to sustainability. ConclusionsGiven evidence that criminalization amplifies drug-related harms, many policymakers are adopting de facto drug policy reforms in the absence of formal legislation. This is the first study to systematically describe relevant implementation processes and emerging policy models. Findings have implications for designing rigorous evaluations on health outcomes and informing sustainable evidence-based policies to promote health and racial equity of PWUD in the US.

EU policy on agricultural land turnover: general characteristics

The evolving land reforms in Ukraine and its recent strides towards EU membership accentuate the critical importance of addressing the circulation of agricultural land. This article analyzes the European Union's policies concerning the formulation and execution of regulations governing the transfer of agricultural land, given its doctrinal and practical significance in the context of Ukraine's transitional phase. This academic article examines the intricate relationship between European Union (EU) legislation and the regulation of land ownership within its member states, with a particular focus on agricultural land. The analysis delves into the legal framework provided by Article 345 of the Treaty on the Functioning of the European Union, which preserves member states' autonomy in land ownership decisions while emphasizing compliance with the principles of free movement of capital. The article reviews key EU guidelines and directives, such as those concerning land policy design and reform processes, common agricultural policy, and financial regulations, which indirectly impact land transactions and ownership. Additionally, it explores the Union's response to challenges such as land grabbing and concentration of ownership, including guidelines for member states to protect agricultural land from speculative practices and monopolization. Furthermore, the article discusses recent legal precedents, notably the CJEU's ruling on Bulgaria's residency requirement for land acquisition, which highlights the tension between national policy objectives and EU principles. Through an analysis of EU legislation, court decisions, and policy recommendations, this article offers insights into the evolving dynamics of land ownership regulation within the EU, aiming to contribute to a deeper understanding of the balance between capital movement and national sovereignty in land governance.

The last mile of policy design: the case of urban food waste intervention

This study investigates the dynamics and challenges in the specification of policy design at the micro level, when broad policy issues are translated into specific interventions. By conducting an in-depth case study of urban initiative dealing with food waste in Warsaw, we unravel the complex process of translating policy objectives into action. Our findings have three points. First, the dynamics of micro-level design provide a broad space for policy designers to make decisions that reshape both the understanding of the policy problem and the change strategies used to address it. Second, policy design can be both engineering and bricolage. It results from changes in context, political considerations, research evidence, and institutional actors’ pragmatic decisions. Third, the Theory of Change can be used as canvas to guide designers through this dynamic process. Future research is recommended to generalize our findings across different contexts and explore the roles of diverse stakeholders in the policy design process.

On the need for a multi-dimensional framework to measure accessibility to urban green

With the recent expansion of urban greening interventions, the definition of spatial indicators to measure the provision of urban greenery has become pivotal in informing the policy-design process. By analyzing the stability of the population and area rankings induced by several indicators of green accessibility for over 1000 cities worldwide, we investigate the extent to which using a single metric provides a reliable assessment of green accessibility in a city. The results suggest that, due to the complex interaction between the spatial distribution of greenspaces in an urban center and its population distribution, a single indicator may inadequately differentiate across areas or subgroups of the population, even when focusing on one form of green accessibility. From a policy standpoint, this indicates the need to switch toward a multi-dimensional framework capable of organically evaluating a range of indicators at once.

Redistributive policy and redistribution preferences: the effects of the Moscow redevelopment program

ABSTRACT How does inclusion in social policy programs strengthen individuals’ support for redistribution, and lead to spillovers in support for future social policy programs? We study a unique dataset of 1,300 Moscow residents to estimate the effect of participating in a government-sponsored redevelopment program on preferences for redistributive social policy. Our design exploits features of the program designed to foster institutional trust by engaging citizens in the policy design process. We report a positive effect: individuals in buildings slated for redevelopment are more likely to agree that the government should reduce income differences between rich and poor, provide for the unemployed, and provide public housing. Our findings suggest that increased trust in the government is a channel through which program participation affects redistribution preferences, show how programs can be used strategically to promote a redistributive agenda, and suggest a pathway for the co-persistence of redistribution preferences and redistributive state policies.

Enhancing Quality in Higher Education Through Evidence-Based and Inclusive Policy Co-Development

Higher education institutions across Africa and beyond are confronted with the need to demonstrate quality, relevance, and accountability amidst numerous challenges. This study used the mixed methodology to explore the adoption of participatory and evidence-based policy design processes in four universities in Zimbabwe. Semi-structured interviews were conducted with 60 participants across administration, faculty and student leadership from two public and two private institutions. Additionally, relevant documents were reviewed to provide contextual information. The data from the interviews were analyzed using deductive coding based on the Advocacy Coalition Framework, as well as inductive coding to identify emerging themes. The findings indicate that stakeholder input and evidence were effectively incorporated into the decision-making process through leadership support, capacity-building initiatives, and engagement structures. However, challenges such as resistance to change, time limitations, and lack of expertise were identified. To enhance ownership and relevance, the study recommends central coordination of policies, gradual implementation of new approaches, and collaboration with policy researchers to strengthen the evidence base. This research underscores the significance of collaborative policy development processes for higher education institutions in developing settings to improve quality and responsiveness to diverse institutional needs.

Employees’ information security awareness (ISA) in public organisations: insights from cross-cultural studies in Sweden, France, and Tunisia

ABSTRACT The dominance of national culture in organisational environments has been widely acknowledged. This study aims to explore the impact of national culture on information security awareness by examining cultural characteristics in the public sector. Drawing on Hofstede's model, a literature review was conducted to analyze existing knowledge and identify cultural traits in selected countries. Empirical data were collected through semi-structured interviews conducted in Sweden, France, and Tunisia. The data were analyzed using the Human Aspects of Information Security (HAIS) model, revealing distinct patterns and emphasising the role of culture in shaping behaviours. The findings underscore the importance of involving Swedish employees in the policy design process to effectively enhance information security awareness. For French employees, it was found that learning from past experiences and respecting hierarchical structures are crucial factors in raising awareness. Conversely, in Tunisia, information security initiatives should take into account the social and relational aspects to promote awareness effectively. These insights provide valuable guidance to managers in multinational organisations, enabling them to comprehend the underlying forces and dynamics in countries with similar characteristics.

Participatory Policy Packaging for Transport Backcasting: A Pathway for Reducing CO2 Emissions from Transport in Malta

Significant emission reductions are needed in the transport sector to reach climate change mitigation objectives. Backcasting, a type of scenario-analysis approach, is a useful tool for the analysis of possible alternative transport futures and strategies to arrive at these futures when the business-as-usual projection is no longer sustainable. The backcasting approach consists of establishing desirable futures and examining the pathways by which those futures can be reached. This paper focuses on the policy packaging phase of a transport backcasting study carried out in the context of Malta as a case study. The aim of this paper is to contribute to the existing literature on transport and climate change using the case of Malta, which presents a context of high dependency on private cars and difficulty in transitioning to sustainable mobility. This paper tests the usefulness of a practice-based approach to transport backcasting. The results of this backcasting framework are a set of climate policies that target different elements of mobility practices and suggest that interventions for sustainable mobility should go beyond transport and target other spheres of social life. Collaboration between stakeholders and participation of citizens during the backcasting process was key to making the policy design process more participatory. Results of this study show how new approaches can open possibilities for a transition towards more sustainable mobility and contribute to widening the knowledge in the field of transport backcasting studies.

Advancing policy design through creative engagement with lived experience: the Tomorrow Party

We consider how lived experience might actively inform policy design. Good policy design calls for analysis of problems, how they might be addressed, and likely outcomes. Policy scholars and practitioners have devised methods that bring rigor to policy design through problem framing, assessment of potential interventions, and prediction of outcomes of those interventions. This pursuit of analytical and predictive rigor has often given short shrift to the insights of people whose lives are affected by current challenges and who will be impacted by policy change. Our theory of change is that creative engagement with citizens can generate insights of high value to the process of policy design. We introduce the Tomorrow Party – a design method for generating novel stakeholder insights regarding desirable future states. We then discuss initial findings from a series of pilots. Those findings suggest the Tomorrow Party is a broadly applicable creative tool for advancing policy design.

윤석열 정부의 고등교육개혁정책 추진과정에 대한 분석

The purpose of this study was to analyze of the characteristics and issues of the current government’s higher education policy design and implementation process, and the contents of major higher education policies. As the results of it, first, the current government’s education reform design and implementation process tends to independently pursue Ministry of Education-led policies that the ruling power wants to do with less than 20% of the presidential election pledges, national tasks, to launch in the image of an unprepared government, and to implement the policies that lacks consistency and reliability in the presidential election process, since the beginning of the administration.
 Second, among the current government’s higher education policies, major contents and issues were discussed, focusing on deregulation policies for higher education, establishment of the Regional Innovation System & Education (RISE), fostering Glocal universities, and special accounts for higher and lifelong education support.
 Currently, the main issues of higher education are to amplify confrontation and conflict with the education community, so the government needs to change its perception of designing and operating predictable and sympathetic higher education policies through transparent and democratic procedures in the future.

Complexity of Tax Aspects in Carbon Tax Implementation

The focus on carbon tax has been central in efforts to reduce greenhouse gas emissions. The use of carbon tax policies as a vital tool to address climate change has been implemented in many countries, including Indonesia. However, the implementation of carbon taxes involves a series of complex challenges. This research aims to examine the complexity of tax aspects that pose challenges in the process of implementing carbon tax policies in Indonesia and the strategies the Indonesian government can employ to overcome these challenges. The research adopts a qualitative approach, collecting data through literature review. It explores the multidimensionality and complexity of carbon tax aspects, encompassing policy design, socio-economic impacts, and administrative constraints. The research findings indicate the need for an integrated carbon tax policy design, focusing on setting appropriate rates and ensuring fair revenue allocation. Evaluating the social and economic impacts of carbon taxes becomes a crucial part of understanding the extensive consequences that may arise. Involvement from industries and other stakeholders in the policy design process is an essential element in addressing this complexity. The study also emphasizes the necessity for improvements in administrative infrastructure and monitoring systems to ensure that carbon taxes are not only effective but also accountable in significantly reducing carbon emissions

The quasi-devolution of policy design during Covid-19 in Israel – The case of family centers for children with disabilities

How does the way in which a policy is formulated affect its dynamics and implementation? To answer this question, we analyze the process of designing a policy to provide services to Israeli families of children with disabilities during COVID-19 as a bricolage. This term refers to a policy design process involving incremental modifications or reformulations of existing policies to deal with a large-scale challenge. We describe the interactions among the multiple layers of governance involved in delivering these services nationwide. Although the macro-level policy was designed to be equivalent throughout the country, budget cuts and the devolution of power made local authorities close services during the first COVID-19 lockdown. We conclude that the devolution of power to local governments in times of crisis works only partially. At the micro level, social workers as directors of services acted as bricoleurs to deliver services. Therefore, national government officials must work with local authorities to find solutions for financially unstable municipalities and develop tools to deal with micro-level challenges. Practical and theoretical implications of the findings are discussed in the context of a civilian-centric emergency and the COVID-19 crisis.

Identifying key factors and actions: Initial steps in the Open Science Policy Design and Implementation Process

The coronavirus pandemic has illustrated the lack of a holistic approach in implementing Open Science (OS), leading to an inability to fully utilise its potential to inform prompt, evidence-based policy responses. In this view, this study aims to identify and categorise the factors influencing the adoption of OS and proposes possible actions for decision-makers to develop relevant policies. To achieve this, semi-structured interviews were conducted with 36 experts from Australia, France, the Netherlands, South Korea, the United Kingdom, and the United States as well as eminent international entities. During the interviews, they were asked to answer a range of questions that emerged from a systematic literature review. The responses were coded and analysed using a grounded theory approach. This led to the identification of four thematic clusters, containing a total of 24 factors that can either enable or inhibit OS practices, namely, (a) external; (b) institutional and regulatory; (c) resource-related; and (d) individual and motivational. Drawing upon Ostrom’s Institutional Analysis and Development framework, we also propose a conceptual model that integrates these factors, accompanied with corresponding actions, into a tangible process of OS policy design and implementation.

Coherent at face value: Integration of forest carbon targets in Finnish policy strategies

Carbon sequestration and capture have gained a central position in forest governance, alongside wood production and biodiversity conservation, resulting in calls for policy coherence and integration across the EU. While coherence is often a target in the technical assessment of the policy design, it is important to understand how incoherent policies are supported by disconnected or incongruent knowledge claims and epistemologies. We address the coherence of forest policy by analysing the content and knowledge claims in forest, bioeconomy, and biodiversity strategies of Finland, an EU member state in which forests have a strong economic, political, and cultural status. Focussing on the argumentation regarding forest carbon, our analysis shows that the policy domains remain largely disconnected and rely on differentiated knowledge bases. Despite the explicit claims about policy coherence, few genuine attempts have been made towards integration and coordination between the domains. Our analysis reveals the different logics with which climate change is to be governed, and the types of knowledge utilised and produced in the integration of forest carbon as a policy object. Our analysis suggests that policy strategies with sectoral foci facilitate incoherent policymaking due to unresolved trade-offs and knowledge disagreements. Knowledge used in the policy design and implementation processes should be discussed thoroughly, and thereby integrated.

Competing landscapes of commerce and tourism: Critical relations and possible strategies in Venice’s historical city

This article investigates the relationship between tourism-related economic activities and neighbourhood shops in the historical centre of Venice, in terms of both their spatial distribution and the conflictual uses of the city. In questioning how to inhabit and revitalise the city through commercial activities, the paper wishes to contribute to the discussion proposed in the special number, by presenting a specific yet paradigmatic context and by reflecting on urban regeneration and revitalisation bottom-up practices. The research first unfolds the landscapes of commerce in the city and identifies polarised geographies of tourism-related activities focusing on retail and catering businesses; secondly, it interrogates spatialised strategies that local actors are developing to reflect on their relation with urban planning and policy design processes.

Women–state relations: The gendered politics of social protection provisioning in Zambia

AbstractDespite clear gendered differences in rights and responsibilities, these variations within citizen‐state relations are often overlooked. Drawing on Ranjita Mohanty's concept of women–state relations and Nancy Fraser's trivalent theory of social justice, this paper asks how access to social assistance is shaped by gender. Analysing the processes of policy design and implementation of Zambia's social cash transfer scheme, the paper examines perceptions of roles and responsibilities in the private domain and claims to state assistance in the public sphere. Based on 77 key informant interviews with institutional stakeholders, and 16 focus group discussions with cash transfer (non‐)beneficiaries, the research finds a predominant belief that ‘able‐bodied’ men and women should be working but dramatically different expectations of women and men in the household. The paper argues that social policies can be rights‐determining rather than rights‐based, demonstrated by the changes to Zambia's targeting model based on perceived responsibilities, with material consequences for citizens and particularly women.