Academic journal article Australian Health Review

Health Policy Analysis: A Tool to Evaluate in Policy Documents the Alignment between Policy Statements and Intended Outcomes

Academic journal article Australian Health Review

Health Policy Analysis: A Tool to Evaluate in Policy Documents the Alignment between Policy Statements and Intended Outcomes

Article excerpt


A health policy is a plan that steers the direction of investment and action designed to alleviate suffering, improve health care or prevent illness. It can be manifested as laws, bureaucratic edicts, practice guidelines or, more vaguely, simply as guiding principles. 1,2 Health policy makers are tasked with navigating a path between competing interests and demands to develop a pragmatic response to one or more health problems.2 There has been increasing interest in evidence-based policy making, which strives to use the best available evidence to inform policy. Although evidence from research is not the only factor influencing policy making, it has considerable potential to contribute to effective health policy.3

Evidence from health policy analysis and evaluation can potentially increase policy impact and provide information that may assist with the allocation of scarce resources. Policy impact can refer to strategies of policy implementation (outputs), or changes in population health or the health of the individual, as is the case when clinical management policies are applied (outcomes).4 If a health policy can be shown to be successful in achieving its goals this may increase the likelihood of ongoing funding. Although there may be opportunities for funding without such evidence, perhaps as a result of political and economic factors, proof of goal achievement is additional enticement to the distributors of funding. Procurement of ongoing funding greatly improves the chances of successful policy implementation.

Detailed health policy analysis and evaluation assists policy makers to improve the chances of successful implementation of future policy by revealing opportunities where enhancements to policy documents may be made. Such enhancements may be added to future policy documents or potentially to the original documents if applied before the policy is finalised. Analysis of the internal validity of policy documents is one approach to achieving these enhancements. Internal validity, in this context, refers to the clarity and comprehensiveness of policy statements to reflect intended outcomes. Health policy documents do not always articulate intended outcomes optimally; policy writers are not commonly responsible for implementing the policy, and details that can affect the ease with which a policy is implemented and thus its success may not be known or may be overlooked.

The development of policy documents is one part of the policy process that enables goals, opportunities, obligations and resources to be recognised in a concrete form and, through careful analysis of the documents (policy document analysis), the extent to which a policy adheres to certain principles, such as stakeholder and legislative support and goal clarity,1,5,6 may be ascertained. Policy documents should be referred to implementers: (1) before action, for guidance on how best to ensure that the policy will be implemented in a way that fulfils its goals, and (2) during the implementation phase to monitor progress and ensure that the process 'stays on track'. Policy documents should also be utilised during the evaluation phase to reconcile policy goals with outcomes and to allow minor iterative or more substantial changes to be made to future policies, thereby increasing their impact.

Policy document analysis is one comparatively straightforward method to appraise the extent to which the policy conforms to influential principles critical for successful implementation. It can be aided by carefully considering and mapping the linkages between closely related policy documents, particularly for complex initiatives. Mapping such linkages may also promote more coherent future policy development.

Complex health issues, such as chronic disease, involve complex initiatives in their management. For instance, the successful management of cardiovascular disease, and its common comorbidities, obesity and diabetes, requires interplay between several health policy areas. …

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