Factors of the policy process influencing Health in All Policies in local government: A scoping review

Abstract

ObjectivesThis review aimed to identify factors in the policymaking environment that influence a Health in all Policies approach in local government, how these vary across different municipal contexts, and the extent that theories of the policy process are applied.MethodsA scoping review was conducted to include sources published in English, between 2001 and 2021 in three databases, and assessed for inclusion by two blind reviewers.ResultsSixty-four sources were included. Sixteen factors of the policy process were identified, expanding on previously reported literature to include understanding and framing of health, use of evidence, policy priority, and influence of political ideology. Eleven sources applied or referred to theories of the policy process and few reported findings based on different local government contexts.ConclusionThere are a range of factors influencing a Health in All Policies approach in local government, although a limited understanding of how these differ across contexts. A theory-informed lens contributed to identifying a breadth of factors, although lack of explicit application of theories of the policy process in studies makes it difficult to ascertain meaningful synthesis of the interconnectedness of these factors.

Active Citizenship as an Integrating Axis between Health in All Policies and the Well-being Economy

“…Most of the cases discussed in this review remain anchored in an unrealistic view, treating policy making as a biomedical exercise and ignoring power relations and politics as a social determinant of health. From this perspective it can be interpreted in different ways by other sectors -even within the sector itself -and working across these boundaries requires dedicated and sustained efforts to challenge existing powerful social, political, commercial and economic interests and dominant ideologies [5,[18][19][20][21].…”

“…Secondly, the relevance and the way in which information is processed and analysed for decision-making depends on several different mutually supportive factors, including a diverse workforce that recognises and embraces social determinants in public health, adequate training and educational opportunities, and an enabling political and policy context that fosters a broad perspective on health [20]. Health leaders must not miss this opportunity to build a common language of goals and solutions to compare trade-offs within and across sectors to address current and upcoming challenges, as well as to encourage institutions to synthesise, build and share knowledge about which health policies work and which do not, rather than trying to duplicate actions [21].…”

Public health practitioners as policy advocates: skills, attributes and development needs

“…A Health in all Policies (HiAP) ( World Health Organization, 2021 ) approach recognizes that many policies impacting population health and health inequalities sit outside the health sector, for example in transport, education, housing and planning sectors. Municipal or local governments, with responsibilities across these sectors but with close links to local communities have been identified as the most feasible tier of government to enact HiAP ( Lilly et al , 2023 ). There is a need for public health and health promotion professionals to champion as policy advocates for health to be considered by policies across these sectors.…”

“…These challenges are often compounded when local policy change is sought in a context linked to big national or multinational commercial interests such as in gambling, alcohol and food policy ( David et al , 2019 , 2020 ). A recent review examining the factors influencing HiaP in local government, identifies policy advocates as an important but under-reported factor influencing the change process ( Lilly et al , 2023 ).…”

Evaluación de las políticas públicas. Una revisión de literatura

“…De la misma manera, favorece a la utilización sostenible y transparente de los recursos y patrimonio público, de tal manera que sean empleados para cumplir con los fines para los cuales se han previsto y asignado(Saldoya et al, 2021;Vázquez et al, 2019). En ese sentido, las políticas públicas son importantes en vista de que son consideradas como el medio principal mediante el cual una sociedad moderna pretende resolver problemas que se presentan en la realidad actual, las mismas que favorecen a la toma de decisiones colectivas, abordando además una cuestión social, económica y ambiental(Quintero, 2020;Lilly et al, 2023).Sin embargo, al momento de diseñar e implementar políticas públicas, los gobiernos locales afrontan una serie de desafíos y retos significativos, entre los cuales destaca la limitación de los recursos debido a que ello restringe la capacidad de estas instituciones para ejecutar los proyectos y programas; así también, el alto nivel de complejidad de la problemática local, por cuanto requiere el planteamiento de alternativas de solución que se adapten a los requerimientos básicos de la localidad; además, la resistencia que pueden tener las entidades frente a los cambios que se presentan y la ausencia de aptitudes del personal para asegurar que las actividades están siendo ejecutadas de acuerdo con lo previsto(Garnelo, 2019). De igual modo, el respeto por los derechos representa un desafío permanente en este proceso, puesto que deben involucrar a todos los actores, de tal manera que sean altamente beneficiosas (Gutiérrez-Ossa & Cardona-Restrepo, 2023).En tanto, se reconoce que uno de los aspectos primordiales que favorece al diseño e implementación de políticas públicas por parte de los gobiernos locales está representado por la participación de los ciudadanos, puesto que son ellos quienes conocen sobre los hechos que acontecen en su realidad cotidiana, de tal manera que favorezcan al planteamiento de alternativas de solución idóneas y creativas(Echavarría, 2019;Urbina et al, 2021;Aquije et al, 2021).…”