Perspectives on health policy dialogue: definition, perceived importance and coordination

Abstract

BackgroundCountries in the World Health Organization African Region have witnessed an increase in global health initiatives in the recent past. Although these have provided opportunities for expanding coverage of health interventions; their poor alignment with the countries’ priorities and weak coordination, are among the challenges that have affected their impact. A well-coordinated health policy dialogue provides an opportunity to address these challenges, but calls for common understanding among stakeholders of what policy dialogue entails. This paper seeks to assess stakeholders’ understanding and perceived importance of health policy dialogue and of policy dialogue coordination.MethodsThis was a cross-sectional descriptive study using qualitative methods. Interviews were conducted with 90 key informants from the national and sub-national levels in Lusophone Cabo Verde, Francophone Chad, Guinea and Togo, and Anglophone Liberia using an open-ended interview guide. The interviews were transcribed verbatim, coded and then put through inductive thematic content analysis using QRS software Version 10.ResultsThere were variations in the definition of policy dialogue that were not necessarily linked to the linguistic leaning of respondents’ countries or whether the dialogue took place at the national or sub-national level. The definitions were grouped into five categories based on whether they had an outcome, operational, process, forum or platform, or interactive and evidence-sharing orientation. The stakeholders highlighted multiple benefits of policy dialogue including ensuring stakeholder participation, improving stakeholder harmonisation and alignment, supporting implementation of health policies, fostering continued institutional learning, providing a guiding framework and facilitating stakeholder analysis.ConclusionPolicy dialogue offers the opportunity to improve stakeholder participation in policy development and promote aid effectiveness. However, conceptual clarity is needed to ensure pursuance of common objectives. While it is clear that stakeholder involvement is an important component of policy dialogue, numbers must be manageable for meaningful dialogue. Ownership and coordination of the policy dialogue are important aspects of the process, and building the institutional capacity of the ministry of health requires a comprehensive approach as opposed to strengthening selected departments within it. Likewise, capacity for policy dialogue needs to be built at the sub-national level, alongside improving the bottom-up approach in policy processes.

Integrative review; identifying the evidence base for policymaking and analysis in health care

“…If key stakeholders are not consulted, a policy decision may receive low support and have a decreased likelihood of successful implementation (Basaza et al, ; Nabyonga‐Orem et al, ). Inclusion of a range of stakeholders in policymaking can build support through several different mechanisms.…”

“…The lack of planning was noted by Blaauw et al () as leading to poor implementation. A traditional top‐down approach was noted to restrict policy implementation (Nabyonga‐Orem et al, ). Similarly, Ditlopo, Blaauw, Rispel, Thomas, and Bidwell () argued that better planning with clear guidelines and improved communication were necessary prerequisites for implementation (Ditlopo et al, ).…”

Promoting the use of evidence in health policymaking in the ECOWAS region: the development and contextualization of an evidence-based policymaking guidance

“…In Ghana, Araujo de Carvalho and co-workers [73] reported that policy briefs were developed and were used to de ne priority problems and health system responses to ageing and health. In Cape Verde, Nabyonga-Orem et al [64] observed that policy dialogue offered the opportunity to improve stakeholder participation in policy development and promoted aid effectiveness. In a second study from Cape Verde, Dovlo et al [74] noted that policy dialogues have proved to be an effective tool in health sector management and could be a crucial component of the governance dynamics of the sector.…”

Access to care for childhood cancers in India: perspectives of health care providers and the implications for universal health coverage

“…social constructs and behaviour) influencing the system [ 18 ]. Qualitative methods can help generate evidence on such tangible and intangible components, by exploring the perspectives of stakeholders such as health care providers on barriers to accessing care [ 19 – 21 ] and to achieving UHC [ 18 , 22 – 27 ], which can influence decision-making and policy dialogue [ 18 , 28 ]. However, such evidence is scarce in the literature on barriers to accessing care for childhood cancers in LMICs [ 29 – 32 ] and of the few qualitative studies in India regarding cancer care [ 33 , 34 ], none focused on paediatric oncology and the health care provider’s perspective.…”