Policy dialogue to improve health outcomes in low income countries: what are the issues and way forward?

Abstract

BackgroundThis paper has three objectives: to review the health development landscape in the World Health Organization African Region, to discuss the role of health policy dialogue in improving harmonisation and alignment to national health policies and strategic plans, and to provide an analytical view of the critical factors in realising a good outcome from a health policy dialogue process.DiscussionStrengthening policy dialogue to support the development and implementation of robust and comprehensive national health policies and plans, as well as to improve aid effectiveness, is seen as a strategic entry point to improving health sector results. However, unbalanced power relations, the lack of contextualised and relevant evidence, the diverse interests of the actors involved, and the lack of conceptual clarity on what policy dialogue entails impact the outcomes of a policy dialogue process. The critical factors for a successful policy dialogue have been identified as adequate preparation; secured time and resources to facilitate an open, inclusive and informed discussion among the stakeholders; and stakeholders’ monitoring and assessment of the dialogue’s activities for continued learning. Peculiarities of low income countries pose a challenge to their policy dialogue processes, including the chaotic-policy making processes, the varied capacity of the actors and donor dependence.ConclusionPolicy dialogue needs to be appreciated as a complex and iterative process that spans the whole process of policy-making, implementation, review and monitoring, and subsequent policy revisions. The existence of the critical factors for a successful policy dialogue process needs to be ensured whilst paying special attention to the peculiarities of low income countries and potential power relations, and mitigating the possible negative consequences. There is need to be cognisant of the varied capacities and interests of stakeholders and the need for capacity building, and to put in place mechanisms to manage conflict of interest. The likelihood of a favourable outcome from a policy dialogue process will depend on the characteristics of the issue under consideration and whether it is contested or not, and the policy dialogue process needs to be tailored accordingly.

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

“…While some respondents defined policy dialogue as a process others regarded it as was a tool or a means to achieve certain objectives. The literature highlights variations in the definition, with some scholars arguing that the varied interpretation of the concept may impact the outcomes from the process [ 12 ]. For example, viewing policy dialogue as a capacity-building process or a tool to bar external influence might mean missing the opportunity to realise the outcomes the process engenders with regard to consensus building, ownership of the outcomes and commitment by all actors.…”

Coordination of the health policy dialogue process in Guinea: pre- and post-Ebola

“…Based on this we developed our conceptual framework for the study (Fig. 2 below) as shown in Nabyonga-Orem et al, this issue [ 8 ]. The framework proposes key elements important for policy dialogue processes: inputs necessary for policy dialogue, processes of implementing the dialogue, and outcomes of the dialogue.…”

Policy dialogue as a collaborative tool for multistakeholder health governance: a scoping study

“…Second, there is dire evidence on the effectiveness of PD. A recently published journal supplement on PD sought to evaluate its impact, 12 examining PD based on the definition put forward by the World Health Assembly in 2011:…”