The ambition of Health in All Policies in Norway: The role of political leadership and bureaucratic change

Hofstad, Hege

doi:10.1016/j.healthpol.2016.03.001

Cited by 23 publications

(34 citation statements)

References 14 publications

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“…15,23 Our study shows that only 12% of the municipalities undertook health overviews before the enactment of the PHA, a proportion that increased to 42% after the act took effect. The relative large increase in adoption after the PHA arguably shows its influence on municipalities.…”

Section: Discussionmentioning

confidence: 76%

“…Research has indicated that developing health overviews is both ambitious and demanding. 15 Among other factors, the complexity of the determinants, access to information, and lack of knowledge may complicate this work. …”

Section: Discussionmentioning

confidence: 99%

“…Yet these undertakings are often new to planning and to policy making at the municipal level. 15 Integrating the public health perspective into public policy — not to mention fair distribution — is challenging. …”

Section: Discussionmentioning

confidence: 99%

“…14 Norway, among other countries, has implemented the HiAP approach in national and local public health policy. 15 …”

Section: Introductionmentioning

confidence: 99%

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Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups

Hagen

Øvergård

Helgesen

et al. 2018

Int J Health Policy Manag

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Background: Norway is internationally known today for its political and socio-economic prioritization of equity. The 2012 Public Health Act (PHA) aimed to further equity in the domain of health by addressing the social gradient in health. The PHA’s main policy measures were (1) delegation to the municipal level of responsibility for identifying and targeting underserved groups and (2) the imposition on municipalities of a "Health in All Policies" (HiAP) approach where local policy-making generally is considered in light of public health impact. In addition, the act recommended municipalities employ a public health coordinator (PHC) and required a development of an overview of their citizens’ health to reveal underserved social segments. This study investigates the relationship between changes in municipal use of HiAP tools (PHC and health overviews) with regard to the PHA implementation and municipal prioritization of fair distribution of social and economic resources among social groups. Methods: Data from two surveys, conducted in 2011 and 2014, were merged with official register data. All Norwegian municipalities were included (N=428). Descriptive statistics as well as bi- and multivariate logistic regression analyses were performed. Results: Thirty-eight percent of the municipalities reported they generally considered fair distribution among social groups in local policy-making, while 70% considered fair distribution in their local health promotion initiatives. Developing health overviews after the PHA’s implementation was positively associated with prioritizing fair distribution in political decision-making (odds ratio [OR] = 2.54; CI: 1.12-5.76), compared to municipalities that had not developed such overviews. However, the employment of PHCs after the implementation was negatively associated with prioritizing fair distribution in local health promotion initiatives (OR = 0.22; CI: 0.05-0.90), compared to municipalities without that position. Conclusion: Development of health overviews — as requested by the PHA — may contribute to prioritization of fair distribution among social groups with regard to the social determinants of health at the local level.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…14 Norway, among other countries, has implemented the HiAP approach in national and local public health policy. 15 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups

Hagen

Øvergård

Helgesen

et al. 2018

Int J Health Policy Manag

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“…In a recent paper, Hofstad [24] points to two basic barriers to the implementation of HiAP in public government in Norway: coordination and durability. Our experience is that these factors can be facilitated through a holistic governance system, where administrative and political leaders commit themselves to societal goals and strategies.…”

Section: Impact and Reflectionsmentioning

confidence: 99%

Health and equity in all policies in local government: processes and outcomes in two Norwegian municipalities

Heimburg

Hakkebo²

2017

Scand J Public Health

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Aims: To identify key factors in implementing Health and Equity in All Policies (HEiAP) at the local level in two Norwegian municipalities in order to accelerate the progress of promoting health, well-being and equity in other local governments. Approach: This case study is presented as a narrative from policy-making processes in two Norwegian municipalities. The story is told from an insider perspective, with a focus on HEiAP policy makers in these two municipalities. Results: The narrative identified key learning from implementing HEiAP at the local level, i.e. the importance of strengthening system and human capacities. System capacity is strengthened by governing HEiAP according to national legislation and a holistic governance system at the local level. Municipal plans are based on theory, evidence and local data. A 'main story' is developed to support the vision, defining joint societal goals and co-creation strategies. Policies are anchored by measuring and monitoring outcomes, sharing accountability and continuous dialogue to ensure political commitment. Human capacity is strengthened through participatory leadership, soft skills and health promotion competences across sectors. Health promotion competence at a strategic level in the organization, participation in professional networks, crowd sourcing toward common goals, and commitment through winning hearts and minds of politicians and other stakeholders are vital aspects. Conclusions: Our experience pinpoints the importance of strengthening system and human capacity in local governments. Further, we found it important to focus on the two strategic objectives in the European strategy 'Health 2020': (1) Improving health for all and reducing health inequalities; (2) improving leadership and participatory governance for health.

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Policy Analysis of Gastrointestinal Cancer Prevention in Iran: A Framework Based on a Qualitative Study

Kabiri¹,

Khodayari‐Zarnaq²,

Khoshbaten³

et al. 2021

World Med & Health Policy

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This study aimed to analyze the current policies of common gastrointestinal cancer prevention. This qualitative instrumental case study was conducted in 2019 to analyze policies using the “policy triangle framework.” Two data collection methods were used: document review and semistructured interviews. The country's related documents were searched through databases. Semistructured interviews were conducted at the interviewee's workplace. In total, 22 participants were interviewed, 12 of whom were from the Ministry of Health. Interviews and documents were analyzed using directed content analysis in MAXQDA v10 software. Interobserver reliability, peer check, and member check were done to confirm the trustworthiness of data. The main contextual factors affecting gastrointestinal cancers in Iran were socioeconomic, structural, political, and legal factors. Content of gastrointestinal cancer prevention in the national policies were mostly about lifestyle changes, food security, and environmental conditions. Efforts for cancer prevention policymaking in Iran starts in 1984 with a top‐down approach to the implementation and three types of evaluation. Stakeholders of gastrointestinal cancer prevention policies in Iran were categorized into three groups of governmental, nongovernmental, and semigovernmental organizations. Coordination among different organizations should be strengthened through setting common goals and creating a shared vision, and finally, political leadership should be realized by the Ministry of Health.

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The ambition of Health in All Policies in Norway: The role of political leadership and bureaucratic change

Cited by 23 publications

References 14 publications

Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups

Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups

Health and equity in all policies in local government: processes and outcomes in two Norwegian municipalities

Policy Analysis of Gastrointestinal Cancer Prevention in Iran: A Framework Based on a Qualitative Study

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