Health Sector Reform

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← No uniform recipe for change

← Emerging HSR:
← Financing the health care/ services
← Insurance (compulsory and private)
← Separation between providers and regulator
← Promoting the private share in service delivery
← Promoting the family medicine/ gateway practice

← Challenges facing the Governments:
← Lack of policy making and analysis capability
← Lack of research based policy making
← Top-down implementation
← Lack of ownership
← Importing best practices without appraisal and adaptation

Policy is not developed in a vacuum BUT
in a comlpex context!!!

How best to formulate policy?
← by comprehensively understanding the policy context
← Failing to understand the context, leads to misconceptions over role, appropriateness, policy process and political feasibility. ← The research focused on observing 7 countries

Policy context
Leichter
1. Situational factors
2. Structural factors
3. Cultural factors
4. Environmental factors

Frenk
1. Political and political regime
2. Ideological
3. Demographic and epidemiological

Walt & Gilson
1. Structural context
2. Policy content
3. Policy actors
4. Processes of decision-making

← Understanding the context is a MUST. Why??
← Objective of HSR: the context explains why the issue is raised on the agenda now! ← Policy appropriateness: helps in identifying options (most appropriate) ← Policy process: especially how different stakeholders/ players react; differences over time and location ← Policy feasibility: margin of maneuvering; constraints,

Accordingly, it is best to consider the following 6 factors in HSE Policy context 1. Demographic and epidemiological
2. Processes of social and economic change
3. Economic and financial policies...
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