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Policy making is the formulation of ideas or plans that are used by an organization or
government as a basis for making decisions. In the field of policy analysis, criteria are evaluative
standards that guide the processes of decision making. They allow in ranking policy options in
order of preference. The most important evaluative criterion is that the projected outcome will
solve the policy problem to an acceptable degree. Criteria can be measures, rules, standards,
and all those attributes considered relevant by the decision maker (individual or group) in a
given situation. A good policy making in the Public Health Organization would require certain
criteria:
Political Viability: Acceptability of the policy option to various relevant stakeholders that hold
Sustainability: Ability of the policy option to maintain its beneficial effects in the longer term.
Equity: Fair social allocation (distribution) of burdens (may be costs) and benefits among social
groups
Economic and social costs: Economic and social costs of a disease/injury; loss of productivity,
Need to act quickly: Need to act quickly (e.g. to mitigate a disaster, to control the spread of a
disease).
Burden of disease: Burden of disease (e.g. measured by the relative number of people dead –
Effect of the problem on special populations: (lower income, women, children, lower income,
Example: If the goal were to have fewer deaths and injuries as possible from traffic accidents,
Is it cost (to the hospitals? To the government? To the population? To certain groups in the
population?)
Is it equity (reduction among certain age groups at risk (males, teenagers, elderly? Other high
risk groups, such as pick up truck drivers, people living in urban areas?
Is it the burden of disease to certain population groups? Loss of social and economic
We would also need to establish the meaning of “fewer death and injuries” since achieving
Then, how much is fewer? For which injuries? What percentage? For which groups? In which
neighborhoods?
Estimation of all impacts for all alternatives is impossible (and not worthwhile)
Solutions to problem
Incomplete analysis
caused by behavioral factors related to limited use of seat belts and to drinking and driving, we know
that the following may reduce then the severity of the problem:
2. Seat belt use (saves over 26 billion dollars a year if use were universal).
Therefore, we may develop the following alternatives and enforce existing laws to ensure that:
1. Develop and implement health education and promotion strategies to modify behavioral factors
related to driver fatigue, driver distraction (talking to passengers, attending to children, eating or
drinking, personal grooming, looking at maps, reading, attention to electronic devices and verbal
exchanges).
2. Develop and implement health education strategies to reduce risky driver behaviors (drinking and
3. Establish automated systems for enforcing speed limit and red light laws.
4. Establish graduated drivers licensing laws that put limits on drivers aged 16–18 (or whatever the
7. Reduce the number of days or hours of operation of liquor stores and bars.
Q2. WHEN NEW POLICIES ARE CREATED, THERE ARE GENERALLY THREE KEY THINGS
AGENDA SETTING: This stage refers to the process through which a policy and the problem it is
among several types of agendas, including discussion agendas and decision agendas. The
discussion agenda, or public agenda, includes issues that have become highly visible and have
thus become the subject of discussion. The decision agenda, or formal agenda, includes the list
of issues the government has decided to address (Cobb & Elder, 1972).
For a policy to be placed on the agenda, there seem to be certain prerequisites. Individuals or
groups must acknowledge that a situation is problematic, identify the problematic aspects of
the situation, propose solutions, and engage in activities that influence the government and
pressure it to intervene, including identifying groups that can play an active role in addressing
the problem (Ripley, 1985, in McCool, 1995, p. 159). A wide range of literature covers this stage
and examines the strategies that groups of actors use to get a policy placed on the
government’s agenda. Therefore during agenda setting, the basic things involves are as follows:
• Identifying a problem situation and collecting evidence indicating the magnitude of the
problem. This information is intended for decision makers as well as other stakeholders.
• Challenging frameworks.
For an issue to be included on the decision agenda, the situation must be perceived as
problematic. Public health actors can assume, therefore, that the information required at this
stage should focus on the significance of a problem and its impact on public health. It is also at
this stage that causal agents are identified; that is, the relationship between a phenomenon
stage of formulation, the public administration concerned examines the various policy options
it considers to be possible solutions. It should be noted that coalitions of actors strive, through
the use of advocacy strategies, to gain priority for one specific interpretation of both the
problem and its solution. It is at this stage that power relationships crystallize, determining the
Adoption is the stage during which decisions are made at the governmental level, resulting in a
outcome of the policy. Several factors combine to determine the actual effects of a policy and
how well it achieves its objectives. Factors noted by Sabatier and Mazmanian include:
• The magnitude of the expected change and the groups targeted by the policy,
• The administrative structures and regulations that will be put in place to support
Note that high demands are placed on the technical administrative apparatus at this stage, and
on groups associated with this policy sector. The term policy network is often used to refer to
the actors within the government, as well as the stakeholders associated with a policy sector,
who are in a sense experts in the area. This policy network will have a major influence on how
and its effects are aligned with the objectives that were explicitly or implicitly set out. This
evaluation can be carried out by the government apparatus, by consultants or by civil society
(Howlett & Ramesh, 2003). Therefore during evaluation, the basic things involves are as
follows.
public policy. With the help of these benchmarks, public health actors can reflect on relevant
questions and identify the players involved with a public problem at different stages, as well the
opportunities for intervention, which constitute so many entry points into the policy
development process.
REFERENCES
Anand, Sudhir, F. Peter and A. Sen. Public Health,, Ethics and Equity. (2004) Oxford University Press. (pp.
Kraft, M. and Scott Furlong. Public Policy: Politics, Analysis and Alternatives. (2004). CQ Press, Chapter 6:
Munger, Michael. Analyzing Policy: Choices, Conflicts and Practice. (2000). New York: W.W. Norton.
Marc Suhrcke, Rachel A. Nugent, David Stuckler and Lorenzo RoccoChronic Disease: An Economic
PerspectiveLondon: http://www.oxha.org/initiatives/economics/knowledge/publications/oxha-
chronic-disease-an-economicperspective.pdf
Pal, Less (2000). “There ought to be a law!” Instrument choice: an overview of the issues. Carleton
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Them.)
Rice, Thomas. (April 1997). Can markets give us the health system we want? Journal of Health Politics,
Stone, D. (2001) Policy Paradox: The Art of Political Decision-making. Revised Edition. New York: W. W.
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