Conceptual underpinnings: Health policy, policy formulation,
and policy
implementation
Managing hypertension and diabetes calls for the adoption of appropriate
health policies. Health policy, an aspect of public policy, is used to
denote “ courses of action that affect that set of institutions ,
organizations, services and funding arrangements of the health care
system in a country” (Palmer & Short, 1994 p.23). Health policies
therefore encapsulate actions or desired actions taken by public,
private or voluntary organizations that impinge on the health of a
population. According to Palmer and Short (1994), health policy differs
from other policies because of the distinctive role and influence of the
medical profession, the complex nature of providing health care, and the
difficulty in differentiating good health services from poor services.
These features make health policy a crucial aspect of the public policy
of a state. To understand health policy though, regard should be given
to understanding social and economic policy since clear linkages exist
and forms an important part in fashioning a robust health policy and
system.
Formulation of health policies is an important consideration in the
management of disease conditions. However, policy formulation has been
conceived as a “highly diffuse, and complex, process which varies by
case….as nuances in particular instances can be grasped only through
empirical case studies” (Howlett, Ramesh, 1995 p.123). However, no
matter how complex the process might be, the basic conception is that
policy formulation starts when governments realize a need and thinks of
a course of action to address that need by exploring various options.
Consequently, policy formulation involves elimination of policy options,
until one or only a few options amongst which policy makers make their
final decision (Howlett and Ramesh, 1995 p.123).
In addressing health needs, options selected must be implemented in
order to realize the benefits of such decisions. Translating health
programs into practice (implementation) is a complex phenomenon. Key
issues to be taken into account include the nature of the health problem
and the context, and the organization of the administrative mechanism in
charge of the task of implementation (Howlett and Ramesh, 1995).
Implementation of health policies may be influenced by socio-economic
conditions, political circumstances, technological issues as well as the
administrative apparatus (Sabatier and Mazmanian, 1980; Brownson
et al ., 2003).