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Overseas Development Institute (ODI)

How can the analysis of power and process in policy-making improve health outcomes?
Moving the agenda forward


ODI Briefing Paper 25

Kent Buse and Clare Dickinson
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Overseas Development Institute (ODI), HLSP Institute

October 2007

SARPN acknowledges ODI as a source of this document: www.odi.org.uk
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Key points

  • Policy analysis can contribute to meeting health objectives by untangling the complex forces of power and process that underpin change.


  • Health policy analysis has not been adequately developed and applied in low and middle income countries.


  • Building a critical mass of networked researchers and policy-makers provides the key to developing the field and improving its contribution to health outcomes.

The Millennium Development Goals (MDGs) Report (UN, 2007) indicates that progress against the goals at mid point is patchy. Many of the key challenges that need to be addressed relate to health: continued high rates of maternal mortality, slow improvements in rates of child survival, and a rising number of deaths due to AIDS in sub- Saharan Africa. Many factors underlie the slow progress. These include lack of investment in weak health systems, insufficient or poorly coordinated donor resources, lack of agreement on effective technical strategies, and limited scaleup of interventions that work. An area that has received less attention but contributes to slow progress in achieving the health-related MDGs is the analysis of how and why national health policies achieve less than expected, perform differently from expected, or even fail.

The Millennium Development Goals (MDGs) Report (UN, 2007) indicates that progress against the goals at mid point is patchy. Many of the key challenges that need to be addressed relate to health: continued high rates of maternal mortality, slow improvements in rates of child survival, and a rising number of deaths due to AIDS in sub-Saharan Africa. Many factors underlie the slow progress. These include lack of investment in weak health systems, insufficient or poorly coordinated donor resources, lack of agreement on effective technical strategies, and limited scaleup of interventions that work. An area that has received less attention but contributes to slow progress in achieving the health-related MDGs is the analysis of how and why national health policies achieve less than expected, perform differently from expected, or even fail.



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