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Table 2 Comprehensive Framework for Multi-Sectoral Approach to Health Policy Analysis

From: Assessment of the multi-sectoral approach to tobacco control policies in South Africa and Togo

Categories

Elements

Indicators

1

Context

Political context

• Political changes or critical events at the national level that have influenced policy development,

• Health sector reforms, fiscal policies among others

• Organizational changes (e.g. government structure)

Timing, Historical/Social factors

• Timeline of policy development

• Historical origins of the policy, including what issues it meant to address, and how issue identification has evolved over time.

• Other global factors that have influenced policy development and how they influenced it.

• Any social factors (e.g. increase in prevalence of NCD)

Economic context

• Country economic growth

• Global and local financial situation and conflicting development agendas

Technological factors

• Technological factors that have influenced policy development

2

Content

Policy interventions

• Specific NCD prevention policies developed

• Which WHO best buy interventions were included

• Rationale for developing the policy

• Type of interventions (upstream, midstream, or downstream)

• Population level coverage of the interventions (universal or targeted)

• Implicit or explicit equity goals (improve health of vulnerable groups, reduce health gaps, flatten social gradient)

3

Stakeholders

Institutions (including rules, laws, norms and customs) and interests that led the process of developing health policies

• Government sector/department that led the process

• Other sectors that were involved

• Levels of government involved (national, local)

• Existence of governance structures for multi-sectoral action at different levels (central government, parliament and civil service), their participation in and experiences with these structures.

• Civil Society Organisations and private entities involved

• Role of sectors involved in formulation (Funding meetings, provision of technical assistance)

Formulation

• Extent of participation in policy formulation,

• Experiences in policy formulation (what went well, and what could have been done differently)

• Interests and concerns with the policy process, how these may have influenced their participation and how these were addressed.

• Relevant institutions not involved in implementation

Implementation

• Key sectors/actors involved in the implementation,

• Their role in the implementation

• Relevant institutions not involved in implementation

• Benefits of involving many actors in implementation

• Challenges of involving many actors in implementation

4

Strategies

Formulation

• Extent to which the visions held by the health sector, by other sectors and by the ruling party are complementary, comprehensive and coherent

• Means of engagement of other sectors, such as consultations, workshops, or meetings.

• Patterns of interaction between health and other sectors:

• Factors that contributed to successful engagement of other sectors

• Benefits of involving different sectors in formulation process

• Challenges encountered in the process

Implementation

• Extent of implementation of the best buys and how implementation is proceeding

• Government management styles:

- Horizontal integration

- Vertical integration

- Mix of horizontal and vertical

• Any gaps in implementation, the constraints and enabling factors to the implementation process,

• Future plans for implementation of the best buys

• Mechanisms for monitoring and evaluation

Funding

• Funding available for implementation of each policy

• Sources of funding

• Amounts

• Funding arrangements such as joint budgeting and delegated financing aimed at addressing supply or demand

Facilitating factors

• Factors facilitating working together of different sectors

Hindering factors

• Factors that have hindered working together of different sectors

Recommendations

• Recommendations and suggestions on how to make multi-sectorality better in the future,

• Mechanisms and structures through which multi-sectoral can be enhanced