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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