Analysis?

Analysis Analysis is the process of breaking a complex topic or substance into smaller parts to gain a better understanding of it.

Policy Analysis?

Policy Analysis Policy analysis is "determining which of various alternative policies will most achieve a given set of goals in light of the relations between the policies and the goals"

Analysis of Policy  Analysis of policy is analytical and descriptive—i.e., it attempts to explain policies and their development.

Analysis for Policy Analysis for policy is prescriptive—i.e., it is involved with formulating policies and proposals 

Policy Studies?

Policy Studies Policy Analysis + Program Evaluation

Program Evaluation Program evaluation is a systematic method for collecting, analyzing, and using information to answer questions about projects, policies and programs, particularly about their effectiveness and efficiency.

QALY The quality-adjusted life year (QALY) is a measure of disease burden, including both the quality and the quantity of life lived.

QALY The QALY is based on the number of years of life that would be added by the intervention. Each year in perfect health is assigned the value of 1.0 down to a value of 0.0 for being dead. If the extra years would not be lived in full health, for example if the patient would lose a limb, or be blind or have to use a wheelchair, then the extra life-years are given a value between 0 and 1 to account for this.

DALY The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. DALYs are calculated by taking the sum of these two components. In a formula: DALY = YLL + YLD YLL= Years of Life Lost YLD= Years Lived with Disability

Policy Analysis Approaches Analycentric Policy Process Meta-policy Approach

Analycentric The analycentric approach focuses on individual problems and their solutions; its scope is the micro-scale and its problem interpretation is usually of a technical nature. The primary aim is to identify the most effective and efficient solution in technical and economic terms (e.g. the most efficient allocation of resources).

Policy Process The policy process approach puts its focal point onto political processes and involved stakeholders; its scope is the meso-scale and its problem interpretation is usually of a political nature. It aims at determining what processes and means are used and tries to explain the role and influence of stakeholders within the policy process. By changing the relative power and influence of certain groups (e.g., enhancing public participation and consultation), solutions to problems may be identified.

Meta-Policy Analysis The meta-policy approach is a systems and context approach; i.e., its scope is the macro-scale and its problem interpretation is usually of a structural nature. It aims at explaining the contextual factors of the policy process; i.e., what are the political, economic and socio-cultural factors influencing it. As problems may result because of structural factors (e.g., a certain economic system or political institution), solutions may entail changing the structure itself.

Models for Policy Analysis Institutional Model Process Model Rational Model Group Model Elite Model Six-Step Model

Eightfold Path The Eightfold Path is a method of policy analysis assembled by Eugene Bardach. It is outlined in his book A Practical Guide for Policy Analysis: The Eightfold Path to More Effective Problem Solving

Bardach’s Proceedure Define the Problem Assemble Some Evidence Construct the Alternatives Select the Criteria Project the Outcomes Confront the Trade-offs Decide Tell Your Story

Pakistani Perspective Having discussed the Bhore’s Report lets discuss the 5-year plans.

1st 5-Year Plan (1955-60) Detailed program for Health Sector Unsatisfactory Implementation Lack of Qualified Personnel Delays in disbursement of funds Only 50% of the total plan allocation of Rs 287 million was utilitzed.

2nd 5-Year Plan (1960-65) Improvement in health performance. 3 New medical colleges in East Pakistan 200 Rural Health Centers were planned Malaria Eradication Plan Smallpox – 79,000 cases in 1958 to only 50 cases in 1964

3rd 5-Year Plan (1965-70) Set some targets – but not achieved LHVs to be increased to 1,700 but only 950 recruited. 547 new RHCs were planned but only 230 were established

4th 5-Year Plan (1970-78) 70-72 Development expenditure fell to Rs 59 million, many programs were scrapped 72-78 Remarkable expansion of health facilities Significant steps in health-related fields. Health expenditure rose from 0.47% of GDP (1970-72) to 0.72% in 1977-78 Extensive deliberations resulted into health policy

4th 5-Year Plan (1970-78) Malaria program was revived and was integrated with health services Declared free from Smallpox in 1976 RHCs increased from 86 to 289 Health Guards were introduced in Northern Areas Medical colleges from 6 to 15 Enrollment from 900 to 4000 Nurses from 5,400 to 9,711 LHVs from 1881 to 3250 Drug Act 1976 modified Generic Drug Scheme 1972

5th 5-Year Plan 1978 625 RHCs and 4,596 BHUs were planned but only 206 RHCs and 1,617 BHUs were built. IMR to be reduced from 105/1000LB to 79, but only 100 Life Expectancy 54 M and 53F – 60M 59F Targets were over ambitious and could not be met

6th 5-Year Plan 1983-88 Most Union Councils provided BHUs Lack of proper incentive

7th 5-Year Plan 1988-93 Very challenging indicators Reduction of IMR from 80 to 60 Life Expectancy from 61 to 63 Protect all newborns from neonatal tetanus by immunizing all females of 15-44 Prevent occurrence of 1st degree malnutrition Eliminate 2nd & 3rd degree malnutrition Reduce anemia in pregnant women to half These targets were not met but there was some gain under EPI

8th 5-Year Plan 1993-98 Context: Building Infrastructure, Focus on Curative rather than Preventive Focus on Maternal & Child Health Social Action Program Draft of National Health Policy Political Commitment Implementation report to PM office at regular intervals