Converting a topic into a policy is carried out in hierarchical stages, all of which depend entirely on each other. Policies comprise of all the established principles that guide the process of making decisions. They give a framework of which activities or rather proposals may be tested by providing a mechanism for measuring any progress. A policy must have goals as well as instruments put down in a broad way through which the laid down goals can be achieved. It should also define the problem. Policy makers are involved in topic formulation, followed by legislation, and then finally policy implementation. At the topic formulation phase, concepts, ideas and any other relevant information from the requisite organizations, individuals and various interest groups are taken into account. At the evaluation phase, justifications, deliberations, debates and discussions of the topics are executed. At the last phase: the implementation phase, impeccable attempts are made to act on the policy adopted. This paper seeks to look at the process of conversion of a topic into a policy by looking at the three essential elements: evaluation, analysis, revision, and further providing a description of the purpose and methodologies used while evaluating and revising a public policy.
Effective evaluation of health topics entails a systematic mechanism of improving and providing an account of various health-oriented actions by ensuring that the procedures adopted are realizable, useful and ethical in any health facility setting. Adhering to the established frameworks and protocols of health policies, evaluation programs constitute a major milestone in understanding the manner of conducting the implementation of health programs (Scriven, 1998, p.57). The entire stage of topic evaluation draws the attention of, not only evaluation experts, but als of all stakeholders. The objective of topic evaluations is to facilitate an understanding of all the policy frameworks through the incorporation of effective planning strategies for public health. Despite the fact that topic evaluation is a critical practice anticipated to be seized by all institutions, it is not amicably practiced within all policies or effectively incorporated in the daily management of majority of the programs (Scriven, 1998, p.61). Evaluation guides the operational principles of all health policies for instance, extending the equity of public health policies.
At this stage, science comes in as the basis for seeing a successful decision-making process so that the various established policies reflect ardently on the capacity of the health programs to guide and prevent derailment from the intended objectives. Through evaluation, the clarity of the earlier laid out ideas in the policy formulation phase are introspected. Introspection plays a crucial role at this stage since it provides feedback information necessary for the effective management and improvement of the existing public health policies. Feedback, being a significant component of the evaluation stage, seems worth noting based on the vitality of information to flow effectively among all the evaluation experts and stakeholders. This therefore, creates an atmosphere that inculcates trust. Policy makers can achieve the feedback through the provision of periodic discursive forums about the findings attained at every step of the evaluation stage. Through the forums, the various interim results are shared among the stakeholders and the experts. Furthermore, through feedback, compliance to public health evaluation standards, as established by the Joint Committee on Standard for Educational Evaluation, can be greatly enhanced (Scriven, 1998, p.69). These standards enable practicability of the performance of sound and realistic health policy evaluations. Evaluation forms the only way through which policy makers can segregate effective polices: those that foster injury prevention and cute health from those that have less likely hood of not fostering these two crucial elements.
Analysis stage constitutes the determination of an alternative policy amongst the different available options that aid in realizing the predetermined goals while considering the existing relationships between the goal and the proposed policies. Generally, one can look at the stage from two dimensions: descriptive and analytical policy analysis, and prescriptive dimension. Descriptive and analytical policy analysis seeks to provide an explanation about the policy developments. On the other hand, prescriptive analysis focuses on policy formulation alongside policy proposals, in an attempt to facilitate improved welfare of the society. The type of the analysis chosen comes in as a function of the purposes intended by the analysis and the area of interest addressed by the policy subject to analysis (Herbert, 1976, p.3).
Policy analysis is more of the responsibility of the public sector of which majority of the public health policies fall. Policy analysis is conducted using quantitative and qualitative methodologies that encompass statistical, research surveys and case studies amongst others. As outlined by Herbert Simon, the analysis procedure constitutes gathering of intelligence, problem identification, assessments of all possible consequences of all options, relating the perceived consequences with the anticipated values and finally, making a choice of the most preferred option in a sequential procedure (Herbert, 1976, p.42). PAM (policy analysis matrix) proves important for displaying the various impacts of different policy alternatives. It helps to give a summary of the various impacts of varying policies for the differing alternatives considered. By examining the matrix critically, one can make a revelation of the possible tradeoffs in relation to the deferring alternatives. If one matrix can serve the role of analyzing all the policy alternatives, then the comparison of the differing policy alternatives seems relatively simplified. On the other hand, the concept of utility plays a vital role, while attempting to aggregate in a single score, the various existing goals in case the impacts of the different policies can only be analyzed using different matrices
The process of making public policies, whether health based or any other, entails the modification or the revision phase. Majority of public health policies are subjected to an incremental fashion of modifications. Efforts and Comprehensive understanding of the existing relationships between the objectives and goals of policies are not required in substantial amounts while making small amendments in the prevailing policies as opposed to major public policies. In the US, perhaps the best example to cite for an incremental public health policy revision is the Medicare policy programs changes observed right from when the program was enacted in 1965. In 1998, the congress incorporated professional clinical nurses and the existing nurses’ practitioners to form part of the providers capable for billing part B health care services given to all Medicare beneficiaries. After this amendment, the US congress has also introduced additional Medicare policies revisions severally. Preventive services policies likewise have been added as part of the revisions in the Medicare programs. Furthermore, recently, part D of the Medicare, which entangles a drug prescription program that is optional and available for all Medicare beneficiaries has been incorporated also.
Importance and methodologies for evaluating and revising a public policy
Evaluation of public policies is crucial since it helps to identify the possible loopholes of the policy implementation. Revising public policies, on the other hand, comes in a crucial process since the stage involves the revalidation of the existing policies, making amendments where possible or in some situations making adjustments to make the policies meet the demands of the changing circumstances (Longest, 2006, p.91). Evidently, without revision, policies cannot be up-to-date based on the prevailing needs of the society, which remain characteristically dynamic in nature depending on other changing phenomena such as technological advancements. Public policy evaluation is a complex procedure accomplished by qualitative and quantitative approaches. In majority of the policies, the evaluation is conducted by deploying both analysis methodologies together. Projective technique forms one of the crucial methodology of revision and evaluation of public policies.
Despite the complexity of this evaluation technique among others, adopting a standard approach poses a shortcoming due to its failure to provide a measurement or rather an investigation of public policies characterized by deep perceptions. Qualitative and quantitative methodologies do not provide conclusive solid evidence. Consequently, completion test and word association methodologies are employed. Both techniques are projective in nature making use of the matrix and context analysis procedures. The merit of the projective methodologies is that, it reflects the attitudes and perceptions of the interest groups to the results of the evaluation. However, drawbacks to the methodology include its evident killing of the level requirements quantification and cost problems. No matter the type of evaluation methodology employed, cost and estimation limitations demand an explicit statement. To deal with the problem of extrinsic heterogeneity, realized between the achieved results and the programs that are ongoing, retrospective evaluations require to be carried out at closer durations after or towards the end of every intervention.
Herbert, S. (1976). Administrative Behavior. New York: The Free Press.
Longest, B. (2006). Health Policy making in the United States. Chicago, IL: Health Administration Press.
Scriven, M. (1998); Minimalist Theory of Evaluation: The Least Theory That Practice Requires. American Journal of Evaluation, 19(1), pp. 57-70.