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Policy process for health sector reforms: a case study of Punjab Province (Pakistan)
Author(s) -
Tarin Ehsanullah,
Green Andrew,
Omar Maye,
Shaw Jane
Publication year - 2009
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.1010
Subject(s) - bureaucracy , underpinning , conservatism , government (linguistics) , civil society , process (computing) , politics , resistance (ecology) , policy analysis , political science , health sector , public administration , economic growth , public economics , economics , sociology , engineering , health services , ecology , linguistics , philosophy , civil engineering , computer science , law , biology , operating system , population , demography
Abstract The health sector in the Punjab (Pakistan) faces many problems, and, the government introduced reforms during 1993–2000. This paper explores the policy process for the reforms. A case study method was used and, to assist this, a conceptual framework was developed. Analysis of four initiatives indicated that there were deviations from the government guidelines and that the policy processes used were weak. The progress of different reforms was affected by a variety of factors: the immaturity of the political process and civil society, which together with innate conservatism and resistance to change on the part of the bureaucracy resulted in weak strategic sectoral leadership and a lack of clear purpose underpinning the reforms. It also resulted in weaknesses in preparation of the detail of reforms leading to poor implementation. The study suggests a need for broadening the stakeholders' base, building the capacity of policy‐makers in policy analysis and strengthening the institutional basis of policymaking bodies. Copyright © 2009 John Wiley & Sons, Ltd.