National public health policy and its local implementation

• Main Author: Douglas, Flora
• Published: University of Aberdeen 2010
• Subjects: 610.7343; Health Policy : Public health
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540331

Translation of national public health policy into local action is poorly understood. This thesis explores this issue using: (a) independent evaluation data of the government-funded Well Men’s Services Pilots Programme (WMS); and (b) an analytical framework derived from ‘rational’ health planning models; particularly the PRECEDE PROCEED (PP) model. A mixed-methods study was conducted, comprising: (i) a review of the health planning literature; (ii) an interpretative documentary analysis of policy documentation and local intervention plans; and (iii) a secondary analysis of 42 semi-structured interviews with local managers and professionals responsible for developing interventions in response to the policy. The research findings (ii&iii) were considered in light of this review. This thesis concluded that rationalist health planning approaches and frameworks are not sufficient to guide the implementation of public health policy to an effective conclusion, and has argued that there is a need to develop new ways of thinking about public health issues that have become ‘policy problems’ deemed in need of intervention and resolution. This new thinking needs to acknowledge the complex and contested nature of health problems. This include accepting: (1) that a range of different perspectives and interpretations of public health policy problems and associated notions of their solutions will reside amongst those individuals and organisations tasked with transforming policy into practice; (2) the inevitability of imperfect and contested evidence; (3) future uncertainties, and; (4) the existence of bureaucratic barriers that will constrain direct engagement of the intended beneficiaries, by policy implementers, in the process of developing interventions.