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Improving policy-making process through bottom-up planning: what are the key to success?

2nd Global Symposium on health system research - Session
by

Jessica Martini

on 6 December 2012

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Transcript of Improving policy-making process through bottom-up planning: what are the key to success?

Improving the policy-making process
through bottom-up planning:
What are the key to success? Policy cycle Bottom-up approaches in development Some bottom-up approaches in health Are we all ready to that (challenging) paradigm shift? Neither that linear nor sequential in reality [Dujardin, 2003; Kerouedan, 2004, Balique, 2011] Need for more coherence
between changes in rhetoric... mindset...
and practices!! On-going gap between discourses...
...and practices Simple consultations Policy-making process(es) Thank you for your attention ! For more information: Jessica.Martini@ulb.ac.be The approach to policy-making remains a top-down one !!

Risk of an overused / overdone concept !! Bottom-up planning approaches Utilitarian viewpoint A successful approach
requires
a paradigm shift Jessica Martini, E Paul, A Fromont, N Ribesse,
V Zinnen,D Van der Roost, J Macq, B Dujardin Policy course of actions (or inactions) that affect the (health) sytems Many levels international
national
regional
local
organization ... Many actors... Policy makers
Service providers
Beneficiaries
Evaluators ... ...and interests / values Political viewpoint More effective interventions when stakeholders are involved Democratic processes (pluralism of people and values) Mechanisms limited to agenda setting/formulation Mechanisms limited to implementation processes Weak empowerment Little influence over decision-making Little influence over prior decisions What elements can
contribute to improving
effective
bottom-up planning ? [Buse,Mays, Walt, 2005] [Dumas, 1983; Chaveau, 1999; Hadjai-Castro, 2008] How best to promote it ? 0 School of public health, Université Libre de Bruxelles

Research centre on health policy and systems
- International health: www.ulb.ac.be/esp

GRAP-PA Santé Project: www.grap-pa.be Logical framework
/ linear planning Development / health as complex adaptive systems

Multifactor: individual, organizational, system capacities Top-down Bottom-up Top-down Main focus on beneficiaries representatives Top-down Consultation mechanism Bottom-up Top-Down Technical implementation (Self-)Learning mechanisms
Possibilities of changes
/ failures Bottom-up Top-Down Focus on specific issues

Short / mid-term quantitative results Systemic approach

Long term results and focus on stakeholders' behavior change

=> empowerment as an outcome Bottom-up Top-down Multiplication of impact M&E M&E: joint /inclusive and focused on implementation processes
Accountability Large inclusivity: beneficiaries, policy makers, service providers, evaluators..and their values Bottom-up Evidence-informed policies

taking stock of stakeholders' (past) experiences
knowledge translation Bottom-up Development / health as complex adaptive systems

Multifactor: individual, organizational, system capacities Bottom-up
Full transcript