Numerous health policies have been developed and implemented worldwide and it may often seem that only technical features affect the policy’s efficacy as well as its entire life cycle, so-to-speak. However, policies depend on a variety of groups, processes, concepts and “reflects the dominant thinking of the day” (Althaus, Bridgman & Davis 2012, p. 35).
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Blank (2013) notes that policies are always flexible especially when it comes to disputable and complex issues, for example, abortion or HIV/AIDS. Notably, the same factors have an impact on policies worldwide. It is possible to consider a policy to define factors that affect its development and implementation.
The policy aimed at introduction of the cervical cancer-preventing vaccine (further also referred to as HPV) in a number of countries proves that policies are far from being simply technical.
Apart from technical features, implementation of policies is often influenced by manufacturer. Thus, Haas et al. (2009) pharmaceutical companies tend to have quite a strong lobby in governments of western countries (for example, Canada, Germany, the USA). Therefore, they develop certain products and are interested in promoting them at all possible levels.
Admittedly, the company with the strongest lobby often becomes the winner even though the products are quite similar (Buse, Mays & Walt 2012). Authorities start developing policies with the use of a product which wins the competition due to the strong position of the manufacturer.
In the case with cervical cancer-preventing vaccine, such companies as Dohme, Merck and Sharp were leading and pushing powers in the process of the policy development (Haas et al. 2009).
Another factor that often has an impact on policies development is marketing of products. Hence, companies use effective marketing strategies to promote their products on the level of healthcare units and authorities (Porter & Teisberg 2013). Notably, direct-to-consumer advertising is allowed in the USA and New Zealand (Haas et al. 2009).
In these countries, the HPV vaccine was aimed at the target group (girls and their mothers) and was extensively advertised. Clearly, this advertising affected people’s opinion or, at least, started a lasting debate on the matter. While developing the policy, officials and authorities had to take into account the product developed and the way people see it.
Haas et al. (2009) also stress that various special interest groups have a significant effect on development of policies. These groups tend to affect or even form public opinion and, as a result, a policy development and implementation.
For instance, the Women’s Health Network (a Canadian organisation) was against the policy on HPV as they stressed that there was insufficient research on the vaccine and long-term outcome as well as possible negative effects were unclear (Haas et al. 2009). Admittedly, concerns of such organisations make people less willing to participate in a program which is a topic of such a heated debate.
Cost effectiveness is another factor affecting implementation of a policy. It is noteworthy that estimation of cost-effectiveness is quite different in all countries but it is far from being comprehensive in each case. Haas et al. (2009) emphasise that variables used for estimation are often unrepresentative and it is always difficult to evaluate long-term outcomes of the program.
Finally, there may also be certain political influence. For instance, in Australia and New Zealand the HPV vaccination policy was a matter of discussion during national elections. Clearly, the process was influenced by the political forces that were eager to gain more votes by supporting or opposing the policy.
At this point, it is possible to employ the triangular model to prove that a policy is not simply technical but is affected by numerous factors. The model implies analysis of the context of the policy, its processes and the way it is used in “particular health policy context” (Buse, Mays & Walt 2012, p. 8).
When it comes to the policy context, it is necessary to refer to the research on a particular health issue and the input of manufacturers who are interested in promoting their products.
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The impact of special interest groups also lies within this terrain as discussion of the matter and the debate which involves interest groups, consumers, researchers and manufacturers as well as policy makers is the context of the policy.
As far as the processes of the policy are concerned, this includes marketing, debate facilitating by interest groups, political influences and assessing cost-effectiveness of the policy. All these factors have a great impact on the policy development and implementation. Finally, the health policy context is created and modified by the debate on the outcomes of the policy.
In conclusion, it is possible to note that a policy is never simply technical as its development and implementation is influenced by a number of factors. These factors are manufacturers’ lobbies, marketing strategies, special interest groups’ activities, assessment of cost-effectiveness and political influences. It is necessary to note that these factors are universal and can be detected in all countries.
Clearly, the extent to which each factor influences this or that policy may be different from country to country. Nonetheless, each of them has to be taken into account when developing, implementing and assessing effectiveness of a policy.
Althaus, C, Bridgman, P & Davis, G 2012, The Australian policy handbook, Allen & Unwin, Crows Nest, NSW.
Blank, RH 2013, Rationing medicine, Columbia University Press, New York, NY.
Buse, K, Mays, N, & Walt, N 2012, Making health policy, McGraw-Hill Education, Maidenhead.
Haas, M, Ashton, T, Blum, K, Christiansen, T, Conis, E, Crivelli, L, Lim, MK, Lisac, M, MacAdam, M, & Schlette, S 2009, ‘Drugs, sex, money and power: an HPV vaccine case study’, Health Policy, vol. 92, no. 1, pp. 288-295.
Porter, M, & Teisberg, O 2013, Redefining health care: creating value-based competition on results, Harvard Business Press, Boston, MA.