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The inter-section of political history and health policy in Asia - the historical foundations for health policy analysis

Grundy, J, Hoban, E, Allender, S and Annear, P 2014, The inter-section of political history and health policy in Asia - the historical foundations for health policy analysis, Social Science & Medicine, vol. 117, pp. 150-159, doi: 10.1016/j.socscimed.2014.07.047.

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Title The inter-section of political history and health policy in Asia - the historical foundations for health policy analysis
Author(s) Grundy, JORCID iD for Grundy, J orcid.org/0000-0003-4928-7076
Hoban, E
Allender, SORCID iD for Allender, S orcid.org/0000-0002-4842-3294
Annear, P
Journal name Social Science & Medicine
Volume number 117
Start page 150
End page 159
Total pages 10
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2014-09
ISSN 1873-5347
Keyword(s) Health and history
Health reform
Policy change
Social transition
Science & Technology
Social Sciences
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Social Sciences, Biomedical
Biomedical Social Sciences
SOCIAL DETERMINANTS
SYSTEMS THINKING
PATH DEPENDENCY
CAMBODIA
ACCESS
TRANSITION
CARE
MONGOLIA
MYANMAR
EQUITY
Summary One of the challenges for health reform in Asia is the diverse set of socio-economic and political structures, and the related variability in the direction and pace of health systems and policy reform. This paper aims to make comparative observations and analysis of health policy reform in the context of historical change, and considers the implications of these findings for the practice of health policy analysis. We adopt an ecological model for analysis of policy development, whereby health systems are considered as dynamic social constructs shaped by changing political and social conditions. Utilizing historical, social scientific and health literature, timelines of health and history for five countries (Cambodia, Myanmar, Mongolia, North Korea and Timor Leste) are mapped over a 30-50 year period. The case studies compare and contrast key turning points in political and health policy history, and examines the manner in which these turning points sets the scene for the acting out of longer term health policy formation, particularly with regard to the managerial domains of health policy making. Findings illustrate that the direction of health policy reform is shaped by the character of political reform, with countries in the region being at variable stages of transition from monolithic and centralized administrations, towards more complex management arrangements characterized by a diversity of health providers, constituency interest and financing sources. The pace of reform is driven by a country's institutional capability to withstand and manage transition shocks of post conflict rehabilitation and emergence of liberal economic reforms in an altered governance context. These findings demonstrate that health policy analysis needs to be informed by a deeper understanding and questioning of the historical trajectory and political stance that sets the stage for the acting out of health policy formation, in order that health systems function optimally along their own historical pathways.
Language eng
DOI 10.1016/j.socscimed.2014.07.047
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 920299 Health and Support Services not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30067380

Document type: Journal Article
Collections: School of Health and Social Development
Population Health
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