Kenya's Health in All Policies strategy: a policy analysis using Kingdon's multiple streams.


Journal

Health research policy and systems
ISSN: 1478-4505
Titre abrégé: Health Res Policy Syst
Pays: England
ID NLM: 101170481

Informations de publication

Date de publication:
06 Feb 2019
Historique:
received: 22 07 2018
accepted: 10 01 2019
entrez: 8 2 2019
pubmed: 8 2 2019
medline: 6 6 2019
Statut: epublish

Résumé

Health in All Policies (HiAP) is an intersectoral approach that facilitates decision-making among policy-makers to maximise positive health impacts of other public policies. Kenya, as a member of WHO, has committed to adopting HiAP, which has been included in the Kenya Health Policy for the period 2014-2030. This study aims to assess the extent to which this commitment is being translated into the process of governmental policy-making and supported by international development partners as well as non-state actors. To examine HiAP in Kenya, a qualitative case study was performed, including a review of relevant policy documents. Furthermore, 40 key informants with diverse backgrounds (government, UN agencies, development agencies, civil society) were interviewed. Analysis was carried out using the main dimensions of Kingdon's Multiple Streams Approach (problems, policy, politics). Kenya is facing major health challenges that are influenced by various social determinants, but the implementation of intersectoral action focusing on health promotion is still arbitrary. On the policy level, little is known about HiAP in other government ministries. Many health-related collaborations exist under the concept of intersectoral collaboration, which is prominent in the country's development framework - Vision 2030 - but with no specific reference to HiAP. Under the political stream, the study highlights that political commitment from the highest office would facilitate mainstreaming the HiAP strategy, e.g. by setting up a department under the President's Office. The budgeting process and planning for the Sustainable Development Goals were found to be potential windows of opportunity. While HiAP is being adopted as policy in Kenya, it is still perceived by many stakeholders as the business of the health sector, rather than a policy for the whole government and beyond. Kenya's Vision 2030 should use HiAP to foster progress in all sectors with health promotion as an explicit goal.

Sections du résumé

BACKGROUND BACKGROUND
Health in All Policies (HiAP) is an intersectoral approach that facilitates decision-making among policy-makers to maximise positive health impacts of other public policies. Kenya, as a member of WHO, has committed to adopting HiAP, which has been included in the Kenya Health Policy for the period 2014-2030. This study aims to assess the extent to which this commitment is being translated into the process of governmental policy-making and supported by international development partners as well as non-state actors.
METHODS METHODS
To examine HiAP in Kenya, a qualitative case study was performed, including a review of relevant policy documents. Furthermore, 40 key informants with diverse backgrounds (government, UN agencies, development agencies, civil society) were interviewed. Analysis was carried out using the main dimensions of Kingdon's Multiple Streams Approach (problems, policy, politics).
RESULTS RESULTS
Kenya is facing major health challenges that are influenced by various social determinants, but the implementation of intersectoral action focusing on health promotion is still arbitrary. On the policy level, little is known about HiAP in other government ministries. Many health-related collaborations exist under the concept of intersectoral collaboration, which is prominent in the country's development framework - Vision 2030 - but with no specific reference to HiAP. Under the political stream, the study highlights that political commitment from the highest office would facilitate mainstreaming the HiAP strategy, e.g. by setting up a department under the President's Office. The budgeting process and planning for the Sustainable Development Goals were found to be potential windows of opportunity.
CONCLUSION CONCLUSIONS
While HiAP is being adopted as policy in Kenya, it is still perceived by many stakeholders as the business of the health sector, rather than a policy for the whole government and beyond. Kenya's Vision 2030 should use HiAP to foster progress in all sectors with health promotion as an explicit goal.

Identifiants

pubmed: 30728042
doi: 10.1186/s12961-019-0416-3
pii: 10.1186/s12961-019-0416-3
pmc: PMC6366019
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

15

Subventions

Organisme : Medizinischen Fakultät Heidelberg, Universität Heidelberg
ID : IN-1150438
Organisme : health systems global
ID : TC01613308

Références

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Auteurs

Joy Mauti (J)

Heidelberg Institute of Global Health, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany. joy.mauti@uni-heidelberg.de.

Lara Gautier (L)

Department of Social and Preventive Medicine, School of Public Health (ESPUM), University of Montreal, 7101, avenue du Parc, 3rd floor, Montreal, Quebec, H3N 1X9, Canada.
Centre d'Etudes en Sciences Sociales sur les Mondes Africains, Américains et Asiatiques (CESSMA), Sorbonne Paris Cité University, Case courrier 7017, 75205, Paris Cedex 13, France.

Jan-Walter De Neve (JW)

Heidelberg Institute of Global Health, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.

Claudia Beiersmann (C)

Heidelberg Institute of Global Health, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.

Jale Tosun (J)

Institute of Political Science, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.

Albrecht Jahn (A)

Heidelberg Institute of Global Health, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.

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