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Participatory policy analysis in health policy and systems research: reflections from a study in Nepal.

Sapkota, S, Rushton, S, van Teijlingen, E, Subedi, M., Balen, J., Gautam, S., Adhikary, P., Simkhada, P., Wasti, S. P., Karki, J. K., Panday, S., Karki, A., Rijal, B., Joshi, S., Basnet, S. and Marahatta, S. B., 2024. Participatory policy analysis in health policy and systems research: reflections from a study in Nepal. Health Research Policy and Systems, 22, 7.

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Participatory policy analysis in health policy and systems research reflections from a study in Nepal.pdf - Published Version
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DOI: 10.1186/s12961-023-01092-5


Background: Participatory policy analysis (PPA) as a method in health policy and system research remains underexplored. Using our experiences of conducting PPA workshops in Nepal to explore the impact of the country’s move to federalism on its health system, we reflect on the method’s strengths and challenges. We provide an account of the study context, the design and implementation of the workshops, and our reflections on the approach’s strengths and challenges. Findings on the impact of federalism on the health system are beyond the scope of this manuscript. Main body: We conducted PPA workshops with a wide range of health system stakeholders (political, administrative and service-level workforce) at the local and provincial levels in Nepal. The workshops consisted of three activities: river of life, brainstorming and prioritization, and problem-tree analysis. Our experiences show that PPA workshops can be a valuable approach to explore health policy and system issues – especially in a context of widespread systemic change which impacts all stakeholders within the health system. Effective engagement of stakeholders and activities that encourage both individual- and system-level reflections and discussions not only help in generating rich qualitative data, but can also address gaps in participants’ understanding of practical, technical and political aspects of the health system, aid policy dissemination of research findings, and assist in identifying short- and long-term practice and policy issues that need to be addressed for better health system performance and outcomes. Conducting PPA workshops is, however, challenging for a number of reasons, including the influence of gatekeepers and power dynamics between stakeholders/participants. The role and skills of researchers/facilitators in navigating such challenges are vital for success. Although the long-term impact of such workshops needs further research, our study shows the usefulness of PPA workshops for researchers, for participants and for the wider health system. Conclusions: PPA workshops can effectively generate and synthesize health policy and system evidence through collaborative engagement of health system stakeholders with varied roles. When designed with careful consideration for context and stakeholders’ needs, it has great potential as a method in health policy and systems research.

Item Type:Article
Uncontrolled Keywords:Health policy and systems research; Nepal; Participatory policy analysis; Qualitative evidence; Humans; Nepal; Health Policy; Data Accuracy; Research Personnel; Policy Making
Group:Faculty of Health & Social Sciences
ID Code:39495
Deposited By: Symplectic RT2
Deposited On:08 Feb 2024 08:12
Last Modified:08 Feb 2024 08:12


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