Applied Political Analysis for Health System Reform

Understanding and managing the political context of health policies is crucial to improving the chances of effectively designing, adopting, and implementing health policies and reforms that can achieve their intended objectives. This article focuses on applied political analysis as an approach to assist policymakers and public health professionals in improving political feasibility for policies and reforms. The article draws on our experience in doing applied political analysis and in advising and teaching others how to do applied political analysis. We describe the role of applied political analysis at six stages of the policy cycle (problem definition, diagnosis, policy development, political decision, implementation, and evaluation). We then present four steps for doing applied political analysis, using a concrete example at each step: 1) agree on the objectives and methods of analysis, 2) conduct a stakeholder analysis, 3) design a set of political strategies, and 4) assess the impact of the strategies on policitcal feasibility of the desired change. Political landscapes can change suddenly in unexpected ways. Doing applied political analysis, however, can increase the likelihood that the proposed policy changes will be adopted and achieve the desired outcomes in implementation. Repeating the analysis over time as the policy process unfolds and keeping track of stakeholders and strategies can increase the chances that health reform teams successfully manage the politics of policy change.