POLICY DEVELOPMENT AND ANALYSIS

MR NKOLE J

NKOLE J 1
 Introduction
• A policy is a deliberate system of principles to guide decisions
and achieve rational outcomes.
• The law compels or prohibits to do something while a policy
guides. Therefore the role of policy is to give guidance. The
intension or purpose for policy varies from organization to
organization and the context in which they are made.
• Policies are broadly instituted to avoid some negative effects.
• For example a policy on purchasing can be instituted to give
guidance on what can be purchased without going through the
purchasing process. This is done to avoid waste.
NKOLE J 2
DEFINITIONS
• A policy is a general plan of action used to guide the
desired outcome. It is a guideline or rule used to make
decisions. The role of policy is to give guidance.
• A policy is a deliberate system of principles to guide
decisions and achieve rational outcomes.
• Policy analysis involves the systematic comparison and
analysis of a set of policy alternatives to determine which
option is most likely to achieve a set of objectives.
• Stakeholder- a person who has interest or concern in
something. NKOLE J 3
 Principles of policy formulation
1. Identify the root problem that requires policy formulation and
define it clearly (understand fully by every one).
2. Give the designers of the policy the maximum time and
flexibility to come up with the policy that will solve the problem
3. Encourage a systems approach to policy – it means consulting
different stakeholders to offer suggestions that will lead to
developing a good policy.

NKOLE J 4
 Forms of policy (ways in which policy exists)

• Broad Policy – these are designed by government and usually

have a wide direction.
• Specific Policy –developed for a particular sector such as
economy, child welfare etc.
• Operational Policy – guide decisions on programs and projects.
This one directed to production.

NKOLE J 5
 Types of policies
i. Company policy
ii. Economic policy
iii. Energy policy
iv. Foreign policy
v. Population policy
• Examples of health-related policies in Zambia
• 1. Reproductive Health Policy
• 2. National HIV/AIDS Workplace Policy
• 3. National HIV/AIDS/STIs/TB
NKOLE J 6
• Mental Health policy • 11. Tobacco control policy
• 6. Oral Health policy • 12. Breast feeding promotion
• 7. Infection prevention policy policy
• 8. Malaria policy • 13. Vaccination
• 9. Public health policy
• 10. Mental health policy

NKOLE J 7
 Purpose of a policy or health care procedure

• 1. To provide standardization in daily operational activities.

• 2. To provide clarity when dealing with issues and activities that
are critical to health and safety that have serious consequences
if not done properly.
• 3. Policy is also used to communicate to employees the desired
outcomes of the organization. They are usually broad, state
what has to be achieved and why and answer major
operational issues.
NKOLE J 8
 Purpose of a policy or health care procedure

• 4. Policies again can help employees understand their roles and

responsibilities within the organization.
• 5. Principles for guiding action and decision making.
• 6. They provide justification for allocation of resources.
• 7. They reflect the ideologies and values of the organization

NKOLE J 9
 Contents of policy document

• Policies are introduced through an official written document.

This document often comes with endorsement or signature of the
executive powers of the organization.
• The format differs from place to place though every policy
document has in common the following:
1. A purpose statement: It is a statement outlining why the
organization is issuing such a policy and what the desired
effect of the policy is.
NKOLE J 10
 Contents of policy document cont..

2. Scope statement: It describes which actions (areas) are

impacted by the policy and who the policy will affect to avoid
unintended consequences.
3. An effective date: It indicates the day on which the policy
comes into force.
4. Responsibilities: A section indicating which departments are
responsible for carrying out individual policy statements
5. Policy statement: a statement indicating the specific
regulations, requirements or modifications to organizational
NKOLE J 11
 Process of policy development
• There are four typical and main steps in the policy process:
1. Identifying a problem
2. Formulating a policy
3. Implementing the policy change and
4. Evaluating the result.
• Each step is usually followed in the order listed to make sure
that the process is done correctly.

NKOLE J 12
 Steps involved in policy development
• 1. Identifying the Problem - The first step in the policy process
is to outline the problem.
• This involves not only recognizing that an issue exists, but also
studying the problem and its causes in detail.
• This stage involves determining how aware the public is of the
issue, deciding who will participate in fixing it, and considering
what means are available to accomplish a solution

NKOLE J 13
 Process of Policy Development cont…
2. Formulating a Policy to Resolve the Problem
• This step is typically marked by discussion and debate
with stakeholders to identify potential obstacles, to suggest
alternative solutions, and to set clear goals and list the steps
that need to be taken to achieve them. It requires a lot of
research, consultation and coordination.
• Major stakeholders have to be involved in this process that
all issues involved are tackled to avoid possible rejection of
the policy.
NKOLE J 14
• Once the policy is developed, the authorities must agree to it.
• A weaker policy may be less likely to pass, whereas a stronger
policy that deals with the problem more directly might not have
problems to gain approval.
• 3. Implementing the Policy - This is the third step of the policy
process where the new policy is put into effect. It requires clear
communication and coordination, as well as sufficient funding in
order to make this step a success.
• The policy can be difficult to implement if the people who are
tasked with carrying out the policy are not committed to
NKOLE J 15
complying with it.
• 4. Evaluating the Effect of the Policy - This step usually involves
a study of how effective the new policy has been in addressing
the original problem, which often leads to policy formulation.
• Policy monitoring is about detecting how the policy is doing.
• It also involves collecting data about the policy on what has
achieved as well as reviewing funds and resources used for
policy implementation.

NKOLE J 16
 Benefits of policy to staff (monitors)
• 1. Helps staff to make decisions more efficiently
• 2. Reduces bias in decision-making
• 3. Provides instructions on how things should be done
• 4. Creates confidence to enable staff to initiate action and take
responsibility without constantly referring to management.
• 5. Increase accountability of the organization

NKOLE J 17
 Development of a ward/health facility policy

• Phase 1 - Establishing a working group - The MoH will

establish a working group (NGOs ,private sector and
government sectors - Sub -committees of specialists in the field).
Terms of reference will be defined by government and
Resources required are provided.
• Phase 2: Analysis of situation- collection of information.
• Phase 3: Formulation of policy - A draft policy is developed
depending of the analysis of information collected containing
the following chapters;
NKOLE J 18
i. Introduction
ii. History of the industry
iii. General orientation of policy
iv. Objectives of the Policy
v. Institutional and operational strategies
vi. Proposed accompanying measures

NKOLE J 19
 Development of a ward/health facility policy cont,,

• Phase 4: Wide circulation of the draft document

• Draft document is circulated to external experts and
stakeholders for comments to analyze and advice where need
be.
• Phase 5: Consensus workshop - A national workshop is
conducted for 3-5 days to develop a given policy based on the
draft policy. All parties concerned with the sector i.e. Ministries,
professional groups, Universities NGOs, partners are involved.

NKOLE J 20
• Phase 6: Finalization of policy - The Policy document would be
finalized on the basis of the recommendations of the National
workshop. After its finalization, the document is transmitted to
MoH who will submit to Cabinet for Government approval and
adoption
• Phase 7: Approval of the policy document – government
through cabinet will approve the policy and it will become
official.

NKOLE J 21
• Phase 8: Publication of the official policy document - The
official policy document is printed in sufficient numbers for
distribution to all concerned.
• Phase 9: Public launching official policy document - The
policy document should be officially launched for advocacy
purposes. The document is widely distributed and promoted in
various seminars. It can then become operational
• Implementation of a policy - Implementation starts with formal
adoption of the policy document.
NKOLE J 22
 Effective Hospital Policy.

• Is reflective of the health goals of the nation at large

• Is written within the scope of the health facility e.g. level 3
hospital.
• Is adopted through proper management procedures
• Is respectful of legal and constitutional rights and requirements;
and
• Is communicated to the persons it will affect e.g. patients or
health workers.
NKOLE J 23
 Policy Monitoring and Evaluation
• Policy monitoring is about detecting how the policy is doing.
• It involves data collecting some data about the policy. This could
be from records, document, feedback from clients, dairy entries
from staff etc.
• Policy evaluation is the last step in the process. You can ask the
following questions;
Is the policy having a direct impact
Are there any needs for modification?

NKOLE J 24
 Analysis of policies
• Policy analysis involves exploring one policy, compare two or
more policies with each other and assess the future implications
of a variety of different policy changes.
• Analysis may examine one stage in policy development or can
look across all stages of policy, from design to implementation
and evaluation.
• The following is a review of the most prominent methodologies
used in policy analysis to describe, analyze, and compare
policies;
NKOLE J 25
 Methods of policy analysis to employ as a nurse manager
when you are trying to change some policies.

1. Needs Assessment – it involves identifying the need to

implement the policy by the assessing the problem that requires
policy formulation. To address problems sensibly a policy
analyst identifies the nature and extent of the problems
through analysis of existing information.
• The policy analyst can then use such information to describe the
current state of need and to forecast likely needs.

NKOLE J 26
• 2. Cost–Benefit Analysis - this is an approach that attempts to
relate the direct and indirect costs of policies to the direct and
indirect benefits of those policies.
• Cost–benefit analysis requires that both the costs and the
benefits of policies be calculated in monetary form. Example:
the cost of removing street vendors in streets and the cost of not
removing street vendors. If the benefits outweigh the costs then
the policy can be implemented.

NKOLE J 27
• 4. Outcome Studies - Outcome studies can document the
comparative effectiveness of different policy alternatives. It
involves comparing policies that have been used before to
address the similar problem at hand.
• Using conventional quasi-experimental and experimental
research designs, policy analysts are able to assess the extent to
which some policy intervention has had the intended impact on
the problem it was designed.

NKOLE J 28
• 5. Case Studies - Case studies involve the systematic and
detailed description and analysis of the formation,
implementation, and evaluation of specific policies. Examples
include analysis of the impact of the Zambian health policy on
access to health.
• 6. Meta-analysis is the statistical procedure for combining data
from multiple studies. It is a statistical method used to provide
a systematic, unbiased way to analyze the results from multiple
studies on the same topic
NKOLE J 29
• When the result is consistent from one study to the next meta
analysis can be used to identify this common effect.
• Meta-analysis can provide guidance to policymakers in the
early phases of policy development by summarizing existing
quantitative studies and can assist them after a series of policy
outcome studies have been conducted.

NKOLE J 30
THE END

NKOLE J 31