Application of “Actor Interface Analysis” to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps
BackgroundThe difference between ‘policy as promised’ and ‘policy as practiced’ can be attributed to implementation gaps. Actor relationships and power struggles are central to these gaps but have been studied using only a handful of theoretical and analytical frameworks. Actor interface analysis pr...
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| Format: | Article |
| Language: | English |
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Kerman University of Medical Sciences
2021-07-01
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| Series: | International Journal of Health Policy and Management |
| Subjects: | |
| Online Access: | https://www.ijhpm.com/article_3924_890efb586f07db353f9b1aec71b33454.pdf |
| _version_ | 1811158780308619264 |
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| author | Rakesh Parashar Nilesh Gawde Lucy Gilson |
| author_facet | Rakesh Parashar Nilesh Gawde Lucy Gilson |
| author_sort | Rakesh Parashar |
| collection | DOAJ |
| description | BackgroundThe difference between ‘policy as promised’ and ‘policy as practiced’ can be attributed to implementation gaps. Actor relationships and power struggles are central to these gaps but have been studied using only a handful of theoretical and analytical frameworks. Actor interface analysis provides a methodological entry point to examine policy implementation and practices of power. As this approach has rarely been used in health policy analysis, this article aims, first, to synthesise knowledge about use of actor interface analysis in health policy implementation and, second, to provide guiding steps to conduct actor interface analysis. MethodsWe conducted an interpretive synthesis of literature using a set of 6 papers, selected using purposeful searches and focusing on actor dynamics and practices of power in policy experiences. Drawing upon the framework synthesis approach and using a guiding framework, the synthesis focused on 4 questions – the type of actor interfaces formed, the power practices observed, the effect of such power practices on implementation and the underpinning factors for the power practices. ResultsMultiple interface encounters and power practices were identified which included domination, control, contestation, collaborations, resistance, and negotiations. The lifeworlds of actors that underpinned the power practices, were rooted in social-organisational power relationships, personal experiences and interests, and social-ideological standpoints like values and beliefs of actors. The power practices influenced implementation both positively and negatively. ConclusionBased on the learnings from synthesis, this paper provides guiding steps for conducting actor interface analysis. Additionally, it presents 2 useful tools for power analysis: (1) ‘actor lifeworlds,’ to understand underpinning factors for power practices and (2) relationships of lifeworlds, interface encounters and power practices with their effect on policy implementation. We suggest that interface analysis should be applied in more empirical settings and across varied health policy experiences to nuance the method better. |
| first_indexed | 2024-04-10T05:30:04Z |
| format | Article |
| id | doaj.art-4659aa9121c7425e9bf1119da013cf19 |
| institution | Directory Open Access Journal |
| issn | 2322-5939 |
| language | English |
| last_indexed | 2024-04-10T05:30:04Z |
| publishDate | 2021-07-01 |
| publisher | Kerman University of Medical Sciences |
| record_format | Article |
| series | International Journal of Health Policy and Management |
| spelling | doaj.art-4659aa9121c7425e9bf1119da013cf192023-03-07T09:08:18ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392021-07-0110Special Issue on Analysing the Politics of Health Policy Change in LMICs43044210.34172/ijhpm.2020.1913924Application of “Actor Interface Analysis” to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding StepsRakesh Parashar0Nilesh Gawde1Lucy Gilson2School of Health System Studies, Tata Institute of Social Sciences, Mumbai, IndiaSchool of Health System Studies, Tata Institute of Social Sciences, Mumbai, IndiaSchool of Public Health and Family Medicine, University of Cape Town, Cape Town, South AfricaBackgroundThe difference between ‘policy as promised’ and ‘policy as practiced’ can be attributed to implementation gaps. Actor relationships and power struggles are central to these gaps but have been studied using only a handful of theoretical and analytical frameworks. Actor interface analysis provides a methodological entry point to examine policy implementation and practices of power. As this approach has rarely been used in health policy analysis, this article aims, first, to synthesise knowledge about use of actor interface analysis in health policy implementation and, second, to provide guiding steps to conduct actor interface analysis. MethodsWe conducted an interpretive synthesis of literature using a set of 6 papers, selected using purposeful searches and focusing on actor dynamics and practices of power in policy experiences. Drawing upon the framework synthesis approach and using a guiding framework, the synthesis focused on 4 questions – the type of actor interfaces formed, the power practices observed, the effect of such power practices on implementation and the underpinning factors for the power practices. ResultsMultiple interface encounters and power practices were identified which included domination, control, contestation, collaborations, resistance, and negotiations. The lifeworlds of actors that underpinned the power practices, were rooted in social-organisational power relationships, personal experiences and interests, and social-ideological standpoints like values and beliefs of actors. The power practices influenced implementation both positively and negatively. ConclusionBased on the learnings from synthesis, this paper provides guiding steps for conducting actor interface analysis. Additionally, it presents 2 useful tools for power analysis: (1) ‘actor lifeworlds,’ to understand underpinning factors for power practices and (2) relationships of lifeworlds, interface encounters and power practices with their effect on policy implementation. We suggest that interface analysis should be applied in more empirical settings and across varied health policy experiences to nuance the method better.https://www.ijhpm.com/article_3924_890efb586f07db353f9b1aec71b33454.pdfactor interface analysishealth policy processqualitative synthesislmic health policypower systematic reviewhealth systems research |
| spellingShingle | Rakesh Parashar Nilesh Gawde Lucy Gilson Application of “Actor Interface Analysis” to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps International Journal of Health Policy and Management actor interface analysis health policy process qualitative synthesis lmic health policy power systematic review health systems research |
| title | Application of “Actor Interface Analysis” to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps |
| title_full | Application of “Actor Interface Analysis” to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps |
| title_fullStr | Application of “Actor Interface Analysis” to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps |
| title_full_unstemmed | Application of “Actor Interface Analysis” to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps |
| title_short | Application of “Actor Interface Analysis” to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps |
| title_sort | application of actor interface analysis to examine practices of power in health policy implementation an interpretive synthesis and guiding steps |
| topic | actor interface analysis health policy process qualitative synthesis lmic health policy power systematic review health systems research |
| url | https://www.ijhpm.com/article_3924_890efb586f07db353f9b1aec71b33454.pdf |
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