Multi-sectoral approach to noncommunicable disease prevention policy in sub-Saharan Africa : a conceptual framework for analysis

Abstract

Conceptual frameworks for health policy analysis guide investigations into interactions between institutions, interests, and ideas to identify how to improve policy decisions and outcomes. This review assessed constructs from current frameworks and theories of health policy analysis to (1) develop a preliminary synthesis of findings from selected frameworks and theories; (2) analyze relationships between elements of those frameworks and theories to construct an overarching framework for health policy analysis; and then, (3) apply that overarching framework to analyze tobacco control policies in Togo and in South Africa. This Comprehensive Framework for Multi-Sectoral Approach to Health Policy Analysis has 4 main constructs: context, content, stakeholders, and strategies. When applied to analyze tobacco control policy processes in Togo and in South Africa, it identified a shared goal in both countries to have a policy content that is compliant with the provisions of international tobacco treaties and differences in strategic interactions between institutions (e.g., tobacco industry, government structures) and in the political context of tobacco control policy process. These findings highlight the need for context-specific political mapping identifying the interests of all stakeholders and strategies for interaction between health and other sectors when planning policy formulation or implementation.