Analysis of the policymaking process in Burkina Faso's health sector: Case studies of the creation of two health system support units

Andre Zida, John N. Lavis, Nelson K. Sewankambo, Bocar Kouyate, Kaelan Moat, Jessica Shearer

Research output: Contribution to journalArticle

Abstract

Background: Burkina Faso has made a number of health system policy decisions to improve performance on health indicators and strengthen responsiveness to health-related challenges. These included the creation of a General Directorate of Health Information and Statistics (DGISS) and a technical unit to coordinate performance-based financing (CT-FBR). We analysed the policymaking processes associated with the establishment of these units, and documented the factors that influenced this process. Method: We used a multiple-case study design based on Kingdon's agenda-setting model to investigate the DGISS and CT-FBR policymaking processes. Data were collected from interviews with key informants (n = 28), published literature, policy documents (including two strategic and 230 action plans), and 55 legal/regulatory texts. Interviews were analysed using thematic qualitative analysis. Data from the documentary analysis were triangulated with the qualitative interview data. Results: Key factors influencing the policymaking processes associated with the two units involved the 'problem' (problem identification), 'policy' (formation of policy proposals), and 'politics' (political climate/change) streams, which came together in a way that resulted in proposals being placed on the decision agenda. A number of problems with Burkina Faso's health information and financing systems were identified. Policy proposals for the DGISS and CT-FBR units were developed in response to these problems, emerging from several sources including development partners. Changes in political and public service administrations (specifically the 2008 appointment of a new Minister of Health and the establishment of a new budget allocation system), with corresponding changes in the actors and interests involved, appeared key in elevating the proposals to the decision agenda. Conclusions: Efforts to improve performance on health indicators and strengthen responsiveness to health-related challenges need focus on the need for a compelling problem, a viable policy, and conducive politics in order to make it to the decision agenda.

Original languageEnglish (US)
Article number10
JournalHealth Research Policy and Systems
Volume15
Issue number1
DOIs
StatePublished - Feb 13 2017

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Burkina Faso
Health
Interviews
Healthcare Financing
Health Information Systems
Climate Change
Budgets
Politics
Health Policy
Appointments and Schedules

Keywords

  • Agenda setting
  • Burkina Faso
  • Health policy
  • Health system financing
  • Policymaking

ASJC Scopus subject areas

  • Health Policy

Cite this

Analysis of the policymaking process in Burkina Faso's health sector : Case studies of the creation of two health system support units. / Zida, Andre; Lavis, John N.; Sewankambo, Nelson K.; Kouyate, Bocar; Moat, Kaelan; Shearer, Jessica.

In: Health Research Policy and Systems, Vol. 15, No. 1, 10, 13.02.2017.

Research output: Contribution to journalArticle

Zida, Andre ; Lavis, John N. ; Sewankambo, Nelson K. ; Kouyate, Bocar ; Moat, Kaelan ; Shearer, Jessica. / Analysis of the policymaking process in Burkina Faso's health sector : Case studies of the creation of two health system support units. In: Health Research Policy and Systems. 2017 ; Vol. 15, No. 1.
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