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An alternative approach to evaluating, measuring, and comparing domestic and international health institutions: Insights from social science theories

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  • Gómez, Eduardo J.

Abstract

Objectives This article introduces the benefits of applying social science theories discussing institutional stasis and change to better measure, explain, and compare elite behavior within health administration and decentralization processes. A new comparative method based on these theories is introduced, as well as methods for collecting and analyzing data.Methods A literature review of health governance, health system governance, and path dependency and institutional change theory was conducted to reveal the limitations of health governance approaches explaining elite behavior. Next, path dependency and institutional change theory was applied to case studies in order to demonstrate their utility in explaining institutional stasis and change.Results Current approaches to analyzing and comparing elite behavior in the health governance frameworks are limited in their ability to accurately explain the willingness of elites to pursue more efficient institutional and policy designs. Current indicators measuring elite behavior are also too static, failing to account for periodic resistance to change and the conditions for it.Conclusions By applying path dependency and institutional change theory, the policy community can obtain greater insight into the willingness and thus capacity of institutions to pursue innovations while developing alternative analytic frameworks and databases that better measure and predict this process.

Suggested Citation

  • Gómez, Eduardo J., 2011. "An alternative approach to evaluating, measuring, and comparing domestic and international health institutions: Insights from social science theories," Health Policy, Elsevier, vol. 101(3), pages 209-219, August.
  • Handle: RePEc:eee:hepoli:v:101:y:2011:i:3:p:209-219
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    References listed on IDEAS

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    1. Ragin, Charles C., 2000. "Fuzzy-Set Social Science," University of Chicago Press Economics Books, University of Chicago Press, edition 1, number 9780226702773, January.
    2. Robert H. Bates & Avner Greif & Margaret Levi & Jean-Laurent, 1998. "Analytic Narratives," Economics Books, Princeton University Press, edition 1, volume 1, number 6355.
    3. repec:ucp:bkecon:9780226702766 is not listed on IDEAS
    4. Schneider, Helen & Stein, Joanne, 2001. "Implementing AIDS policy in post-apartheid South Africa," Social Science & Medicine, Elsevier, vol. 52(5), pages 723-731, March.
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