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Health reforms and policy capacity: the Canadian experience

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  • Jean-Louis Denis
  • Susan Usher
  • Johanne Préval

Abstract

Recent work on health system strengthening suggests that a combination of leadership and policy capacity is essential to achieve transformation and improvement. Policy capacity and leadership are mutually constitutive but difficult to assemble in a coherent and consistent way. Our paper relies on the nested model of policy capacity to empirically explore how health reformers in seven Canadian provinces address the question of policy capacity. More specifically, we look at emerging representations of policy capacity within the context of health reforms between 1990 and 2020. Based on the exploration of the scientific and grey literature (legislation, annual reports of Ministries, agencies and organizations, meeting minutes, press, etc.) and interviews with key informants (n = 54), we identify how policy capacity is considered and framed within health reforms A series of core dilemmas emerge from attempts by each province to develop policy capacity for and through health reforms.

Suggested Citation

  • Jean-Louis Denis & Susan Usher & Johanne Préval, 2023. "Health reforms and policy capacity: the Canadian experience," Policy and Society, Darryl S. Jarvis and M. Ramesh, vol. 42(1), pages 64-89.
    • Handle: RePEc:oup:polsoc:v:42:y:2023:i:1:p:64-89.
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    File URL: http://hdl.handle.net/10.1093/polsoc/puac010
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    References listed on IDEAS

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    1. Jean Louis Denis & Nancy Côté & Charles Fleury & Graeme Currie & Dimitrios Spyridonidis, 2021. "Global health and innovation: A panoramic view on health human resources in the COVID‐19 pandemic context," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(S1), pages 58-70, May.
    2. Jones, Lorelei & Exworthy, Mark, 2015. "Framing in policy processes: A case study from hospital planning in the National Health Service in England," Social Science & Medicine, Elsevier, vol. 124(C), pages 196-204.
    3. Blanchet, Nathan J. & Fox, Ashley M., 2013. "Prospective political analysis for policy design: Enhancing the political viability of single-payer health reform in Vermont," Health Policy, Elsevier, vol. 111(1), pages 78-85.
    4. Merli Tamtik, 2016. "Institutional Change Through Policy Learning: The Case of the European Commission and Research Policy," Review of Policy Research, Policy Studies Organization, vol. 33(1), pages 5-21, January.
    5. Bossert, Thomas John & Mitchell, Andrew David, 2011. "Health sector decentralization and local decision-making: Decision space, institutional capacities and accountability in Pakistan," Social Science & Medicine, Elsevier, vol. 72(1), pages 39-48, January.
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    Cited by:

    1. Azad Singh Bali & M Ramesh, 2023. "Knowledge–practice gap in healthcare payments: the role of policy capacity," Policy and Society, Darryl S. Jarvis and M. Ramesh, vol. 42(3), pages 406-418.

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