Policy toolkit for strengthening health sector reform

Many Latin American countries have begun to reform their health sectors. In these countries, a lot of debate, analysis, and assistance has been directed toward the technical content of the reforms. Often, the government determines the direction and outline of health sector reforms. Once there is concurrence on the general direction of reform, responsibility is transferred from the politicians to health sector reform teams or other groups of technical experts within the government, usually in the ministry of health. Although these technical experts are often skilled analysts, they may lack the skills and experience needed to negotiate the complex political process that is at the core of health sector reform. In fact, until recently, few have paid much attention to the political feasibility of reforms. Now, a growing number of observers and participants have begun to acknowledge and become interested in the political process that underlies health sector reform. Despite this increasing recognition of the role of politics, however, health sector technical experts may not recognize that policy reform is a process that can be managed or consider managing that process to be part of their job. Furthermore, they may not understand how to manage the political environment and influence the policy process in order to increase the feasibility and success of proposed reforms. This toolkit was designed specifically to help health sector reform teams better understand the nature of the political process and develop skills to actively manage that process. The remainder of this introductory section presents a conceptual framework for understanding the various stages of the policy process as well as for using the guidelines and tools included in this toolkit.