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Integrated care presents health workforce planners with significant uncertainty. This results from: (1) these workforces are likely in the future to be different from the present, (2) integrated care's variable definitions and (3) workforce policy and planning is not familiar with addressing such challenges. One means to deal with uncertainty is scenario analysis. In this study we reveal some integration-supportive workforce governance and planning policies that were derived from the application of scenario analysis.

Through a mixed methods design that applies content analysis, scenario construction and the policy Delphi method, we analysed a set of New Zealand's older persons health sector workforce scenarios. Developed from data gathered from workforce documents and studies, the scenarios were evaluated by a suitably qualified panel, and derived policy statements were assessed for desirability and feasibility.

One scenario was found to be most favourable, based on its broad focus, inclusion of prevention and references to patient dignity, although funding changes were indicated as necessary for its realisation. The integration-supportive policies are based on promoting network-based care models, patient-centric funding that promotes collaboration and the enhancement of interprofessional education and educator involvement.

Scenario analysis for policy production is rare in health workforce planning. We show how it is possible to identify policies to address an integrated care workforce's development using this method. The article provides value for planners and decision-makers by identifying the pros and cons of future situations and offers guidance on how to reduce uncertainty through policy rehearsal and reflection.

Many of the challenges experienced by the New Town remain the same 50 years on: funding major infrastructure, land acquisition and planning still requires national political and policy support. In the scramble to deliver the thousands of new homes needed, the British government is revisiting policy levers and programmes of the past. Ebbsfleet, a large new settlement in Kent, two decades into realisation, shows how subsequent government visions overlay the historic New Town principles, the characteristics underpinning Garden Cities or the newly emerging Healthy New Towns (HNT). Rediscovering New Town design principles has prompted a reinvention of the historic planning mechanisms that delivered them. The influence of policy actors is contrasted to Ebbsfleet Development Corporation’s emergent role as the practical delivery agency. Comparing criteria for recent government new settlement programmes reveals the Housing Ministry’s rapid shift from promoting sustainable development to facilitating private-sector investment in exchange for guaranteed housing delivery. A similar dilution is seen in the HNT Network, where the New Towns’ provision of health-giving environments for populations escaping from city slums has been supplanted by a broader (more diffuse) facilitation of healthy wellbeing. In a fluid policy context, Ebbsfleet’s adoption of these principles could cynically be read as market-led place rebranding not reinvention. Will the historic lessons of the early New Towns have been learnt so that the new wave of Garden Cities or Healthy New Towns fare better?

In recent years, effective leadership initiatives have been emphasized in the healthcare industry all over the world. This paper aims to examine contemporary healthcare development in the Kingdom of Saudi Arabia (KSA) and prescribe four essential policy dimensions to its leadership, depicting the imperative needs for direction, integration, revision, and evidence – the “DIRE needs” approach.

The paper reviews literature on the contemporary KSA health system and provides guidelines for policy reforms vis‐à‐vis the emerging challenges.

First, the paper offers a conceptual model to examine the ongoing and future health policy development of the KSA. It identifies four key policy dimensions – direction, integration, revision, and evidence and links these to the scope of broader health sector reforms. Second, it characterizes these dimensions as key initiatives for health resource capacity and infrastructural development, essentially the primary health care, which need to be taken up by KSA mainstream health services leadership. Third, it underlines the importance of integrating institutional research and information systems for evidence‐based policy‐making and practicable implementation. Fourth, it offers a social science research perspective to the need for multi‐dimensional health policy reforms in the KSA.

This paper opens up KSA health leadership initiatives that may be viewed as the DIRE needs, to be mainstreamed in the domains of policy and strategic planning, research and development, and healthcare management practices.

Social research in KSA health policy and planning is rare. This paper introduces a context‐specific multi‐dimensional model that provides critical insights into challenges and complexities that the Saudi health leadership must attend to. It defines a set of four essential benchmarking dimensions for guiding future policy reforms.

The purpose of this paper is to describe and discuss policy analysis in Nepal and review the wide range of choices feasible in decentralisation decision making.

In this paper an iterative qualitative method was developed and used in the research, which consisted of focus group interviews, key informant interviews, document analysis, including descriptive statistics, and analysis of the policy context. Participants in the research reflected the urban/rural mix of districts and the geography of Nepal. Analysis combined transcribed interviews with findings from document searches and analysis of the policy context. Coding was pre‐determined during the training workshop and further codes were generated during and after the fieldwork.

The paper finds that Nepal is in the process of decentralising public services from the central level to the local level, particularly to local bodies: District Development Committees (DDCs), Village Development Committees (VDCs) and Municipalities. Key contextual factors referred to are the overall structure of decentralisation, the social context of poverty and the political instability leading to a fluid political situation characterised by political tension, armed conflict, controversies and agreements while carrying out the research. The key issues identified and discussed in the paper are the policy process leading to decentralisation, the organisational structure and tension in the proposed system, the systems of resource generation, allocation, planning and management and lastly the forms of accountability, participation, public‐private relations and collaborative strategies.

The paper discusses the challenges faced in conducting such a policy analysis, the broad ranging and unremitting nature of the decentralisation process, and the contextual setting of the process of change.

The NHS has been the object of much international interest from its inception and through its periodic reforms. However, UK policy‐makers have expressed only limited and selective concern for health sector reforms in other countries. This paper seeks to identify key elements of the present process and content of reforms to the UK NHS and examine the extent to which international learning would be important in developing these reforms. Particular emphasis is placed on learning from developing country experience. The paper therefore considers the policy process in the UK, the focus on primary care, the shift from competitive to collaborative strategies in addition to prioritising and planning. Each is considered in relation to developing country experience and the opportunities for learning. The paper concludes by setting out four areas leading to an international opening in NHS policy processes: developing political space in policy making, developing mechanisms for international exchanges, understanding policy context, and broadening international experience and changing values. The notion of a one‐way process in international policy learning is rejected: while the South can learn from the North, so too can the North from the South.

There is limited research examining community-based youth empowerment that addresses smoking prevention in the rural Indonesian context. This paper describes participatory action research (PAR) applied to develop a framework for empowering youth aged 17–25 years toward smoking prevention. This research conducted in the Indonesian rural community setting was divided into four stages: diagnosing, planning action, taking action and evaluating action.

PAR was chosen as the approach to developing a framework for youth empowerment in smoking prevention programs. In this study, the PAR cycle started with a prestep stage through interviews with village heads, community leaders, youth organization organizers, observations of target resources and observations of participation in youth activities as well as forming teamwork with target participants. The diagnosis stage consists of three activities, that is, focus group discussions with youth groups of male and female, youth assessment of empowerment domains through the Participatory Rural Appraisal (PRA) with the Empowerment Assessment Rating Scale (EARS) and measuring individual and group involvement levels related to the smoking behavior prevention program by questionnaire. The EARS assessment results were presented in the action planning stage, followed by a discussion on youth empowerment plans and strategies. In the action stage, activities and programs are planned according to the planning discussion, that is: training in healthy life skills (outbound and training) and initiating youth health programs without smoking called “Remaja Berdaya Sehat Tanpa Rokok” (Empowered Youth Healthy Without Smoking) or the JayaStar Program. After these community participation activities, the evaluating action stage will assess the empowerment domain in the youth groups, conduct focus group discussions with parents, evaluate the impact of empowerment on individual and group changes with a questionnaire and facilitate self-reflection by the youth community called Madiska.

This protocol describes a doctoral research project on developing a youth empowerment framework in smoking prevention programs through PAR. The intended study will provide valuable information on the planning, implementation and evaluation of youth empowerment in the prevention of smoking behavior.

This research project is expected to contribute to the literature relating to PAR for rural settings and the use of empowerment strategies to prevent youth smoking behavior. The results can be replicated in the same settings, but the process of empowerment must still be adapted to the characteristics and local wisdom of the community.

With the advent of the Darzi review in 2008, and more recently the White Paper “Equity and Excellence: Liberating the NHS” (2010), the NHS in England is being redesigned to provide high quality, person‐centred services with improved capacity and performance. In this change oriented scenario, stakeholder consultation has a critical role to play given the widespread advocacy in government policy and healthcare literature. In order to support informed decision making, the purpose of this paper is to: explore healthcare infrastructure planning through various approaches to stakeholder consultation within English Primary Care Trusts (PCTs); and develop a conceptual approach to strategic asset management (SAM) based on the findings of stakeholder consultation and engagement exercises.

A multi‐method triangulation approach including action research has been adopted to evaluate current stakeholder consultation practices with a local PCT and to explore their approach to healthcare infrastructure planning through: a literature review of stakeholder engagement and theory; evaluation of a local consultation exercise; and a web based document review of consultation practices within 149 English PCTs.

PCT estate managers and healthcare planners have to operate within constantly changing dynamic healthcare environments and need to reduce uncertainty and indecision that often surrounds the debate of reconfiguration of healthcare facilities and services. Consultations by the PCTs vary in: the level of detail provided to the public; sample sizes; detail and transparency of the consultation; distribution and analyses of the consultation; and techniques and approaches.

The findings of this study can be used by healthcare policy makers to: inform how clinical commissioning groups (CCGs) could be better involved during patient and public engagement; and determine practical ways of putting patients at the heart of General Practitioners (GP) commissioning.

The research identifies gaps within current stakeholder consultation practices in English PCTs and develops a conceptual approach to SAM that accounts for stakeholder consultation; decision making levels within healthcare infrastructure planning within a wider competency based organisational view, which currently does not exist.

The aim of this paper is to examine how internal communication of reform objectives to health workforces and stakeholders has influenced the implementation of Ghana's health sector decentralisation at district level.

Data collection involved in‐depth interviews with district public health officials, private health providers, local government officials and health‐related non‐government organisations which had been working in the district for at least two years.

The study's findings showed that communication (the sharing of information) about reform objectives were centralised among the top hierarchy of the District Health Management Teams; and the process of transferring reform information to district health workforces and stakeholders was through a top‐downward approach. This vertical style of communication resulted in limited information getting through to district health workforces tasked with the implementation. This impacted negatively on reform implementation.

The paper reveals that there is a connection between the level of comprehension of the objectives for decentralisation reform both by the health workforce and stakeholders, particularly the expected new roles they are supposed to play. A lack of effective transfer of information affects commitment and ownership of the decentralisation reform at district level; contributing significantly to the poor implementation of the reform programme.