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This chapter investigates the origins of cross-sectoral collaboration by exploring when and why policy networks form within the Turkish health sector – a least likely case for network formation. The analysis presented here draws on information collected from a number of official documents, semi-structured interviews with professional experts, and two multi-stakeholder meetings. Timewise, networks entered the policy jargon during the introduction of the Health Transformation Program in 2003. Yet, the years between 2011 and 2015 were ground-breaking in producing concrete cross-sectoral collaborative instruments of policy making. The findings of the analysis reveal that policy networks form as a result of central government’s choice to devolve responsibility and expand the policy space with new issues and actors. Moreover, policy networks emerge not only during the times of policy change which has a reactionary, abrupt, and nature but also during the times of policy stability and legitimacy. These contextual factors are crucial in maintaining an atmosphere of trust among stakeholders, particularly between state and non-state actors. The refugee crisis and spreading securitization discourse in the post-2015 period explain the shifting policy and political agenda leading to public sector retrenchment from cross-sectoral projects within the field of health. This chapter intends to contribute to the literature of comparative public policy by examining the link between policy networks and policy change in addition to adding to the debates on network governance by exploring the processes of network formation. Finally, this chapter contributes to Turkish studies by examining the process of network formation within the Turkish health sector.

Efforts of governments to adjust the responsiveness and efficiency of their health care systems are evident across the globe. In the seemingly constant search for solutions providing both better health outcomes and manageable costs, the directions and designs for change are neither consistent nor well studied. Opportunities for shared learning concerning what strategies for transforming health care systems lead to effective and sustainable change are being missed. There is an urgent need to study and understand the processes of change initiated by health policy shifts aimed at controlling health care costs, altering health service delivery and influencing outcomes of health care. In partial response to this need, research was initiated to study health policy transition within the Western Canadian province of Alberta. The primary objective of this research was: to identify, describe, compare and contrast the processes of change adopted and implemented in a variety of health authorities as a result of health policy shift. Change processes initiated by a specific health policy shift (the restructuring of Alberta’s health care system) were explored from the perspective of the change agents (individuals managing the health system reforms) in order to discover indicators of effective change and to identify questions for further consideration and testing in relation to change process related to health policy shift. This qualitative exploratory study coincided with real time alteration to the health system via legislated health policy shift. Findings relate changes in the structure, process and outcome of the health policy transition. Additionally, a number of questions linked to the reported findings are highlighted to encourage additional and continuing efforts to improve understanding of change process related to health policy shift.

Retention of medical doctors and nurses in remote and rural areas is a key issue in India. The purpose of this paper is to assess the relevant policies and provisions with respect to health care professionals, aiming to develop feasible retention strategies in rural areas of Odisha state of India.

The study employed documentary review and key informant interviews with policy elites (health planners, policy maker, researchers, etc.). The document review included published and unpublished reports, policy notifications and articles on human resources for health (HRH) in Odisha and similar settings. Throughout the study, the authors adapted World Health Organization’s framework to study policies relevant to HRH retention in rural areas. The adapted framework comprised of the four policy domains, education, regulation, financial incentives, professional and personal support, and 16 recommendations.

In Odisha, the district quota system for admission is not practiced; however, students from special tribal and caste (Scheduled Tribe and Scheduled Caste) communities, Socially and Educationally Backward Classes of citizens, and Persons with Disabilities have some allocated quota to study medicine and nursing. Medical education has a provision of community placement in rural hospitals. In government jobs, the newly recruited medical doctors serve a minimum of three years in rural areas. Doctors are given with location-based incentives to work in remote and difficult areas. The government has career development, deployment, and promotion avenues for doctors and nurses; however, these provisions are not implemented effectively.

The government could address the rural retention problems, as illustrated in the study and put in place the most effective policies and provisions toward recruitment, deployment and attraction of HRH in remote and rural areas. At the same time, implementation HRH strategies and activities must be rigorously monitored and evaluated effectively.

The purpose of this paper is to explore how strategies are put in place to formulate policies regarding the introduction and implementation of relationship marketing (RM) in the health sector, and how RM strategies are designed as part of the curricula for the training of prospective health professionals in Ghana.

Data were gathered using interviews and documentary review. A purposive sampling technique was used to recruit policy makers and health educationists in Accra for in-depth interviews. Qualitative interviews were analysed using framework analysis.

The findings revealed that, currently, there is no policy framework on RM in the health sector nor included in the curricula of health training institutions in the country.

Due to limited time and funding constraints, the study could not include many policy makers, educationists, health providers, facilities and regions outside the Greater Accra region of Ghana. This means that the authors missed out on useful insights from other relevant policy makers/educationists who would have added to the knowledge that this study contributes. There were still some areas that this study could not cover, including the lack of an exploration of the perceptions of health providers and patients.

Evidence from the current research provides the basis for scaling up of a similar study to the whole country to address the perennial RM or quality of care/patient satisfaction issues persisting in health facilities in the country. The outcome of this large-scale study would help to confirm the findings of the current study on the adoption and incorporation of RM into both policy framework and curricula of health training institutions in Ghana. The findings would culminate in the preparation and utilisation of guidelines on RM for client-centred service delivery in the health sector of the country.

This paper argues that RM orientation could enable health professionals to improve upon their healthcare service performance and quality of care so as to enhance patient satisfaction.

The study recommends that RM should be adopted by health policy makers and designers of curricula for health training institutions.

The purpose of this paper is to explore health researchers’ involvement of policy or decision makers in knowledge translation activities in Malawi.

The case study collected quantitative through questionnaire from health researchers from the University of Malawi. The study used inferential statistics for the analysis of the quantitative data. Pearson χ² test was used to establish the relationship between categorical data and determine whether any observed difference between the data sets arose by chance. The Kruskal–Wallis H test was used to determine if there were statistically significant differences between independent variable and dependent variables. Data has been presented in a form of tables showing means, standard deviation and p-values.

Health researchers sometimes involve policy or decision makers in government-sponsored meetings (M=2.5, SD=1.17). They rarely involve policy or decision makers in expert committee or group meetings (M=2.4, SD=1.20). Researchers rarely involve policy or decision makers in conferences and workshops (M=2.4, SD=1.31). Rarely do researchers involve policy or decision makers in formal private or public networks (M=2.4, SD=1.17). In events organised by the colleges researchers rarely involve policy or decision makers (M=2.3, SD=1.11); and rarely share weblinks with policy or decision makers (M=2.0, SD=1,17). On average, health researchers occasionally conduct deliberate dialogues with key health policy makers and other stakeholders (M=2.5, SD=1.12). The researchers rarely established and maintained long-term partnerships policy or decision makers (M=2.2, SD=1.20). They rarely involve policy or decision makers in the overall direction of the health research conducted by themselves or the Colleges (M=2.1, SD=1.24).

The study recommends that there should be deliberate efforts by health researchers and policy makers to formally engage each other. Individuals need technical skills, knowledge of the processes and structures for engaging with health research evidence to inform policy and decision making. At the institutional level, the use of research evidence should be embedded within support research engagement structures and linked persons.

Formal interactions in a form of expert meetings and technical working groups between researchers and policy makers can facilitate the use of health research evidence in policy formulation.

In terms of framework there is need to put in place formal interaction frameworks between health researchers and policy makers within the knowledge translation and exchange.

There is dearth of literature on the levels of involvement and interaction between health researchers and health policy or decision makers in health policy, systems and services research in Malawi. This study seeks to bridge the gap with empirical evidence.

Although there has been a commitment to develop a policy framework to support vulnerable adults at risk of abuse, there remains concern around its lack of use within National Health Service inpatient settings and mental health services in particular. A gap between policy and practice appears to have developed, which leaves inpatients vulnerable to inadequate responses to allegations of adult abuse. This article will provide a critical overview of the policy and practice issues that affect the use of adult protection procedures.

This paper presents a thematic synthesis of mental health policies published in England from 1999 to 2020.

This paper aims to present a thematic synthesis of mental health policies published in England from 1999 to 2020. The authors specifically focus on ethnicity-related mental health issues highlighted in policies, policy recommendations and performance measurements of policy implementation.

Findings from this synthesis demonstrate that ethnic mental health inequalities remain comparable over the past two decades. Ongoing issues include a lack of data on the ethnicity of mental health services users. Where data is available, these highlight ethnic inequalities in access to, experiences of and outcomes of mental health services, as well as a lack of cultural capability in health-care professionals. Policy recommendations have also remained the same during this time and include: collecting data on the ethnicity of service users, raising awareness of the cultural needs of Black and Minority ethnic populations amongst health-care professionals, recruiting BME staff into mental health care services and improving community engagement. The synthesis identified poor indicators of performance measurement on policy implementation and weak monitoring regimes.

The synthesis identified poor indicators of performance measurement on policy implementation and weak monitoring regimes.

This paper presents a thematic synthesis of mental health policies published in England from 1999 to 2020.

This study aims to explain the emergence and development of the concept of “Policy Networks” as a unit of analysis in the realm of public policies and their role in formulating a comprehensive policy for health insurance. The developments that took place over the past few decades had impacted a shift in the state’s role in shaping public policies, from a sole, key actor to one among other actors, both governmental and non-governmental, working interdependently through a set of networks.

The present study adopts the social network analysis as an approach and the social policy network as a tool to analyze public policymaking. The approach suggests the presence of a number of actors and interest groups that are actively involved in public policy and decision-making. These groups may vary from a cause to another and also from time to time. This research investigates and juxtaposes a selected sample of members of the health insurance policy network in Egypt.

In light of the study findings, one can see the existence of a policy network for the comprehensive health insurance system in Egypt. The study reveals the interrelations among a number of official and non-official key actors. The network has gone through several phases; the pre-establishment phase during the early stages of policymaking; the official establishment phase during the formative stage; and finally, the network operation phase during the implementation stage. The study also concludes that the policy network has influenced the different stages of policymaking through several tools and strategies. Moreover, the roles of different actors varied within the network; international organizations were the primary influencer in the early stages of policymaking; syndicates dominated the formative stage; and the public sector played the leading role in the implementation stage.

Serious attempts were made to benefit from policy networks with a particular focus on using the strengths of each actor while establishing an official institutional framework that consolidates coordination and cooperation among the involved parties. This framework should keep pace with global changes and developments. It should also have an official meeting venue. Above all, all parties should be listened to and their demands should be considered seriously as long as they are not actualized at the expense of the public interest nor do they undermine the sovereignty of the state. The study also enhances researchers to use policy networking as a unit for analyzing public policy and their effect on these policies.

Public policymaking in Egypt can become more responsive to people’s demands and more democratic once it was made through informative and interactive policy network. This pattern of policymaking will enhance both efficient and responsive.

Practical Implications: public policy making in Egypt can become more responsive to people demands and more democratic once it was made through informative and interactive policy network. This pattern of policymaking will enhance both efficient and responsive.

In addition to its practical contributions to the field of policymaking, this research fills a gap in the literature on the theoretical level.

The purpose of this paper is to undertake an examination of the Local Health Integration Network (LHIN) Health Policy proposal. This policy established a decentralized approach to health system management in the province of Ontario, Canada by creating 14 crown agencies, LHINs.

This policy is examined against the five policy stages of the Stages Model: agenda setting, formulation, legitimation, implementation and evaluation. The examination was based on a review of grey literature, including key government reports and briefs.

This policy did not follow the Stages Model sequentially: the policy was implemented while it was still undergoing its legitimacy phase. Formal reviews were undertaken following implementation and found areas for improvement: poor integration amongst all the LHINs; poor patient navigation persists; LHINs lack the capacity and competency to engage in regional capacity planning; and planning and integration is not centered around patient needs. As a result, a decade after the introduction of LHINs, the Ontario HealthCare System has not achieved systems improvement when measured against accepted government indicators of performance.

This integration policy highlights the context and evolution of Ontario’s healthcare system governance in the past decade and contributes to the body of knowledge on the impact of regionalization on health systems and patient care.

The purpose of this paper is to provide an exploratory account of the links between devolution, homelessness and health in the UK. Specifically, it focusses on the policy context and governance structures that shape the systems of healthcare for homeless people in London, Scotland, Wales and Northern Ireland.

Empirically the paper draws on semi-structured interviews with a small sample of policy and practice actors from the devolved territories. Qualitative interviews were supplemented by a comparative policy analysis of the homelessness and health agenda within the devolved regions. Theoretically, it takes inspiration from Chaney’s concept of the “issue salience of homelessness” and explores the comparative character of healthcare as pertains to homeless people across the devolved territories.

The paper provides clear evidence of areas of divergence and convergence in policy and practice between the devolved regions. These features are shown to be strongly mediated by the interplay of two factors: first, the scope and scale of national and local homelessness prevention strategies; and second, intra-national variation in public health responses to homelessness.

The paper offers considerable insight from a comparative policy perspective into the nature of healthcare provision for homeless people in the devolved regions.