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Health Research Policy and Systems
Published in: Health Research Policy and Systems 1/2017

Open Access 01-12-2017 | Research

Analysis of the policymaking process in Burkina Faso’s health sector: case studies of the creation of two health system support units

Authors: Andre Zida, John N. Lavis, Nelson K. Sewankambo, Bocar Kouyate, Kaelan Moat, Jessica Shearer

Published in: Health Research Policy and Systems | Issue 1/2017

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Abstract

Background

Burkina Faso has made a number of health system policy decisions to improve performance on health indicators and strengthen responsiveness to health-related challenges. These included the creation of a General Directorate of Health Information and Statistics (DGISS) and a technical unit to coordinate performance-based financing (CT-FBR). We analysed the policymaking processes associated with the establishment of these units, and documented the factors that influenced this process.

Method

We used a multiple-case study design based on Kingdon’s agenda-setting model to investigate the DGISS and CT-FBR policymaking processes. Data were collected from interviews with key informants (n = 28), published literature, policy documents (including two strategic and 230 action plans), and 55 legal/regulatory texts. Interviews were analysed using thematic qualitative analysis. Data from the documentary analysis were triangulated with the qualitative interview data.

Results

Key factors influencing the policymaking processes associated with the two units involved the ‘problem’ (problem identification), ‘policy’ (formation of policy proposals), and ‘politics’ (political climate/change) streams, which came together in a way that resulted in proposals being placed on the decision agenda. A number of problems with Burkina Faso’s health information and financing systems were identified. Policy proposals for the DGISS and CT-FBR units were developed in response to these problems, emerging from several sources including development partners. Changes in political and public service administrations (specifically the 2008 appointment of a new Minister of Health and the establishment of a new budget allocation system), with corresponding changes in the actors and interests involved, appeared key in elevating the proposals to the decision agenda.

Conclusions

Efforts to improve performance on health indicators and strengthen responsiveness to health-related challenges need focus on the need for a compelling problem, a viable policy, and conducive politics in order to make it to the decision agenda.
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Metadata
Title
Analysis of the policymaking process in Burkina Faso’s health sector: case studies of the creation of two health system support units
Authors
Andre Zida
John N. Lavis
Nelson K. Sewankambo
Bocar Kouyate
Kaelan Moat
Jessica Shearer
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Health Research Policy and Systems / Issue 1/2017
Electronic ISSN: 1478-4505
DOI
https://doi.org/10.1186/s12961-017-0173-0

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