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Author Sheikh, Kabir ♦ Porter, John
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Philosophy & psychology ♦ Psychology ♦ Social sciences ♦ Sociology & anthropology ♦ Economics ♦ Microeconomics & related topics ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Incidence & prevention of disease ♦ Diseases ♦ Management & auxiliary services ♦ General management
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Virus Diseases ♦ Diseases ♦ Behavior and Behavior Mechanisms ♦ Psychological Phenomena and Processes ♦ Psychiatry and Psychology ♦ Natural Science Disciplines ♦ Physical Sciences ♦ Social Sciences ♦ Anthropology, Education, Sociology and Social Phenomena ♦ Health Care Economics and Organizations ♦ Health Services Administration ♦ Health Care ♦ Geographic Locations ♦ Geographic Locations
Subject Keyword Discipline Medicine ♦ Hiv Infections ♦ Diagnosis ♦ Health Policy ♦ Practice Guidelines As Topic ♦ Standards ♦ Decision Making ♦ Empirical Research ♦ Humans ♦ India ♦ Interprofessional Relations ♦ Policy Making ♦ Professional Role ♦ Journal Article ♦ Research Support, Non-u.s. Gov't
Abstract The implementation of standardized policy guidelines for care of diseases of public health importance has emerged as a subject of concern in low and middle-income countries (LMIC) globally. We conducted an empirical research study using the interpretive policy analysis approach to diagnose reasons for gaps in the implementation of national guidelines for HIV testing in Indian hospitals. Forty-six in-depth interviews were conducted with actors involved in policy implementation processes in five states of India, including practitioners, health administrators, policy-planners and donors. We found that actors' divergences from their putative roles in implementation were underpinned by their inhabitation of discrete 'systems of meaning' - frameworks for perceiving policy problems, acting and making decisions. Key gaps in policy implementation included conflicts between different actors' ideals of performance of core tasks and conformance with policy, and problems in communicating policy ideas across systems of meaning. These 'discursive' gaps were compounded by the lack of avenues for intellectual intercourse and by unaccounted interrelationships of power between implementing actors. Our findings demonstrate the importance of thinking beyond short-sighted ideals of aligning frontline practices with global policymakers' intentions. Recognising the deliberative nature of implementation, and strengthening discourse and communications between involved actors may be critical to the success of public health policies in Indian and comparable LMIC settings. Effective policy implementation in the long term also necessitates enhancing practitioners' contributions to the policy process, and equipping country public health functionaries to actualize their policy leadership roles.
Spatial Coverage India
Description Country affiliation: India
Author Affiliation: Sheikh K ( Public Health Foundation of India, Gurgaon, India. kabirsheikh@yahoo.co.uk)
ISSN 02779536
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2010-12-01
Publisher Place Great Britain (UK)
e-ISSN 18735347
Journal Social Science & Medicine
Volume Number 71
Issue Number 11


Source: WHO-Global Index Medicus