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Application of "Actor Interface Analysis" to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps

Background: The difference between ‘policy as promised’ and ‘policy as practiced’ can be attributed to implementation gaps. Actor relationships and power struggles are central to these gaps but have been studied using only a handful of theoretical and analytical frameworks. Actor interface analysis...

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Autores principales: Parashar, Rakesh, Gawde, Nilesh, Gilson, Lucy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kerman University of Medical Sciences 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9056141/
https://www.ncbi.nlm.nih.gov/pubmed/33059427
http://dx.doi.org/10.34172/ijhpm.2020.191
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author Parashar, Rakesh
Gawde, Nilesh
Gilson, Lucy
author_facet Parashar, Rakesh
Gawde, Nilesh
Gilson, Lucy
author_sort Parashar, Rakesh
collection PubMed
description Background: The difference between ‘policy as promised’ and ‘policy as practiced’ can be attributed to implementation gaps. Actor relationships and power struggles are central to these gaps but have been studied using only a handful of theoretical and analytical frameworks. Actor interface analysis provides a methodological entry point to examine policy implementation and practices of power. As this approach has rarely been used in health policy analysis, this article aims, first, to synthesise knowledge about use of actor interface analysis in health policy implementation and, second, to provide guiding steps to conduct actor interface analysis. Methods: We conducted an interpretive synthesis of literature using a set of 6 papers, selected using purposeful searches and focusing on actor dynamics and practices of power in policy experiences. Drawing upon the framework synthesis approach and using a guiding framework, the synthesis focused on 4 questions – the type of actor interfaces formed, the power practices observed, the effect of such power practices on implementation and the underpinning factors for the power practices. Results: Multiple interface encounters and power practices were identified which included domination, control, contestation, collaborations, resistance, and negotiations. The lifeworlds of actors that underpinned the power practices, were rooted in social-organisational power relationships, personal experiences and interests, and social-ideological standpoints like values and beliefs of actors. The power practices influenced implementation both positively and negatively. Conclusion: Based on the learnings from synthesis, this paper provides guiding steps for conducting actor interface analysis. Additionally, it presents 2 useful tools for power analysis: (1) ‘actor lifeworlds,’ to understand underpinning factors for power practices and (2) relationships of lifeworlds, interface encounters and power practices with their effect on policy implementation. We suggest that interface analysis should be applied in more empirical settings and across varied health policy experiences to nuance the method better.
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spelling pubmed-90561412022-05-04 Application of "Actor Interface Analysis" to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps Parashar, Rakesh Gawde, Nilesh Gilson, Lucy Int J Health Policy Manag Systematic Reviews Background: The difference between ‘policy as promised’ and ‘policy as practiced’ can be attributed to implementation gaps. Actor relationships and power struggles are central to these gaps but have been studied using only a handful of theoretical and analytical frameworks. Actor interface analysis provides a methodological entry point to examine policy implementation and practices of power. As this approach has rarely been used in health policy analysis, this article aims, first, to synthesise knowledge about use of actor interface analysis in health policy implementation and, second, to provide guiding steps to conduct actor interface analysis. Methods: We conducted an interpretive synthesis of literature using a set of 6 papers, selected using purposeful searches and focusing on actor dynamics and practices of power in policy experiences. Drawing upon the framework synthesis approach and using a guiding framework, the synthesis focused on 4 questions – the type of actor interfaces formed, the power practices observed, the effect of such power practices on implementation and the underpinning factors for the power practices. Results: Multiple interface encounters and power practices were identified which included domination, control, contestation, collaborations, resistance, and negotiations. The lifeworlds of actors that underpinned the power practices, were rooted in social-organisational power relationships, personal experiences and interests, and social-ideological standpoints like values and beliefs of actors. The power practices influenced implementation both positively and negatively. Conclusion: Based on the learnings from synthesis, this paper provides guiding steps for conducting actor interface analysis. Additionally, it presents 2 useful tools for power analysis: (1) ‘actor lifeworlds,’ to understand underpinning factors for power practices and (2) relationships of lifeworlds, interface encounters and power practices with their effect on policy implementation. We suggest that interface analysis should be applied in more empirical settings and across varied health policy experiences to nuance the method better. Kerman University of Medical Sciences 2020-10-13 /pmc/articles/PMC9056141/ /pubmed/33059427 http://dx.doi.org/10.34172/ijhpm.2020.191 Text en © 2021 The Author(s); Published by Kerman University of Medical Sciences https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Systematic Reviews
Parashar, Rakesh
Gawde, Nilesh
Gilson, Lucy
Application of "Actor Interface Analysis" to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps
title Application of "Actor Interface Analysis" to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps
title_full Application of "Actor Interface Analysis" to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps
title_fullStr Application of "Actor Interface Analysis" to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps
title_full_unstemmed Application of "Actor Interface Analysis" to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps
title_short Application of "Actor Interface Analysis" to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps
title_sort application of "actor interface analysis" to examine practices of power in health policy implementation: an interpretive synthesis and guiding steps
topic Systematic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9056141/
https://www.ncbi.nlm.nih.gov/pubmed/33059427
http://dx.doi.org/10.34172/ijhpm.2020.191
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