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PUN688 Health Policy in a Global Context Assignment - Queensland University of Technology, Australia

Q1. Select one of the theoretic frameworks (Hall, Land, Park & Webb, 1975, Kingdon, 1984 or Zahariadis, 2016) available in section 2.1.3 Theoretic Approaches for Agenda Setting on page 23. Apply this framework to a case study of your choosing and explain what it tells us as well its strengths and weaknesses by drawing on policy theory covered by the unit.

Answer - Agenda Setting Theory by Zahariadis

The theory presented by Nikolaos Zahariadis is referred to the agenda-setting, in which the author mainly explains how and why private matters become the public issues and the priority for the government(Zahariadis, 2016). The agenda theory mainly describes the ability to influence the importance of the topics of the public agenda. The agenda-setting is basically related to public relations or media. Today, public relations have become an important function of management due to its important areas like lobbying, public reputation, and crisis management, etc. Agenda setting theory is basically a theory about mass media on the public focus attention. The following case study represents the strengths and weaknesses of the theory in public relations progress.

Public relations serves a wide variety of institutions in society, such as foundations, colleges, hospitals, and government agencies. In order to achieve their basic goals, they need to develop and efficient relationship with many different audiences such as local communities, customers and society at large. The setting of political communications has been recognized as the role of mass media in setting agendas for public debates(Cairney & Zahariadis, 2016). Some of the researchers have discovered that such type of agendas is pinned by the shared beliefs and values. Such type of shared beliefs is known as the early recognizers who identify the emerging issues and disseminate them to the public.

The agenda-setting is now becoming an important position between the media contents and other external factors of media. Basically, the agenda of media represents the public relation in the reflection of corporate agendas. This theory helps the functions of public relations to indicate the issues earlier. It can be considered as an efficient influence on the issue that provides mass media on the agenda when it is necessary. The public is supported by the corporates through public relations as they have a basic aim to plan to bea pressure group in public management. The practitioners of public relations in agenda-setting can help in forming an interactive dialogue between opposed factions by offering alternatives to value frames.

Besides the basic strengths of the theory, there are different weaknesses in applying agenda-setting theory in public relations. For example, the agenda-setting theory has gone beyond the original limits including mass media and public agenda. Now, there is a vast amount of information available in the mass media, that does not only tell us what to think but also tell us who to think and what to do about it. In this case, Twitter is a good example that allows the public instant access to information where a lot of information regarding political figures is posted. Most of the information regarding political figures is not true which then becomes the concern of the government. The main issue is that the media now has a lot of power to transfer the important issues as the expansion of users and content choices control overexposures. However, it can be indicated that the agenda-setting theory can lose its relevance completely due to un-massed media.

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Q2. Provide a detailed account of Leichter's (1979) delineation of policy context and explain how these factors influence how issues are understood and which solutions are deemed viable across different jurisdictions.

Answer - Account of Leichter

The book written by Howard Leichter is based on the case policy in four nations. It is an interesting book with a perfect tone, method and wide range of topics along with evidence in the treatment of how and why the government of Britain, Japan, Germany, and Soviet Union step forwarded to form a health care program and policy that they have today(Leichter, 1979). The long title of the book indicates the dilemmas he faced in giving the focus to the efforts regarding policies. In the book, he basically represents two arguments; one is related to the issue of comparative policy analysis illustrated in the first part of the book. In that section, he has completed review the competing conception and conflicting findings of comparative analysis. Moreover, he also has focused on the configurative studies to sort out the environmental influences, structural features, situational factors, and cultural features to produce effective results of policy in particular cases.

Leichter has successfully determined the cross-national policy studies along with the facts and statistical data from which an individual can learn(Leichter, 1979). Such type of information helpful in understanding the limits of what is possible for the government to do and other ways related to the familiar problem. It also allows to weigh the determinant of policy more carefully. This policy helps in permitting the separation cultural specific determinant from generic one, which is almost impossible when there is a case of single national institute. Furthermore, the comparative analysis also helps in indicating the ways through the structure of institutions shape the politics played out within them. The analyst has basically stretched his mind to learn what is more under the specified condition.

Leichter has also illustrated some important lies in particular history and culture that are related to national institutions and policies(Leichter, 1979). However, all of the factors described by Leichter regarding policies influence the issues and solutions that seem viable across several jurisdictions. The most influencing factors are the national and global factors, structural factors and factors acknowledged in public health system work. Some of the other factors that are influenced in this case are macroeconomic factors and the social factors that are less often examines, such as history, ideology, etc. All of these factors are associated with the policies and help in understanding the basic issues that are associated with these factors, such as political issues, health system issues, etc.

Most the scholars argue and ask questions about how people understand world and the system of policy change(Smith, 2018). Whatever the position one adopts, it is important to remember that analysis of policy is not an element science but an art and craft that help the people to understand the issues through a comparative analysis. It is because people can learn a lot of things from the people who have already sought to understand these policies and have engaged with those policy processes to understand the viable solutions.

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Q3. Utilising the policy analysis framework outlined by Althaus, Bridgman & Davis (2013) examine how a jurisdiction of your choosing could go about reducing harms associated with E-cigarettes/vaping equipment in the wake of emerging evidence.

Answer - Frameworks outline by Althaus, Bridgman, and Davis

Bridgman and Davis have been come up with a policy cycle that involves eight steps of policy issues such as coordination, evaluation, policy instruments, implementation, consultation, implementation, policy analysis, and decisions(Althaus, Bridgman, & Davis, 2013). The policy analysis framework indicated by Althaus and others helps in utilizing the public policy by a government to address the public issue through enforcing laws and actions pertaining to the problem. In this case, policymakers need to form an effective and efficient approach to address the issue of e-cigarettes in the country.

Basically, an e-cigarette is known as a device that contains a large amount of nicotine in solution and produces the nicotine aerosols(Voos, Goniewicz, & Eissenberg, 2019)l. E-cigarettes are known as more harmful than normal cigarettes. Its flavor has induced the youth to use the e-cigarettes to a greater extent. Marketers are selling e-cigarettes because it influences the marketing and is increasing the sales to a greater extent. The products are also getting promoted due to the use of social media, newspapers and TV advertisements. These promotions induce the youth and other people to smoke it which leads to lot of side effects such as irritation in eye, destruction of central nervous system, and respiratory irritation.

In this case, the jurisdiction can use the framework of policy presented by Althaus, David, and Bridman to create a public policy for the regulations for e-cigarette regulations(Althaus, Bridgman, & Davis, 2013). It is because the users of e-cigarettes need some efficient and effective interventions to support the cessation of e-cigarettes. Moreover, the policymakers can also form some policies for the nicotine replacement therapy that can be beneficial for the clinical experts to advice the smokers on quitting it and indicating the disadvantages of smoking e-cigarettes. The motivation programs can also help in improving the smokers to quit it and live a better life. Some of the evidence treatment for the e-cigarette smokers are assess, arrange, ask, assist and advice. A clinical expert should focus on these five A's to treat the patient who is smokers. Clinical experts can also use readiness to make them ready for the treatment plan with the help of counseling and mediation.

Jurisdiction can also induce policies related to the pharmacological intervention by indicating nicotine replacement medications like bupropion and varenicline safe the smoking cessation. In this case, counseling can also be used in the support program to enhance the effect of medication. However, the patient should be advised not to smoke indoor and avoid the exposure of nicotine and toxins. The jurisdiction should address the issue of e-cigarette as a part of the policy in which the e-cigarette companies should engage in public and political relations strategy to make them quit. Moreover, they could also use social media to include policy agendas. In this case, policymakers can create regulatory instructions on the e-cigarette to reduce the number of smokers and issue of smoking. The implementation of policy can help in prohibiting the use of e-cigarettes and can assist in establishing the standard rules for its functions and uses. It can help the jurisdiction to induce a clean air environment such as smoke-free environment to reduce the use of product reinforcement.

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Q4. Construct a log frame for a fictitious programme of your choosing and show its alignment to a broader policy objective. Provide a brief reflection on what the log frame tells us and highlight any areas of particular vulnerability.

Answer - Log Frame for Factious Programme

Basically, log frame helps in the planning of a program or project, and the implementation and management of that program in a structured way(Turner, 2016). The following log frame is designed for the child labor program, in which the program is trying to reduce the issues of child labor. The main elements of the logical framework are as follows:

Development Objectives

The long term goal of this program is to form policy or regulation related to child labor to eliminate the issue from the country.

Activities

The immediate objectives of the program include combating abusive child labor through rehabilitation. For this purpose, proper pre-vocational training will be given. Moreover, the teachers will also be mobilized to combat child labor.

Outputs

The fundamental outcomes of this program will be as follows:

I. Development of viable policy for pre-vocational training

II. Providing pre-vocational training onsite such as at workshops and training institutes.

III. Development of staff at the policy and implementation level that is capacitated to fight for child labor.

IV. Proper review of the formal and non-formal situation of education in the specific area.

V. Development of provisional workshops for expert teachers.

Reflection and Alignment

The following log frame is basically designed to address the issue of child labor and form a specific policy to reduce it. I have determined the long term objectives of the frame, which actually indicates what we are going to achieve through this program. According to the policy of child labor, children under eighteen are defined as child, and until then the individual cannot work for hazardous job. The issue of child labor is not just associated with the issue of harsh working of child, but also the issue of education, health, capital markets, and social security. In order to achieve a sustainable reduction in child labor, there is a need to form a proper policy that can target three groups, such as children that are involved in child labor, that are harmed by exposure to child labor, and that the children that are in their worst form.

This log frame basically indicates the need for a proper child labor policy and its implementation, but the most important thing is the analysis of the given policies related to child labor. For example, the international policy of child labor eliminates the child under 18 from the worst labor, but not from the slavery, trafficking of children, child prostitution or pornography, or trafficking of drugs, which is a serious concern. The main limits of the log frame are that there some vague planning of the program. Moreover, there is no proper planning regarding time dimension in the log frame that can indicate when the program is going to start and fulfill its objectives. Furthermore, there is no such use of static nature of the program that can determine the accuracy of the program. This log frame has helped in understanding the basic concept of analyzing policies while forming a program or planning a program properly.

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Q5. Utilising McConnell's (2010) framework for determining policy success, assess the successes or failings of Australia's more recent iterations of childhood vaccination reform.

Answer - Utilizing McConnell's Framework

Most of the protagonists of the policy have claimed that policy is known as the success factor when the opponents frame the policies as failures. According to Alan McConnell is that the policy outcomes are placed often somewhere between the extremes(McConnell, 2010). If we consider the multidimensional aspect of policy then we can succeed in gaining some respect according to facts and their interpretations. The following table determines the dimensions of policy success presented by March and McConnell.

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Recent Reforms in Childhood Immunization

The latest coverage of childhood immunization has been increased in the last couple of years according to the National Immunization Program which can be indicated through the following graph.

figure1.jpg

The current schedule of NIP is structured according to the government report, with the recommended vaccines by age group and other medical risks (health, 2019). All of these are available free of charge to Australians who came in those risk groups. The diseases that mainly include in this group are measles, influenza, polio, hepatitis A and rubella that are extremely rare in Australia. Therefore, the lack of visibility can cause certain problems and has its own challenges, which can lead to complacency among healthcare providers. The present arrangements of the governance for the NIP can indicate the collaborative approach between the Australian government and state governments that characterized their program in 1997.

The main strategic priorities of the Australian reforms depends on improving immunization coverage and ensuring the effective governance of the program. The program also made some achievements during the period of immunization strategy 2013-2018. For example, the coverage of immunization is now above 90% for all the monitored age groups; however it is 94.6% among 5-year old children. In this case, the indigenous people were the first who achieved the target of about 94%, which is known as an important gain in improving the health outcomes of the children due to vaccination. The rates of HPV vaccination are now higher than ever in both males and females above 15 age. Moreover, some new vaccines have also been introduced for influenza especially for the children. In this case, Australia is known as the first country that implemented the whole-of-life immunization register.

Proper maintenance of immunization has been done by Australian Health Protection Committee including jurisdictional immunization(Hungerford, et al., 2018). Essential vaccines are now easily procured by NIP to enhance the efficiency and value for money in administration. The Australian government works closely with pharmaceutical companies to support the supply of vaccines in the country. Different health campaigns were also developed by the immunization program that provided parents with the evident information in order to support their decisions on vaccinations. In this case, the advisory committee of vaccine plays an integral role by providing advice to support the registration portion of the vaccines. The advisory committee provides efficient advice with ongoing monitoring of technical inputs. They also investigate the situations and conditions that are conducted on immunization, which helps in indicating the essential threats and adverse events that are directly reported to the therapeutic administration.

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