Understanding Political Priority Development for Public Health Issues in Turkey: Lessons from Tobacco Control & Road Safety

political priority;agenda setting;health policy;Turkey;tobacco control;road safety;Public Health Studies

Hoe, ConnieBishai, David M. ;

Johns Hopkins University

关键词: political priority;    agenda setting;    health policy;    Turkey;    tobacco control;    road safety;    Public Health Studies;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/39532/HOE-DISSERTATION-2015.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Background: In the last decade, tobacco control received political priority in Turkey while road safety did not despite the large health and economic burden road traffic injuries posed on the Turkish population. Political priority relates to the agenda-setting phase of the policy process and has been widely acknowledged as an important facilitating factor in the attainment of public health goals. Unfortunately, however, few studies currently exist to help us understand how it develops for public health issues in countries like Turkey. Objective: Using a framework adapted from John Kingdon’s Multiple Streams Theory, the primary objective of this study was to compare tobacco control with road safety for the purpose of assessing how political priority for public health issues develop in Turkey. Method: A comparative mixed-methods case study design was used. Qualitative data were gathered from key informant interviews (N=42), and documents (N=307) and quantitative data were collected from online self-administered surveys (N=153). For each case, qualitative data were analyzed using deductive and inductive coding and quantitative data were analyzed using descriptive statistics and nonparametric tests. All results were triangulated. Finally, cross-case analysis was employed such that the themes from the two cases could be compared. Results: Political priority emerged for tobacco control as a result of the development and convergence of four streams – problem, policy, political, and global – while a policy window was opened. Although the full development of all streams was found to be crucial, the transformation of the political stream appeared to be most significant. These streams were found to overlap at different points in time and influenced by an integrated group of diverse actors. Without all of these events and actors in place at the same time, the study showed that a public health problem is not likely to reach political priority in Turkey as seen in the case of road safety where only two of the four streams were developed, a policy window never opened, and many key actors were absent.Conclusion: The revised framework generated from this study could potentially help actors promoting public health issues in Turkey or other similar contexts.