对印度国家烟草控制计划和政策实施情况的现实主义评估。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Pragati B Hebbar, Vivek Dsouza, Gera E Nagelhout, Sara van Belle, Prashanth Nuggehalli Srinivas, Onno C P Can Schayck, Giridhara R Babu, Upendra Bhojani
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引用次数: 0

摘要

人们对研究和解读政策与计划的实施情况越来越感兴趣,因为这提供了一个机会,可以 减少研究成果转化为政策和得到实施所需的政策转化时间,并了解政策可能失败的原因。现实主义评估是一种理论驱动的方法,它接受复杂性,并有助于确定在特定背景下产生所观察到的政策结果的机制。我们的目标是采用现实主义评价方法,研究《2003 年香烟和其他烟草制品法》(COTPA)这一综合性国家烟草控制政策和《2008 年国家烟草控制计划》(NTCP)实施过程中的促进因素和障碍。我们在对中低收入国家(LMICs)的烟草控制政策进行现实主义文献回顾的基础上,提出了初步计划理论(IPT)。我们选择了三个不同的州--喀拉拉邦、西孟加拉邦和阿鲁纳恰尔邦--作为案例研究对象,这三个州的控烟法律和项目实施程度各不相同。在所选的三个邦中,我们对 48 个邦和地区级利益相关者进行了深入访谈,并进行了非参与者观察,以完善 IPT。之后,我们组织了两次地区磋商,涵盖了印度 20 个邦的利益相关者,进行了第二次迭代,以进一步完善计划理论。根据访谈数据,我们共提出了 300 个 "干预-背景-行动者-机制-结果"(ICAMO)组合,随后将其归纳为喀拉拉邦、西孟加拉邦和阿鲁纳恰尔邦的具体叙事计划理论。我们确定了五种机制:集体行动、责任感、个人动机、恐惧和优先次序,这些机制的触发(或未触发)导致了不同的实施结果。我们确定了实施《印度儿童保育和保护法》和《印度国家儿童保育计划》的促进因素和障碍,这对进一步实施这些政策以及印度的实施研究具有重要的研究和实践意义。未来,研究人员可以在本研究提出的完善的计划理论基础上,发展出一套中间理论来解释印度和其他低收入、中等收入国家的烟草控制政策实施情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A realist evaluation of the implementation of a national tobacco control program and policy in India.

There is a growing interest in studying and unpacking implementation of policies and programmes as it provides an opportunity to reduce the policy translation time lag taken for research findings to translate to policies and get implemented and understand why policies may fail. Realist evaluation is a theory-driven approach that embraces complexity and helps to identify the mechanisms generating the observed policy outcomes in given context. We aimed to study facilitators and barriers while implementing the Cigarettes and Other Tobacco Products Act, 2003 (COTPA) a comprehensive national tobacco control policy, and the National Tobacco Control Programme (NTCP), 2008 using realist evaluation. We developed an initial program theory (IPT) based on a realist literature review of tobacco control policies in Low- and Middle-Income Countries (LMICs). Three diverse states -Kerala, West Bengal, and Arunachal Pradesh- with varying degree of implementation of tobacco control law and program were chosen as case studies. Within the three selected states, we conducted in-depth interviews with 48 state and district-level stakeholders and undertook non-participant observations to refine the IPT. Following this, we organized two regional consultations covering stakeholders from 20 Indian states for a second iteration to further refine the program theory. A total of 300 Intervention-Context-Actor-Mechanism-Outcome (ICAMO) configurations were developed from the interview data, which were later synthesized into state-specific narrative program theories for Kerala, West Bengal and Arunachal Pradesh. We identified five mechanisms: collective action, felt accountability, individual motivation, fear, and prioritization that were (or were not) triggered leading to diverse implementation outcomes. We identified facilitators and barriers to implementing the COTPA and the NTCP, which have important research and practical implications for furthering the implementation of these policies as well as implementation research in India. In the future, researchers could build on the refined program theory proposed in this study to develop a middle-range theory to explain tobacco control policy implementation in India and other LMICs.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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