合作动力与共同动机:探索赞比亚的烟草控制政策制定。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Adam Silumbwe, Miguel San Sebastian, Joseph Mumba Zulu, Charles Michelo, Klara Johansson
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引用次数: 0

摘要

在赞比亚,制定烟草控制政策的努力已经停滞了十多年,该国尚未接近制定一项政策。对这一政策制定过程中的动态及其如何影响政策目标和结果的实现进行的研究十分有限。本研究探讨了赞比亚烟草控制政策制定过程中的合作动力如何影响利益相关者的共同动机。研究采用了定性案例研究设计,采用了协作治理视角,包括对烟草控制政策工作组会议及其内部协作动态的深入探讨。协作治理综合框架将相互信任、相互理解、内部合法性和共同承诺视为共同动力的关键要素,本研究对该框架进行了调整。从 27 位关键信息提供者那里收集了数据,并使用主题分析法对数据进行了分析。一些合作动力阻碍了烟草控制利益相关者之间的相互信任,包括对相关忠诚的担忧、对烟草生产禁令的恐惧、筒仓心态以及缺乏全面对话。所有利益相关方都认为,烟草控制信息共享有限以及缺乏可靠的当地烟草负担证据阻碍了相互理解。多种因素妨碍了内部合法性,包括部门代表缺乏权威性,以及认为拟议的政策内容缺乏背景性。认识到多部门行动的必要性、其他部门缺乏政治意愿以及地方对这一进程的拨款有限,这些都是影响共同承诺的因素。为了在赞比亚和其他地方加快制定烟草控制政策,政策制定者必须采取建立在共同动机基础上的战略,有意识地为公开讨论和相互尊重的互动创造机会,促进向合作信息共享的文化转变,并解决不平等的权力关系,以便在各部门采取适当的烟草控制行动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Collaborative dynamics and shared motivation: exploring tobacco control policy development in Zambia.

In Zambia, efforts to produce a tobacco control policy have stalled for over a decade, and the country is not yet close to developing one. Limited studies have explored the dynamics in this policy process and how they affect the attainment of policy goals and outcomes. This study explored how collaborative dynamics within tobacco control policy development shaped shared motivation among stakeholders in Zambia. The study used a qualitative case study design that adopted a collaborative governance lens, comprising an in-depth exploration of the tobacco control policy working group meetings and their internal collaborative dynamics. The integrative framework for collaborative governance, which identifies mutual trust, mutual understanding, internal legitimacy and shared commitment as key elements of shared motivation, was adapted for this study. Data were collected from 27 key informants and analysed using thematic analysis. Several collaborative dynamics thwarted mutual trust among tobacco control stakeholders, including concerns about associated loyalties, fear of a ban on tobacco production, silo-mentality and lack of comprehensive dialogue. All stakeholders agreed that the limited sharing of information on tobacco control and the lack of reliable local evidence on the tobacco burden hindered mutual understanding. Diverse factors hampered internal legitimacy, including sector representatives' lack of authority and the perceived lack of contextualization of the proposed policy content. Acknowledgement of the need for multisectoral action, lack of political will from other sectors and limited local allocation of funds to the process were some of the factors that shaped shared commitment. To accelerate the development of tobacco control policies in Zambia and elsewhere, policymakers must adopt strategies founded on shared motivation that deliberately create opportunities for open discourse and respectful interactions, promote a cultural shift towards collaborative information sharing and address unequal power relations to enable shaping of appropriate tobacco control actions in respective sectors.

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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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