THE UGANDA SAFE-BIRTH ORGANISATION (TUSBO)

16 May 2011

POLITICS, POLICY, PROBLEMS AND THE TAXI OF UGANDA: WHAT CAN PUBLIC HEALTH SPECIALISTS LEARN?


Streams model
There are many different models to explain the policy process. One of them is the multiple streams model of policy-making  by J.W. Kingdon (1984). Kingdon’s model, which focuses more on the flow and timing of policy action than on its component steps, is useful in understanding the complexities and realities of policy-making. In this model, particular attention is paid to three streams: the problem stream, the policy stream, and the political stream, which move independently through the policy system.
This model explains why some issues and problems become prominent in the policy agenda and are eventually translated into concrete policies, while others never achieve that prominence. Kingdon’s starting point is the "garbage can model" of policy-making, developed in 1972 by Cohen, March, and Olsen. This model contradicts the rational approach to decision-making, claiming that policies are not the product of rational actions, because policy actors rarely evaluate many alternatives for action and because they do not compare them systematically.
Kingdon’s model underlines the existence of three distinct, but complementary, processes, or streams, in policy-making. It is the coupling of these streams that allows, at a given time and in a given context, for a particular issue to be turned into a policy (opening a “policy window”). These three streams are:
1.      The stream of problems. The rationale behind this stream is that a given situation has to be identified and explicitly formulated as a problem for it to bear the slightest chance of being transformed into a policy. A situation that is not defined as a problem, and for which alternatives are never envisaged or proposed, will never be converted into a policy. The feeling that a current or foreseen situation is wrong and that something should, and can, be done to improve it is a prerequisite for turning an issue into a policy. Moreover, it is necessary to be able to demonstrate that the problems mentioned can actually be attributed to causes within human control and thus that action can be taken to change the situation.
Take the issue of walk to work demonstration and analyze whether Dr. Besigye has defined food and fuel prices as a problem whose solution is within government control.
Can you think of how any public health problem can be turn into a “hot political potato”?
2.      The stream of policies. The second stream used to explain how an issue rises or falls on an agenda has to do with the stream of policies. This stream is concerned with the formulation of policy alternatives and proposals. New policies will never be shaped if there are no ideas or policy proposals on which they can be based and developed. An important aspect of the streams model developed by Kingdon is linked to the idea that such proposals and solutions, which must be technically feasible, are not initially built to resolve given problems; rather they float in search of problems to which they can be tied. A variety of actors can participate in the elaboration of such solutions and alternatives, and in the drafting of proposals for policy reform.
3.      The stream of politics. Although they take place independently of the other two streams, political events, such as an impending election or a change in government, can lead a given topic and policy to be included or excluded from the agenda. Indeed, the dynamic and special needs created by a political event may change the agenda. In the political stream, consensus is usually obtained as a result of bargaining rather than persuasion. The question is, “how will this benefit me?”
Thus, more attention is paid to assessing the costs and benefits of a policy proposal to the politicians and stakeholders than to underlining its technical and operational importance and relevance.
Look at the way Reproductive Health Uganda has lately strategically been advocating for family planning as economic development issue rather than a birth control issue (where the heartbeat of the president lies!). Why did they change their name from family planning Uganda to Reproductive Health Uganda?
As mentioned above, these three streams are separate and independent; problem recognition, the formulation of policy proposals, and political events each has its own dynamic and pace. As such, no stream is decisive to the overall policy process, though all streams are important. It is when they meet and coincide (thus, opening a policy window) that an issue is transformed from a mere topic and/or problem into a concrete policy, that is, a compelling problem is linked to a plausible solution that meets the test of political feasibility.
For example, supporters of a given policy reform take advantage of a political context that favours and seeks new ideas and approaches, claiming that their proposal for reform is also a solution to a previous problem. In this instance, there is a complete linkage between the three streams, which increases the chances for an issue to become a policy.
However, it is not always necessary for all three streams to meet simultaneously for a policy to develop. In some cases, partial couplings, the convergence of two of the streams, are sufficient, though the whole policy-making process is more uncertain. Kingdon argues that policy entrepreneurs play a key role in connecting the streams, and that there are different types of couplings. Couplings can be more or less ‘tight’ or “loose”, depending on the degree to which streams, though independent, depend on each other for an issue to develop into a concrete policy.
Contrary to other models, the streams model does not picture the policy-making process as one that involves steps and stages. Rather, it views the policy process as the result of the intersection of at least two independent streams at one time. In this model, there is no chronological sequence or priority among the streams. Streams act and react according to their own logic, until a window of opportunity is opened and two or more streams coincide and become a policy.
The major strength of this model is that it recognises that the policy process is fluid and non-linear, and that it involves a vast number of actors and forces. It also explains how a given issue becomes a specific policy—or not.
Major Ssebagala once, being interviewed on WBS TV said, in response to why the City Bus project failed aborted, “major stakeholders could not allow me; they run the taxi business!”
This was a major eye-opener to policy formulation in Uganda. Please react to this article.

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