Inside the Policy Process: using textual analysis to measure people-centred approach in tuberculosis policymaking

Through a radical change of perspective, the current WHO End TB Strategy recognizes for the first time the role of social determinants in TB diffusion, encouraging the adoption of a people-centred approach, and engaging communities in TB care service provision. This study analyses to what extent actors involved into the elaboration of National Strategic Plans (NSPs) to fight TB perceive these components and propose a consistent perspective. Through computational textual analysis applied to 25 open-question interviews carried out to actors directly involved into the elaboration of NSPs, this study provides evidence of major traits of expression and specificities to detect common trends and draw informative insights for policy design at country level. The identification of conceptual clusters in the narratives allows the selection of keywords, whose distribution is used to assess to what extent respondents are oriented towards a partnering approach, and are focused on people-centred policies. A significant number of respondents, especially if having experienced the StopTB Partnership initiative, support a people-centred approach by emphasizing the importance of the relational components for affected people, and the setup of inclusive processes of community-based care and support services. Results suggest a clear perception of the strategic utility of a national partnering approach. The findings have important implications towards a rights-enhancing policy in service provision: strengthening partnering efforts appears as an effective strategy to promote a people-centered approach in TB policy design.