IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v123y2014icp45-54.html
   My bibliography  Save this article

A retrospective health policy analysis of the development and implementation of the voluntary health insurance system in Lebanon: Learning from failure

Author

Listed:
  • El-Jardali, Fadi
  • Bou-Karroum, Lama
  • Ataya, Nour
  • El-Ghali, Hana Addam
  • Hammoud, Rawan

Abstract

Public policymaking is complex and suffers from limited uptake of research evidence, particularly in the Eastern Mediterranean Region (EMR). In-depth case studies examining health policymaking in the EMR are lacking. This retrospective policy analysis aims at generating insights about how policies are being made, identifying factors influencing policymaking and assessing to what extent evidence is used in this process by using the Lebanese Voluntary Health Insurance policy as a case study. The study examined the policymaking process through a policy tracing technique that covered a period of 12 years. The study employed a qualitative research design using a case study approach and was conducted in two phases over the course of two years. Data was collected using multiple sources including: 1) a comprehensive and chronological media review; 2) twenty-two key informant interviews with policymakers, stakeholders, and journalists; and 3) a document review of legislations, minutes of meetings, actuarial studies, and official documents. Data was analyzed and validated using thematic analysis. Findings showed that the voluntary health insurance policy was a political decision taken by the government to tackle an urgent political problem. Evidence was not used to guide policy development and implementation and policy implementers and other stakeholders were not involved in policy development. Factors influencing policymaking were political interests, sectarianism, urgency, and values of policymakers. Barriers to the use of evidence were lack of policy-relevant research evidence, political context, personal interests, and resource constraints. Findings suggest that policymakers should be made more aware of the important role of evidence in informing public policymaking and the need for building capacity to develop, implement and evaluate policies. Study findings are likely to matter in light of the changes that are unfolding in some Arab countries and the looming opportunities for policy reforms.

Suggested Citation

  • El-Jardali, Fadi & Bou-Karroum, Lama & Ataya, Nour & El-Ghali, Hana Addam & Hammoud, Rawan, 2014. "A retrospective health policy analysis of the development and implementation of the voluntary health insurance system in Lebanon: Learning from failure," Social Science & Medicine, Elsevier, vol. 123(C), pages 45-54.
    • Handle: RePEc:eee:socmed:v:123:y:2014:i:c:p:45-54
    DOI: 10.1016/j.socscimed.2014.10.044
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953614006972
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2014.10.044?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Lois Orton & Ffion Lloyd-Williams & David Taylor-Robinson & Martin O'Flaherty & Simon Capewell, 2011. "The Use of Research Evidence in Public Health Decision Making Processes: Systematic Review," PLOS ONE, Public Library of Science, vol. 6(7), pages 1-10, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Maria José Sousa, 2022. "Digital Technologies and Public Policies Applied to Green Cities," Land, MDPI, vol. 11(11), pages 1-18, November.
    2. Caitlin M. Walsh & Takondwa Mwase & Manuela De Allegri, 2020. "How actors, processes, context and evidence influenced the development of Malawi's Health Sector Strategic Plan II," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(6), pages 1571-1592, November.
    3. Olga Gershuni & Katarzyna Czabanowska & Genc Burazeri & Vesna Bjegovic-Mikanovic & Grzegorz Juszczyk & Anna Cichowska Myrup & Volodymyr Kurpita, 2021. "Aligning Best Practices: A Guiding Framework as a Valuable Tool for Public Health Workforce Development with the Example of Ukraine," IJERPH, MDPI, vol. 18(17), pages 1-13, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Paula Hooper & Sarah Foster & Billie Giles-Corti, 2019. "A Case Study of a Natural Experiment Bridging the ‘Research into Policy’ and ‘Evidence-Based Policy’ Gap for Active-Living Science," IJERPH, MDPI, vol. 16(14), pages 1-14, July.
    2. Nancy Li & Markus Luczak-Roesch & Flavia Donadelli, 2023. "A computational approach to study the gap and barriers between science and policy," Science and Public Policy, Oxford University Press, vol. 50(1), pages 15-29.
    3. Cyr, Pascale Renée & Jain, Vageesh & Chalkidou, Kalipso & Ottersen, Trygve & Gopinathan, Unni, 2021. "Evaluations of public health interventions produced by health technology assessment agencies: A mapping review and analysis by type and evidence content," Health Policy, Elsevier, vol. 125(8), pages 1054-1064.
    4. Matthew Calver, 2016. "Measuring the Appropriate Outcomes for Better Decision-Making: A Framework to Guide the Analysis of Health Policy," CSLS Research Reports 2016-03, Centre for the Study of Living Standards.
    5. Courtney A. Cuthbertson & Don E. Albrecht & Scott Loveridge, 2017. "Rural versus urban perspectives on behavioral health issues and priorities," Community Development, Taylor & Francis Journals, vol. 48(4), pages 515-526, August.
    6. Heather Munthe‐Kaas & Heid Nøkleby & Sarah Rosenbaum, 2022. "User experiences of structured stakeholder engagement to consider transferability: The TRANSFER approach," Campbell Systematic Reviews, John Wiley & Sons, vol. 18(4), December.
    7. Pierre-Olivier Bédard, 2015. "The Mobilization of Scientific Evidence by Public Policy Analysts," SAGE Open, , vol. 5(3), pages 21582440156, September.
    8. Pauline Zardo & Adrian G Barnett & Nicolas Suzor & Tim Cahill, 2018. "Does engagement predict research use? An analysis of The Conversation Annual Survey 2016," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-21, February.
    9. Zardo, Pauline & Collie, Alex & Livingstone, Charles, 2014. "External factors affecting decision-making and use of evidence in an Australian public health policy environment," Social Science & Medicine, Elsevier, vol. 108(C), pages 120-127.
    10. P Th Houngbo & H L S Coleman & M Zweekhorst & Tj De Cock Buning & D Medenou & J F G Bunders, 2017. "A Model for Good Governance of Healthcare Technology Management in the Public Sector: Learning from Evidence-Informed Policy Development and Implementation in Benin," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-22, January.
    11. Natasa Loncarevic & Pernille Tanggaard Andersen & Anja Leppin & Maja Bertram, 2021. "Policymakers’ Research Capacities, Engagement, and Use of Research in Public Health Policymaking," IJERPH, MDPI, vol. 18(21), pages 1-17, October.
    12. Dagenais, Christian & Dupont, Didier & Brière, Frédéric N. & Mena, Diego & Yale-Soulière, Gabrielle & Mc Sween-Cadieux, Esther, 2020. "Codifying explicit and tacit practitioner knowledge in community social pediatrics organizations: Evaluation of the first step of a knowledge transfer strategy," Evaluation and Program Planning, Elsevier, vol. 79(C).
    13. Richard A. Sharpe & Tim Taylor & Lora E. Fleming & Karyn Morrissey & George Morris & Rachel Wigglesworth, 2018. "Making the Case for “Whole System” Approaches: Integrating Public Health and Housing," IJERPH, MDPI, vol. 15(11), pages 1-22, October.
    14. Schwarzman, Joanna & Bauman, Adrian & Gabbe, Belinda J. & Rissel, Chris & Shilton, Trevor & Smith, Ben J., 2022. "How practitioner, organisational and system-level factors act to influence health promotion evaluation capacity: Validation of a conceptual framework," Evaluation and Program Planning, Elsevier, vol. 91(C).
    15. Lavinia Bianco & Salvatore Raffa & Paolo Fornelli & Rita Mancini & Angela Gabriele & Francesco Medici & Claudia Battista & Stefania Greco & Giuseppe Croce & Aldo Germani & Simona Petrucci & Paolo Anib, 2022. "From Survey Results to a Decision-Making Matrix for Strategic Planning in Healthcare: The Case of Clinical Pathways," IJERPH, MDPI, vol. 19(13), pages 1-30, June.
    16. Redman, Sally & Turner, Tari & Davies, Huw & Williamson, Anna & Haynes, Abby & Brennan, Sue & Milat, Andrew & O'Connor, Denise & Blyth, Fiona & Jorm, Louisa & Green, Sally, 2015. "The SPIRIT Action Framework: A structured approach to selecting and testing strategies to increase the use of research in policy," Social Science & Medicine, Elsevier, vol. 136, pages 147-155.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:123:y:2014:i:c:p:45-54. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.