title: Stakeholder learning for health sector reform in Lao PDR.
abstract: Development organizations and academic institutions have expressed the need for increased research to guide the development and implementation of policies to strengthen health systems in low- and middle-income countries. The extent to which evidence-based policies alone can produce changes in health systems remains a point of debate; other factors, such as a country's political climate and the level of actor engagement, have been identified as influential variables in effective policy development and implementation. In response to this debate, this article contends that the success of health sector reform depends largely on policy learning-the degree to which research recommendations saturate a given political environment in order to successfully inform the ideas, opinions and perceived interests of relevant actors. Using a stakeholder analysis approach to analyze the case of health sector reform in Lao PDR, we examine the ways that actors' understanding and interests affect the success of reform-and how attitudes towards reform can be shaped by exposure to policy research and international health policy priorities. The stakeholder analysis was conducted by the WHO during the early stages of health sector reform in Lao PDR, with the purpose of providing the Ministry of Health with concrete recommendations for increasing actor involvement and strengthening stakeholder support. We found that dissemination of research findings to a broad array of actors and the inclusion of diverse stakeholder groups in policy design and implementation increases the probability of a sustainable and successful health sector reform.
authors.affiliation: University of California, Davis, UC Davis School of Medicine, Department of Psychiatry and Behavioral Sciences, 2825 50th Street, Sacramento, CA 95817, Health Systems Development, WHO Lao Country Office, 125 Saphanthong Road, Unit 5, Ban Saphangthongtai, Sisattanak District, Vientiane Capital, Lao PDR and Simonepphillips@gmail.com.
authors.forename: Simone
authors.initials: S
authors.lastname: Phillips
authors.affiliation: Cabinet, Ministry of Health, Lao PDR, Rue Simuang, Ban Thatkhao, Sisattanak District, Vientiane, Lao PDR.
authors.forename: Soulivanh
authors.initials: S
authors.lastname: Pholsena
authors.affiliation: Health Systems Development, WHO Lao Country Office, 125 Saphanthong Road, Unit 5, Ban Saphangthongtai, Sisattanak District, Vientiane Capital, Lao PDR and.
authors.forename: Jun
authors.initials: J
authors.lastname: Gao
authors.affiliation: Health Systems Development, WHO Country Office for Bangladesh, United House, 10 Gulshan Avenue, Gulshan-1, Dhaka-1212, Bangladesh.
authors.forename: Valeria
authors.initials: V
authors.lastname: Oliveira Cruz
mesh_terms: D018166:Health Care Reform; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D033181:Information Dissemination; D007812:Laos; D011050:Policy Making
keywords: Health sector reform; Lao PDR; health policy and systems research; stakeholder analysis