Unravelling networks in local public health policymaking in three European countries - a systems analysis.
BACKGROUND
Facilitating and enhancing interaction between stakeholders involved in the policymaking process to stimulate collaboration and use of evidence, is important to foster the development of effective Health Enhancing Physical Activity (HEPA) policies. Performing an analysis of real-world policymaking processes will help reveal the complexity of a network of stakeholders. Therefore, the main objectives were to unravel the stakeholder network in the policy process by conducting three systems analyses, and to increase insight into the similarities and differences in the policy processes of these European country cases.


METHODS
A systems analysis of the local HEPA policymaking process was performed in three European countries involved in the 'REsearch into POlicy to enhance Physical Activity' (REPOPA) project, resulting in three schematic models showing the main stakeholders and their relationships. The models were used to compare the systems, focusing on implications with respect to collaboration and use of evidence in local HEPA policymaking. Policy documents and relevant webpages were examined and main stakeholders were interviewed.


RESULTS
The systems analysis in each country identified the main stakeholders involved and their position and relations in the policymaking process. The Netherlands and Denmark were the most similar and both differed most from Romania, especially at the level of accountability of the local public authorities for local HEPA policymaking. The categories of driving forces underlying the relations between stakeholders were formal relations, informal interaction and knowledge exchange.


CONCLUSIONS
A systems analysis providing detailed descriptions of positions and relations in the stakeholder network in local level HEPA policymaking is rather unique in this area. The analyses are useful when a need arises for increased interaction, collaboration and use of knowledge between stakeholders in the local HEPA network, as they provide an overview of the stakeholders involved and their mutual relations. This information can be an important starting point to enhance the uptake of evidence and build more effective public health policies.
Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands. h.p.e.m.spitters@tilburguniversity.edu.
Hilde P E M
HP
Spitters
Research Centre for Prevention and Health, Capital Region of Denmark, Ndr, Ringvej 57, Afsnit 84/85, 2600, Glostrup, Denmark.
Cathrine J
CJ
Lau
Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, 7 Pandurilor St. Universitas, Room 910, 400376, Cluj-Napoca, Romania.
Petru
P
Sandu
Youth Care, Special Needs Education and Research, P.O. Box 6546, 6503 GA, Nijmegen, The Netherlands.
Marcel
M
Quanjel
Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, 7 Pandurilor St. Universitas, Room 910, 400376, Cluj-Napoca, Romania.
Diana
D
Dulf
Research Centre for Prevention and Health, Capital Region of Denmark, Ndr, Ringvej 57, Afsnit 84/85, 2600, Glostrup, Denmark.|Department of Health Sciences and Technology, Aalborg University, Frederik Bayers vej 7D2, DK-9220, Aalborg, Denmark.
Charlotte
C
Glümer
Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.|National Institute of Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
Hans A M
HA
van Oers
Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE, Tilburg, The Netherlands.
Ien A M
IA
van de Goor
D003299:Cooperative Behavior; D003718:Denmark; D006291:Health Policy; D006801:Humans; D009426:Netherlands; D011050:Policy Making; D011634:Public Health; D012383:Romania; D013597:Systems Analysis; D057170:Translational Research, Biomedical
Local policymaking process; Public health; Relations; Schematic model; Stakeholder network; Systems analysis