TY - JOUR ID - 3924 TI - Application of “Actor Interface Analysis” to Examine Practices of Power in Health Policy Implementation: An Interpretive Synthesis and Guiding Steps JO - International Journal of Health Policy and Management JA - IJHPM LA - en SN - AU - Parashar, Rakesh AU - Gawde, Nilesh AU - Gilson, Lucy AD - School of Health System Studies, Tata Institute of Social Sciences, Mumbai, India AD - School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa Y1 - 2021 PY - 2021 VL - 10 IS - Special Issue on Analysing the Politics of Health Policy Change in LMICs SP - 430 EP - 442 KW - Actor Interface Analysis KW - Health Policy Process KW - Qualitative Synthesis KW - LMIC Health Policy KW - Power Systematic Review KW - Health Systems Research DO - 10.34172/ijhpm.2020.191 N2 - BackgroundThe difference between ‘policy as promised’ and ‘policy as practiced’ can be attributed to implementation gaps. Actor relationships and power struggles are central to these gaps but have been studied using only a handful of theoretical and analytical frameworks. Actor interface analysis provides a methodological entry point to examine policy implementation and practices of power. As this approach has rarely been used in health policy analysis, this article aims, first, to synthesise knowledge about use of actor interface analysis in health policy implementation and, second, to provide guiding steps to conduct actor interface analysis. MethodsWe conducted an interpretive synthesis of literature using a set of 6 papers, selected using purposeful searches and focusing on actor dynamics and practices of power in policy experiences. Drawing upon the framework synthesis approach and using a guiding framework, the synthesis focused on 4 questions – the type of actor interfaces formed, the power practices observed, the effect of such power practices on implementation and the underpinning factors for the power practices. ResultsMultiple interface encounters and power practices were identified which included domination, control, contestation, collaborations, resistance, and negotiations. The lifeworlds of actors that underpinned the power practices, were rooted in social-organisational power relationships, personal experiences and interests, and social-ideological standpoints like values and beliefs of actors. The power practices influenced implementation both positively and negatively. ConclusionBased on the learnings from synthesis, this paper provides guiding steps for conducting actor interface analysis. Additionally, it presents 2 useful tools for power analysis: (1) ‘actor lifeworlds,’ to understand underpinning factors for power practices and (2) relationships of lifeworlds, interface encounters and power practices with their effect on policy implementation. We suggest that interface analysis should be applied in more empirical settings and across varied health policy experiences to nuance the method better. UR - https://www.ijhpm.com/article_3924.html L1 - https://www.ijhpm.com/article_3924_890efb586f07db353f9b1aec71b33454.pdf ER -