Unpacking “Health Reform” and “Policy Capacity”; Comment on “Health Reform Requires Policy Capacity”

Document Type : Commentary


School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia


Health reform is the outcome of dispersed policy initiatives in different sectors, at different levels and across time. Policy work which can drive coherent health reform needs to operate across the governance structures as well as the institutions that comprise healthcare systems. Building policy capacity to support health reform calls for clarity regarding the nature of such policy work and the elements of policy capacity involved; and for evidence regarding effective strategies for capacity building.


Main Subjects

  1. Peters DH, El-Saharty S, Siadat B, Janovsky K, Vujicic M, eds. Improving Health Service Delivery in Developing Countries: From Evidence to Action. Washington: World Bank; 2009.
  2. World Health Organization (WHO). Health Systems Financing: The Path to Universal Health Coverage - Plan of Action. Geneva: WHO; 2012.
  3. Forest PG, Denis JL, Brown LD, Helms D. Health reform requires policy capacity. Int J Health Policy Manag. 2015; 4(5): 265-266. doi:10.15171/ijhpm.2015.85
  4. World Health Organization (WHO). Everybody's Business: Strengthening Health Systems to Improve Health Outcomes: WHO's Framework For Action. Geneva: WHO; 2007.
  5. Immergut EM. Health Politics: Interests and Institutions in Western Europe. Cambridge: Cambridge University Press; 1992.
  6. Lin V, Guo Y, Legge D, Wu Q, eds. Health Policy in and for China. Beijing: Peking University Medical Press; 2010.
  7. Gregory R. Political rationality or 'incrementalism'. Charles Lindblom's enduring contribution to public policy making theory. Policy Polit. 1989;17:139-153.
  8. Pei L, Legge D. Personnel reform in Chinese hospitals: policy interdependence and the challenge of coherent incrementalism. China Journal of Social Work. 2013;6(1):25-39. doi:10.1080/17525098.2013.766623
  9. Pei L, Legge D, Stanton P. Policy contradictions limiting hospital performance in China. Policy Stud. 2000;21(2):99-113.
  10. Ramesh M, Wu X, He AJ. Health governance and healthcare reforms in China. Health Policy Plan. 2014;29(6):663-672. doi:10.1093/heapol/czs109
  11. Lipsky M. Street Level Bureaucracy. New York: Russell Sage Foundation; 1979.
  12. Kingdon JW. Agendas, Alternatives, and Public Policies. Boston: University of Michigan; 1984.
  13. Du L, Killingsworth J, Liu G, Legge D. Macroeconomics and health. In: Lin V, Guo Y, Legge D, Wu Q, eds. Health Policy in Transition: The Challenges for China. Beijing: Peking University Medical Press; 2010:350-367.
  14. Cao Q, Shi L, Wang H, Dong K. Report from China: health insurance in China - evolution, current status, challenges. Int J Health Serv. 2012;42(2):177-195. doi:10.2190/HS.42.2.b
  15. Rhodes R. Understanding Governance: Policy Networks, Governance, Reflexivity and Accountability. Bristol Pa: Open University Press; 1997.
  16. Burris S, Drahos P, Shearing C. Nodal Governance. Australian Journal of Legal Philosophy. 2005;30:30-58.
  17. Gleeson D, Legge D, O'Neill D. Evaluating policy capacity: learning from international and Australian experience. Aust New Zealand Health Policy. 2009;6:3. doi:10.1186/1743-8462-6-3
  18. Gleeson D, Legge D, O'Neill D, Pfeffer M. Negotiating tensions in developing organizational policy capacity: Comparative lessons to be drawn. Journal of Comparative Policy Analysis. 2011;13(3):237-263.
  19. Adams D, Colebatch HK, Walker CK. Learning about learning: discovering the work of policy. Australian Journal of Public Administration. 2015;74(2):101-111.