From Mid-Level Policy Analysis to Macro-Level Political Economy; Comment on “Developing a Framework for a Program Theory-Based Approach to Evaluating Policy Processes and Outcomes: Health in All Policies in South Australia”

Document Type : Commentary


Canada Research Chair, Globalization and Health Equity, Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada


This latest contribution by the evaluation research team at Flinders University/Southgate Institute on their multiyear study of South Australia’s Health in All Policies (HiAP) initiative is simultaneously frustrating, exemplary, and partial. It is frustrating because it does not yet reveal the extent to which the initiative achieved its stated outcomes; that awaits further papers. It is exemplary in describing an evaluation research design in which the research team has excelled over the years, and in adding to it an element of theory testing and re-testing. It is partial, in that the political and economic context considered important in examining both process and outcome of the HiAP initiative stops at the Australian state’s borders as if the macro-level national and global political economy (and its power relations) have little or no bearing on the sustainability of the policy learning that the initiative may have engendered. To ask that of an otherwise elegant study design that effectively engages policy actors in its implementation may be demanding too much; but it may now be time that more critical political economy theories join with those that elaborate well the more routine praxis of public policy-making.


Main Subjects

  1. Lawless A, Baum F, Delany-Crowe T, et al. Developing a framework for a program theory-based approach to evaluating policy processes and outcomes: health in all policies in South Australia. Int J Health Policy Manag. 2017; Forthcoming.
  2. A Health Lens Analysis across the South Australian Government's Seven Strategic Priorities. Accessed December 28, 2017.
  3. Health in All Policies Summary Report 2014. Accessed December 28, 2017.
  4. Baum F, Lawless A, Delany T, et al. Evaluation of Health in All Policies: concept, theory and application. Health Promot Int. 2014;29 Suppl 1:i130-142. doi:10.1093/heapro/dau032
  5. Delany T, Lawless A, Baum F, et al. Health in All Policies in South Australia: what has supported early implementation? Health Promot Int. 2016;31(4):888-898. doi:10.1093/heapro/dav084
  6. Andrews T. What is social constructionism? Grounded Theory Review 2012;11(1). Accessed December 28, 2017.
  7. Lawless A, Freeman T, Bentley M, Baum F, Jolley G. Developing a good practice model to evaluate the effectiveness of comprehensive primary health care in local communities. BMC Fam Pract. 2014;15:99. doi:10.1186/1471-2296-15-99
  8. Freeman T, Baum F, Lawless A, et al. Revisiting the ability of Australian primary health care services to respond to health inequity. Aust J Prim Health 2016;22:332-338. doi:10.1071/PY14180  
  9. Mahoney J, Rueschemeyer B, eds. Comparative Historical Analysis in the Social Sciences. Cambridge: Cambridge University Press; 2003.
  10. Baum F, Freeman T, Sanders D, et al. Comprehensive primary health care under neo-liberalism in Australia. Soc Sci Med. 2016;168:43-52. doi:10.1016/j.socscimed.2016.09.005
  • Receive Date: 30 December 2017
  • Revise Date: 01 February 2018
  • Accept Date: 03 February 2018
  • First Publish Date: 01 July 2018