The previous steps have highlighted the complexity of many contemporary health problems.
Problem identification – the first step in the policy development process
This complexity presents difficulties when undertaking problem identification. According to the Centers for Disease Control and Prevention (2019), problem identification consists of:
- Clearly identifying the root cause of a problem
- Developing a detailed problem statement that includes the problem’s effect on a population’s health
This is the first step in the policy development process. In the healthcare policy arena, this requires the involvement of different stakeholders. We will look more closely at stakeholders in the next step. Problems can take on different meanings for people from different backgrounds, hence the need for mutual interdependency among stakeholders during the process of problem identification.
Problem identification is a useful strategic activity which enables us to gain a clear view of the health challenges experienced within a particular geographical area. The underlying health problem may not be obvious, hence the need to adopt strategic tools such as Root Cause Analysis to identify the root cause of the problem. The use of such evidence-based tools provides the most effective way of analysing problems from which alternative solutions can be identified to address them.
Elements of a robust problem identification
The identification should consider what the main problems are and their impact at the different levels of society. Perhaps more importantly, the causes of the problems should be examined to find possible interventions. Once these have been identified, a list of priority plans will follow, and this sets the tone for the policy development process.
A robust problem identification according to the WHO (2020) might include an assessment of:
- Social determinants of health and health needs, including current and projected disease burdens and health challenges
- Expectations, including current and projected demand for services as well as social expectations
- Health system performance and of performance gaps in responding to needs and expectations
- Capacity of the health sector to respond to current challenges and to anticipate future ones
- Health system resources (human, physical, financial, informational), and of resource gaps, in responding to needs and expectations
- Stakeholder positions (including, where appropriate, of external partners)
Now that we’ve explored problem identification, let’s pause to consider your thoughts on this process.
Do you think those involved in problem identification may need the support and contribution of others?
Share your thoughts in the comments area.
Blumstein, J. F., & Zubkoff, M. (1979). Public Choice in Health: Problems, Politics, and Perspectives on Formulating National Health Policy. Journal of Health Politics, Policy and Law, 4(3)
Centers for Disease Control and Prevention. (2019). Problem Identification. https://www.cdc.gov/policy/polaris/policyprocess/problem_identification.html [11 May 2020]
World Health Organization. (2020). Situation Analysis and Priority Setting. https://www.who.int/nationalpolicies/processes/priorities/en/
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