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The Power of Engagement: Stakeholder Analysis

In this lecture, Yodi Mahendradhata explain how to conduct a stakeholder analysis. (Step 3.11)
YODI MAHENDRADHATA: The Power of Engagement– Stakeholder Analysis. How do we actually engage stakeholders to support successful implementation of public health programs? That’s the big question we will try to address through the next few slides.
But first, let me take you back to the health policy triangle. The triangle basically suggests that policies are influenced by policy content, process, contexts, and actors or stakeholders. Now notice here that actors and stakeholders are actually at the center of this health policy framework. This underlines the importance of stakeholder in policy engagement. Now in India, for example, the [? polio ?] program was gearing up to reach the last 1% of their population where polio was still a challenge. Now at that instance, the program officials came together with government officials, community mobilizers, physician communities– for instance, the Indian Associate of Pediatrics– professional organizations, religious leaders, a few families from affected communities, and media partners.
Together, they agreed that polio can be eradicated, provided all the resources are utilized in an intelligent and evidence-based way. So as stakeholders, together, they agreed to advocate to prioritize the issue, to actively contribute to planning discussions across phases, and also to provide funding or inclined resource or capacity. So clearly, effective stakeholder engagement enhanced policy support and ownership. Now in order to get to an effective stakeholder engagement, we need an understanding of power relations and potential alliances and conflicts among stakeholders. Stakeholder analysis is the process of identifying policies’ key stakeholders and assessing their interest in the policies and the ways in which these stakeholders may influence the policies’ outcomes. Stakeholder analysis provides the foundation for planning stakeholder engagement throughout policy cycle.
Now there are multiple methods which can be utilized and can be adapted to conduct stakeholder analysis. In general, the stakeholder analysis process can be divided into three phases– planning, conducting, and analyzing. And we generally recommend the following 12-step guideline for stakeholder analysis, which have been proposed by Hyder et al. So here are the first three. First, articulate a clear problem statement. What is actually the problem that we are dealing with? Second, clearly define the new policy to be considered. It should be clear to everyone what is exactly the new policy we are considering. Third, we need to identify who are actually the key stakeholders of the policy and systematically consider categories of stakeholders– internal stakeholders, external stakeholders, and so on.
Next, we should attempt to identify different groups within an organization. So perhaps, we have organizations already identified. But within those organizations, we need to identify the different groups that may have different perspectives or levels of power. The Ministry of Health, for example, is a very big organization. And you would have different perspectives of levels of powers within the Ministry of Health, for example. Next, having done that, we need to articulate the current level of power or influence for each of the stakeholders, and then also articulate the type of power or influence for each of the stakeholders. Then we also articulate the current level of agreement with the policy for each stakeholder– to what level they agree or disagree.
And then we come to the part of identifying the main concerns of each stakeholder about the policy. And having done that, we can start classifying the stakeholders into one of the five categories, which we will discuss in more details later on. Then we could move on to articulating the main approaches. The main strategy is to actually deal with the stakeholders and describe a plan to deal with stakeholders, bearing in mind its type of power and main concerns. And at the end, we come to the part where we describe plans to periodically repeat the stakeholder analysis. So those are the 12 steps in brief. But let me highlight again step 5 and 7, as these are critical.
So just to remind you, step 5 is about articulating the current level of power or influence for each stakeholder. OK, step 7 was about articulating the level of agreement with the policy for each stakeholder. So to help us do that, here we have a nice metric, which should be able to help us in articulating power and policy agreement for each stakeholder. Because based on those two parameters, you could actually position each stakeholder into the appropriate boxes in this metric. This will then help us classify the stakeholders based on implications for engagement. So the two dimensional considerations would actually then allow us a grid construction that defines five stakeholder categories. First, we have the drivers.
These are those who have high levels of agreement, and also high level of power. And then we have the blockers. They have high levels of power, but they have a very low level of agreement. So they block things. And then you have the supporters. They have high level of agreement. They support the policy. But they have low level of power. And then you have the bystander, who have low level of agreement, and also a low level of power. And at the center, you have the abstainers, who have intermediate levels of agreement and power. So articulation of approaches or strategies to deal with stakeholders should be based on the stakeholder category.
So for example, drivers should be empowered with provision of resources and opportunities for influence. What do we do with the blockers? We should move them to become supporters, abstainers. While for the supporters, they should be involved at least in discussion and technical steps. And both bystanders and abstainers should be at least monitored for opportunities to move them into more positive positions. Now at this stage, you should be ready to actually try to do a stakeholder analysis yourself. Now here we have a mini exercise, which should only take you around 20 minutes. So please start by reviewing a country program summary for an overview of the context, key players, challenges, and then complete a mini stakeholder analysis using these guiding steps.
First, clearly define the new policy, and then identify the key stakeholder, and then articulate current level of power and influence, articulate current level of agreement, and then classify the stakeholders into one of the five categories. If you are following this course individually, you can do this mini exercise as a thought process on your own. If you are following this as a group, then you could actually simulate a more realistic stakeholder analysis by working this out with others. In any case, I’m sure, by the end of the exercise, you would have a better grasp of what it takes to do a proper stakeholder analysis. Good luck.

Yodi Mahendradhata, MD, MSc, PhD, FRSPH
Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia

Effective stakeholder engagement enhances policy support and ownership. This requires a nuanced understanding of power relations and potential alliances, as well as conflicts among stakeholders. A stakeholder anlaysis thus provides a foundation for stakeholder engagement.

After you complete the lecture, please take a moment to review the the reading Stakeholder analysis for health research: Case studies from low- and middle-income countries.

In the next activity, you will be invited to conduct your own Stakeholder analysis.

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