ArticleBMC health services research2018
Elusive implementation: an ethnographic study of intersectoral policymaking for health.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Governance of Intersectoral Collaborations for Population Health and to Reduce Health Inequalities in High-Income Countries: A Complexity-Informed Systematic Review.International journal of health policy and management · 2022Pooled it
- 'When global health meets global goals': assessing the alignment between antimicrobial resistance and sustainable development policies in 10 African and Asian countries.BMJ global health · 2025Article
- Converging global health agendas and universal health coverage: financing whole-of-government action through UHC.The Lancet. Global health · 2023Review
- Policy analysis of the protection of Iranian households against catastrophic health expenditures: a qualitative analysis.BMC health services research · 2023Article
- Intersectoral Collaboration to Promote Child Development: The Contributions of the Actor-Network Theory.Qualitative health research · 2023Article
- Factors of the policy process influencing Health in All Policies in local government: A scoping review.Frontiers in public health · 2023Article
- Theory-based capacity building intervention for intersectoral action for health at local governments: An exploratory pilot study.Journal of advanced nursing · 2022Article
- Addressing Policy Coherence Between Health in All Policies Approach and the Sustainable Development Goals Implementation: Insights From Kenya.International journal of health policy and management · 2022Review
- Beyond numbers, coverage and cost: adaptive governance for post-COVID-19 reforms in India.BMJ global health · 2021Article
- Factors influencing delivery of intersectoral actions to address infant stunting in Bogotá, Colombia - a mixed methods case study.BMC public health · 2020Article
- Reducing Health Inequities Through Intersectoral Action: Balancing Equity in Health With Equity for Other Social Goods.International journal of health policy and management · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor more than 30 years policy action across sectors has been celebrated as a necessary and viable way to affect the social factors impacting on health. In particular intersectoral action on the social determinants of health is considered necessary to address social inequalities in health. However, despite growing support for intersectoral policymaking, implementation remains a challenge. Critics argue that public health has remained naïve about the policy process and a better understanding is needed. Based on ethnographic data, this paper conducts an in-depth analysis of a local process of intersectoral policymaking in order to gain a better understanding of the challenges posed by implementation. To help conceptualize the process, we apply the theoretical perspective of organizational neo-institutionalism, in particular the concepts of rationalized myth and decoupling.
methodsOn the basis of an explorative study among ten Danish municipalities, we conducted an ethnographic study of the development of a municipal-wide implementation strategy for the intersectoral health policy of a medium-sized municipality. The main data sources consist of ethnographic field notes from participant observation and interview transcripts.
resultsBy providing detailed contextual description, we show how an apparent failure to move from policy to action is played out by the ongoing production of abstract rhetoric and vague plans. We find that idealization of universal intersectoralism, inconsistent demands, and doubts about economic outcomes challenge the notion of implementation as moving from rhetoric to action.
conclusionWe argue that the 'myth' of intersectoralism may be instrumental in avoiding the specification of action to implement the policy, and that the policy instead serves as a way to display and support good intentions and hereby continue the process. On this basis we expand the discussion on implementation challenges regarding intersectoral policymaking for health.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.