[논문]Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis

Park, Yukyung; Kim, Chang-Yup; You, Myoung Soon; Lee, Kun Sei; Park, Eunyoung

doi:10.3961/jpmph.14.029

Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis 원문보기

Journal of preventive medicine and public health = 예방의학회지, v.47 no.6, 2014년, pp.298 - 308

Park, Yukyung (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) , Kim, Chang-Yup (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) , You, Myoung Soon (Graduate School of Public Health, Seoul National University) , Lee, Kun Sei (Department of Preventive Medicine, Konkuk University School of Medicine) , Park, Eunyoung (Seoul Metropolitan Government Public Health Policy Institute)

Abstract ▼ AI-Helper

Objectives: To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs. Methods: We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts ('gu's) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. Results: The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively. Conclusions: Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.

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문제 정의

The primary objective of this study was to determine the state of citizen participation that is taking place in public health policy processes in South Korea. In particular, the focus was on local level, not the central government level, policy process; a local community represents the actual field where people are affected by endless encounters with problems and resolutions, including health issues [12].

제안 방법

The survey was conducted via snowball sampling. First, the most readily accessible person in charge of each of the two policy cases from each district was surveyed as a representative of the corresponding health center. A list of agencies that had primary connections to the health center was obtained, and these agencies were surveyed.
The survey was conducted via snowball sampling. First, the most readily accessible person in charge of each of the two policy cases from each district was surveyed as a representative of the corresponding health center.
For the policy-network analysis, the focus was on egocentric network data collection; therefore, data used in previous policynetwork studies were referenced, and a survey that fit the study objectives and cases was constructed [13]. The survey was evaluated through a pilot study and internal meetings of researchers; following these actions, it was distributed to agency representatives or workers responsible for case policies from the agencies identified as participants. The survey consisted of three sections: 1) network participants: the general classification under which the agency belonged, awareness of policy participation, and agencies associated with the policy process; 2) network characteristics: content of exchange between associated agencies (information, resources, and route of exchange), strength, reliability, frequency, and nature (cooperation or conflict); and 3) network formation: reasons for participating in the policy, reasons for exchange between associated agencies, and agencies with influence during the policy participation process.
Even that study was on the analysis of project structure and exploration of development directions and did not cover public participation. Therefore, the present study aimed to identify the pattern of participation in both the public and private sectors by using a policy-network analysis at the community level, which is closely tied to the daily routines of residents, the actual subjects of healthcare, and thereby explored the state of citizen participation and its potential.
At the time of this study (2012), four districts that had completed the establishment of urban sub-health centers within Seoul, the operational status of the metabolic syndrome management programs, and survey accessibility were considered. This resulted in the final selection of two districts, which included four policy-networks, consisting of establishment of an urban subhealth center to examine the policy decision processes and a metabolic syndrome management program to examine the policy implementation process from each of the two districts within Seoul, for the survey.

대상 데이터

The analysis was at the organization level; study participants included all agencies, groups, or organizations (collectively referred to as “agencies” hereafter) from both the public and private sectors that participated or were still participating in each of the policies under study.
The organizations ultimately selected for the analysis were 8 and 9 agencies from districts A and B, respectively, for the urban sub-health center establishment process, and 30 and 32 agencies from districts A and B, respectively, for the metabolic syndrome management program. In the process of the urban sub-health center’s establishment, the participating agencies were 6 out of 8 (75%) from district A and 6 out of 9 (66.
For the metabolic syndrome management program, it covered past one year from the survey. The survey was conducted in July and August 2012. The policy-network analysis consisted of examining the interactions and relationship structures of administrators involved in the policy promotion process in the studied cases.

이론/모형

For the general characteristics and awareness of the agencies, frequency analysis, t-tests, and Wilcoxon rank-sum tests were performed, and for policy-network analysis, social network analysis was used. A social network analysis consists of visualization and analysis of structural properties; visualization, which is considered to have an advantage over other methods of analysis, intuitively displays the connection between the activity performers that exists as numeric data, which may be difficult to understand [15].

성능/효과

The network density of district A’s metabolic syndrome management program implementation process was 6.4%, representing 56 connections out of 870 possible connections, which, when compared to the network of policy-making process for establishment of urban sub-health center, was very low.

참고문헌 (22)

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Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis 원문보기

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