Assessing the utility of Kingdon’s multiple streams framework for studying policy implementation : a case study of mobile hospitals in Lusaka Province, Zambia

Kabwe, Kabaso (2019-12)

Thesis (PhD)--Stellenbosch University, 2019.

Thesis

ENGLISH ABSTRACT: Despite policy implementation research being 30 years and having been analysed using various perspectives, very few have analysed it using Kingdon’s (1984) multiple streams framework. Whether the framework can be applied to analyse stages of the policy process such as policy implementation has been debated in policy studies. The few studies which have applied the framework have mainly used it to analyse policy implementation from the perspective of explaining a policy implementation gap. This research uses the framework to assess its utility for furthering our understanding of policy implementation, using mobile hospitals in Lusaka Province, Zambia as a case. The study argues that the multiple streams framework in its current state does not provide an adequate lens through which to study policy implementation in this context due to its limited focus on the impact of institutional factors on policy. Access to health care services for all is one of the main challenges facing the Zambian health system. Mobile hospitals were introduced in 2011 to help address inequities in accessing health care in rural areas. Using qualitative methodology and data collection methods such as observation, key informant in-depth interviews, and a review of several secondary sources, this dissertation sought to answer the main question, “What is the value of Kingdon’s multiple streams framework for studying policy implementation?” The study found that while the framework was not comprehensively illuminating in certain aspects, it was however valuable as it brings into focus the agenda setting and policy formulation stages of the policy process when studying policy implementation which other approaches to implementation do not necessarily do. Doing so helps to provide a better understanding of policy implementation. The study argues that a study of policy implementation using a multiple streams framework must begin by examining the political structure in which actors operate. To enable a contextualised understanding of policy implementation, the study, therefore, modified the framework by placing institutional factors at the centre of the political stream because they affect policy implementation in contexts where executive power is strong and other institutions and non-state actors are weaker. This means that the president, as head of the executive has significant impact on policy implementation, and the influence of other actors is limited. The study contributes to policy implementation literature and to debates on refining the multiple streams framework to address some of its limitations.

AFRIKAANSE OPSOMMING: Ten spyte daarvan dat die implementeringsnavorsingsveld meer as 30 jaar oud is en vanuit verskeie perspektiewe al ontleed is, is min ontledings al gedoen met Kingdon (1984) se veelvoudige-strome raamwerk. Hierdie raamwerk word beskou as een van die mees invloedrykste analitiese raamwerke om kontemporêre openbare beleidsprosesse te verstaan. Of die raamwerk toegepas kan word om die fases van die beleidsproses, soos die implementering van beleid, te ontleed, is in beleidstudies bespreek. Die min studies wat die raamwerk toegepas het, het dit hoofsaaklik gebruik om implementering te analiseer vanuit die perspektief van die leemte vir die implementering van beleid. Hierdie navorsing gebruik die raamwerk om sy nut te evalueer om ons begrip van beleidsimplementering te bevorder, deur gebruik te maak van mobiele hospitale in Lusaka Provinsie, Zambië as ‘n gevallestudie. Dié studie beweer dat die veelvoudige-strome raamwerk in sy huidige toestand nie ‘n toereikende lens bied waardeur beleidsimplementering in hierdie konteks bestudeer kan word nie, as gevolg van die beperkte fokus op die impak van institusionele faktore op beleid. Toegang tot gesondheidsorgdienste vir almal is een van die grootste uitdagings wat die Zambiese gesondheidstelsel in die gesig staar. In 2011 is mobiele hospitale dus bekendgestel om ongelykhede aan te spreek om toegang tot gesondheidsorg in landelike gebiede te kry. Deur middel van kwalitatiewe metodologie en data-insamelingsmetodes soos waarneming, in-diepte onderhoude met sleutel-informante en ‘n oorsig van verskeie sekondêre bronne, beoog die proefskrif om die hoofvraag te beantwoord: “Wat is die waarde van Kingdon se veelvoudige-strome raamwerk vir die bestudering van beleidsimplementering?” Die studie het bevind dat die raamwerk waardevol is omdat dit fokus op agenda-instelling en beleidsformuleringsstadia van die beleidsproses wanneer daar gekyk word na beleidsimplementering wat ander benaderings tot implementering nie noodwendig doen nie. Dit help om ‘n beter begrip van beleidsimplementering te gee. Die studie beweer dat ‘n studie van beleidsimplementering deur die veelvoudige-strome raamwerk moet begin deur die hele politieke struktuur waarin akteurs werk, te ondersoek. Om sodoende ‘n meer kontekstuele begrip van beleidsimplementering moontlik te maak, het die studie die raamwerk verander deur institusionele faktore in die middel van die politieke stroom te plaas omdat dit beleidsimplementering beïnvloed in ‘n konteks waar die uitvoerende gesag sterk is terwyl ander instansies en nie-staatsinstellings akteurs swak is. Die studie het bevind dat die president as hoof van die uitvoerende gesag in hierdie verband aansienlike impak het op beleidsimplementering en die invloed van ander akteurs word deur politiek en magsdinamika beperk. Die studie dra by tot die beleidsimplementeringsliteratuur en debatte oor die verfyning van die raamwerk om sodoende van sy beperkings aan te spreek.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/107289
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