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Healthcare Policy Making Stages

  • Rebecah M. Deguit
Covering assessment criteria:

  • Analyse and discuss the key policy making stages in healthcare policy formation.
  • Discuss areas of policy and politics advocacy healthcare professionals may become involved with.
  • Analyse and discuss decision-making models and processes used to influence decision-making within healthcare.


It is important to understand the policy development process so that as an advocate you can plan the type of input you need in order to have an impact on the final policy. There are five key stages in the health policy-making process. For each of the stages listed, explain what is included in the step and discuss the processes that are undertaken in the stage.



A policy is a set of rules governing a community to achieve a desired outcome. It directs actions and decisions towards certain goals to have the best results. A policy is important in order for individuals to live in harmony within the community.

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As nurses, it is our duty to be advocates not only for our patients, but also to the public in general. We must know and be familiarized that there are existing regulations or policies that may act as an obstruction or opposing our views. To be successful advocates, we should understand these factors so that we may be able to apply or use them properly.


Being advocates, it is essential to have a clear understanding of how the policies are being developed. This is done in order for us to participate in the process. A policy undergoes different processes before it is carried out by the government. Each phase is equally significant as the next. These key stages include:

Problem identification and agenda setting. This is the first step in making a policy. It involves recognizing existing problems, carefully examining those problems and its causes, and doing extensive research and brainstorming of different ideas to find the possible interventions or solutions. Once it has being identified, a list of prioritized plans will be done. This generally happens when a group of people require government action to an issue(s), or when the public do not agree on the processes in addressing certain problems.

Policy formation. There are several potential ways to solve a certain problem so brainstorming is required in formulating a policy. In this process, policy makers come up with new methods of solving the identified problems. People from the legislature and bureaucracy are involved in the process. Among these processes are:

  1. Organize the policy process. In this process, policy makers decide how to manage the development process that will classify the policy’s structure, its major goals, and its priority components. In here, planning of people or groups involved in the process is also recognized.
  1. Identify the main problems. This step in policy-making requires skilled people from different departments to take part in the analysis and give suggestions on what actions to make in order for the problems to be addressed appropriately. After they have come up with a proposal, discussion is then made for them to have a unanimous recommendation to the government.
  1. Make a detailed situation analysis. In this process, there is a need to look at the identified problems more closely and its causes to pinpoint possible interventions, planning what are the things that need to be done first, selection of most appropriate strategies to the desired result is made, and sets a baseline for monitoring and evaluation.
  1. Set goals and objectives for a national health policy. After the existing problems have been identified, setting of attainable as well as realistic goals and objectives are done and planning of suitable approaches towards addressing the main problems is made. An example of this may be the need for accessible essential drugs for everyone in the community. Based on the given example, one possible objective would be to make the drugs affordable and increase the supply of medicines especially in remote areas.
  1. Draft the text of the policy. Once systematic analyses of the main objectives, goals and methods have been made, a draft of the text is arranged. It must contain the overall aim of the policy. Mostly, necessary drugs are guaranteed accessible, safe, and of high quality to the residents. The specific goals should also be discussed. With regards to healthcare, a draft outline of the plan of the national drug policy must be arranged. It must establish the broader purpose of the policy. In general, this is to make sure of the availability, dependability, efficiency, and of high quality of vital drugs for the individuals in the community.
  1. Circulate and revise the draft policy. After the text of the policies have been drafted, they must be disseminated to all the people concerned, primarily within the ministry of health, then in other departments, and lastly to significant organizations and institutions outside of the government in order for them to give their insights or critics. After an extensive discussion of the draft policies is done, they are then edited and finalized based on the suggestions or critics of the different organizations.

Adoption. Following a variety of presented plans, one policy is acknowledged by the decision-makers. The adoption of a policy takes place when the Congress passes legislation. Policy adoption requires a lot of time in that a series of processes are made in order to come up with a complex policy.

Policy implementation. In this stage, the policy is translated into action. It entails circulation of the facts about the adopted policy and implementing it. Checking of financial resources is important to correspond with the plans and interventions that will be implemented. This step also requires proper communication and cooperation to be successful in applying the policy.

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Policy monitoring and evaluation. This is the last step of policy-making wherein the policy is being examined and analyzed if it is really addressing the problem being identified and if the goals and objectives were met. In here, people scrutinize the process and the outcomes of the policy. This stage is an ongoing process and may be a basis for modification in the agenda, policy formation, or its implementation.


Policy-making is then a cyclical and continuous process, with many people being involved in the course of action. The process of creating and adopting laws takes lots of time, and of course, budget. Everyone is influenced by policies in the health care system everyday thus it is important to review them daily so that public’s safety and well-being is assured. As nurses work hand in hand with the clients and their families, primarily they are the ones to assess if the health care system is effective or not in dealing with the needs of the clients.


  • Houghton Mifflin Harcourt. (2014). The policymaking process. Retrieved from:


  • Medscape Multispecialty. (2007). Influencing health care in the legislative arena. Retrieved from: http://www.medscape.com/viewarticle/553404_4
  • UShistory.org. (2008-2014). Policy making: political interactions. Retrieved from:


  • World Health Organization. (n.d.). Health service planning and policy-making: a toolkit for nurses and midwives. Retrieved from:


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