Problematizations in health policy: questioning how “problems” are constituted in policies
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(Published version)
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2016
Authors
Bacchi, C.
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Journal article
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Sage Open, 2016; 6(2):1-16
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Carol Bacchi
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Abstract
This article directs attention to the significance, for health promotion advocates, of reflecting on how “problems” are constituted, or brought into existence, as particular sorts of problems, within policies and policy proposals. To this end, it introduces a poststructural analytic strategy called “What’s the Problem Represented to be?” (WPR approach), and contrasts this perspective to the ways in which “problems” are commonly conceptualized in health policy analyses (e.g., “a problem stream,” “wicked problems”). Such a perspective offers a significant rethinking of the conventional emphasis on agenda setting and policy-making processes in considering the meaning of success or failure in health policy initiatives. The starting point is a close analysis of items that are “successful,” in the sense that they make the political agenda, to see how representations of “problems” within selected policies limit what is talked about as possible or desirable, or as impossible and undesirable. This form of analysis thus enables critical reflections on the substantive content of policy initiatives in health policy. The article takes a step back from policy process theories, frameworks, and models to offer reflections at the level of paradigms. Highlighting potential dangers and limitations in positivism, interpretivism, and critical realism, it uses international, Australian, and South Australian examples in health policy to explore what poststructural policy analysis contributes to understanding the broad political influences shaping contemporary modes of rule.
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Published 22 June 2016
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© The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).