1.4. The policy-making process 

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. Perhaps you have identified a need for a policy and want to advocate for it to be put on the agenda. Your approach will be different to that needed if you want to be involved in the formulation, adoption, implementation or evaluation phases of the process. So what are the phases of the policy development process? 

The five key stages in the health policy-making process are: 

• Problem identification and agenda setting, in which policy problems are defined and the policy agenda set. Here it is acknowledged that public problems will only reach the political agenda if they are converted into political "issues". This usually occurs when an interested group demands government action on a problem, or when there is public disagreement over ways in which a problem should be addressed. 
• Policy formation is the stage in which policies are created or changed. Policies are products of the political context within which they are developed. It is useful to understand policy formation as a social and political process in order to conceptualize how policies are formulated. 
• Adoption is the stage when the policy is enacted, or brought into force, for example, by state or federal legislation. New or changed public policies are often adopted by means of a decision of the cabinet, or indeed of an individual minister, without any legislative change. 
• Policy implementation includes the actions and mechanisms whereby policies are brought into practice, that is, where what is written in the legislation or policy document is turned into a reality. In this stage the content of the policy, and its impact on those affected, may be modified substantially, or even negated. In analyzing this stage in the policy-making process, one needs to examine how, when and where particular policies have been implemented. 
• Policy evaluation, the final stage in the policy-making process, includes monitoring, analysis, criticism and assessment of existing or proposed policies. This covers the appraisal of their content, their implementation and their effects. Moreover, evaluation is designed to help governments to implement policies in an effective and efficient manner.