Analysis On The Implementation Strategy For "Health In All Policies" Based On Policy Change Analysis

Objectives: In view of the complexity of multi-sectoral cooperation involved in the implementation of "Health in All Policies"(hereinafter referred to as HiAP).This study takes "Tobacco Control" as the theme of policy change analysis,and understands the role played by various government departments,non-governmental organizations and individuals in policy change,as well as the core beliefs,resources and external environment that influence their policy orientation.On this basis,the implementation strategy of HiAP is put forward to promote the landing of HiAP in China as soon as possible.Methods: Taking "China's Tobacco Control" as an example,this paper chooses the Advocacy Coalition Framework(ACF)to analyze the policy changes of China's tobacco control actions from 1978 to 2018,finds out the government departments involved,deeply analyses the cooperation and game among departments and the backgrounds,measures and policy orientations of their actions,and puts forward the core strategies for the implementation of HiAP in China--multi-ministries.On this basis,this paper combs the strategies and models of HiAP implementation in foreign countries through literature review,and summarizes the advantages,disadvantages,opportunities and challenges of HiAP implementation in China by SWOT analysis.Finally,it puts forward the implementation strategies of HiAP in China based on the above results,expert consultation and field interviews.Results:1.China's tobacco control action covers many government departments,such as health,industry,civil affairs,finance,development and reform,education,transportation,industry and commerce,quality control and so on.It basically coincides with the participation of government departments in the implementation of "Health in All Policies".The enlightenment of the case of "China's tobacco control" on the implementation strategy of HiAP in China includes:(1)the implication value of "health" elements in the field of political policy in China is relatively low,and "health belief" is not well received in all sectors.Improving the "health belief" of alliance departments and neutral departments,such as education,sports,environment and civil affairs,is to achieve the goal.(2)When the core beliefs conflict,it is not appropriate to use moderate means to mediate,but to seek higher-level strength assistance and take tough measures.In the design of organizational structure,the participation of government leaders at all levels,such as the State Council,provinces and municipalities,is essential.(3)When implementing HiAP,we must first analyze the resources that each department has and rationally allocate the tasks of each department in promoting the implementation of HiAP.(4)In addition to government departments,HiAP requires the participation of non-governmental forces,such as professional NGOs,experts and scholars in various fields,the news media and the general public under the influence of policies.2.Overseas implementation strategies of HiAP mainly include:(1)Finland's cross-sectoral cooperation strategy;(2)Ukraine's temporary agency strategy;(3)Thailand's legislative model;(4)South Australia's "health prism analysis".3.SWOT analysis of China's implementation of HiAP shows that:(1)The advantage lies in the high cohesion of political decision-making.Sustainable development has become the mainstream of economic transformation.The continuous improvement of residents' health literacy promotes their understanding of the diversification of health influencing factors.(2)The disadvantage lies in the difficulty of multi-sectoral coordination,the absence of a fundamental law in the field of health and health,and the difficulty in implementing the whole process of health impact assessment.(3)Opportunities lie in the promotion of HiAP into the national health work policy.Governments at all levels attach great importance to it.Related research discussions are gradually increasing.Successful cases in the world are used for reference.WHO has issued a special "National Action Framework for Integrating Health into All Policies" to guide policy implementation.Sports,education,civil affairs,environmental protection and other departments are powerful policy support.(4)The challenge is that there are still conflicts of interest between some departments and the health sector,and there is no mature and specific operational mechanism and implementation path,which can easily become slogans and ideas in form.4.The implementation strategies of HiAP in China include:(1)Legislation should be taken first,and the relevant content of HiAP should be added to the existing health-related bills.(2)From the national level,an integrated cross-sectoral Committee based on top-level design should be established at all levels.(3)Combining top-down with pilot projects.(4)Conduct a whole-process health impact assessment to assess the policies formulated by various departments.(5)Implement differentiated conflict reconciliation to minimize or indirectly resolve conflicts of interest.Conclusions: "Health in All Policies" is an important principle that must be adhered to in the future development of our country.It is also an important policy that urgently needs to be landed on some special issues as soon as possible,such as tobacco control and environmental protection.Through the analysis of policy changes in the process of tobacco control in China and SWOT analysis of the implementation of HiAP in China,it is found that the core of HiAP in China lies in coordinating interdepartmental beliefs and interests and fully realizing multisectoral cooperation.It is necessary to establish a comprehensive coordination mechanism from the top to the bottom,and establish a multisectoral cooperation committee under the legislative background.Membership system,carry out the whole process of health impact assessment,differentiate contradictions and reconciliation.At the same time,in view of some areas where the resistance to reform is greater and the promotion of policies is difficult,on the basis of the existing implementation strategy of HiAP,we should integrate the existing deliberative and coordinating bodies,carry out external independent health impact assessment,change the consciousness from top to bottom from the leading cadres,and improve and optimize the strategies for key breakthroughs in key departments,so as to better promote them.HiAP has landed in China in an all-round way.