Addressing the theoretical, practical and ethical challenges inherent in prospective health policy analysis

As a function of the inherently political nature of health policy, there have long been calls for, as well as guidance on, analysis of its political dimensions to inform practice. Yet there are few accounts in the literature of systematic attention to real-time documentation and analysis of political-economy factors and feedback to engender reform. The dearth of such prospective policy analysis is perhaps understandable given the many intrinsic difficulties in such an enterprise. This paper provides an outline approach of how researchers might work together with advocacy coalitions (or other political actors) to document and analyse the efforts of such coalitions to use policy analysis to influence the policy processes-agenda setting, policy formulation and policy implementation-in which they engage. In so doing, it identifies challenges based on reviews of the theoretical, methodological and empirical literature as well as the experience of the author. The aim of the paper is to generate debate to assist in resolving the myriad challenges inherent in prospective policy analysis. The paper responds to appeals for political research which addresses the problems confronting political actors so as to guide future action-research for evidence-informed, pro-poor health policy.