Behavioral Science in Public Policy: Understanding policymaker’s behaviors in policy development

Policymaking consists of complex human behaviors, including those exhibited by policy makers themselves, which can have a major impact on how a policy shapes up and how well it is implemented. Drawing insights from our work in Zambia to understand behavioral elements of decision-making involved in the formulation and execution of a sustainable Voluntary Male Medical Circumcision (VMMC ) policy, we present in this article the role of behavioral research in the context of organisational development and institutional decision-making and what one can hope to achieve from it.

By: Nishan Gantayat

Public Policy is increasingly striving to be impact-oriented, and evidence-based to tackle some of the most pressing problems in public domain such as education, public health, poverty etc effectively. Policy effectiveness can be imagined to be existing at the interaction of policy design and policy implementation which exist within an organisational structure. Policymaking involves a set of individuals, the policy makers, who work within an institutional/organisational setting, involved in designing and implementation of strategy and tactics to reach the intended goal of public welfare. At the heart of these elements are human beings who constantly assess their decisions. This assessment is rooted in complex appraisal mechanisms and is not very straightforward. Exploring behaviors of policy makers can be a step towards developing effective, efficient, sustainable, and relevant policies.

Policy has long been associated with a macro-level approach involving institutional capacity for delivering impact. But it is equally critical to understand the micro behaviors of the stakeholders. In last few years there have been efforts [1,2,3] to push for behaviorally informed policymaking which puts the policy-beneficiary interaction at the heart of policy formulation to make policies more relevant and improve their implementation and sustainability. But there is one interaction that has immense potential in improving policymaking thereby a policy itself, but has not been explored much. And that is the interaction of policy makers with the policy itself during decision-making.

ORGANISATION DEVELOPMENT AND POLICY

Facilitation of a policy takes place through a centralized nodal unit, be it the Ministry of Health (MoH), or a Centre for Disease Control or a National Transportation Council, depending on the policy of concern. Organisation structure of the nodal unit can have a profound effect on the sustainability and effectiveness of a policy. The state of an organisation impacts the formulation and facilitation of a policy. Such as how many levels of internal stakeholders exist within an organisation, operational setting for implementation, or the types of resources available such as the data management system, the performance assessment tool, or the accounting protocol. Policymaking takes place within the boundaries of the organisation. Within the structural boundaries of the organisation there exists the complex interplay of the stakeholder decisions, hierarchical structures, and organisation resources. Hence a crucial element for designing an effective public policy is getting the right picture of the organisation’s as-is and to-be state in alignment with the policy demands. This transition requires analysis of the gap that exists between the two states and then using the results towards building an organisational development (OD) plan.

Organisational Development, a structured organisational change management process, aids the execution of a policy by building the desired state of the organisation. Traditional organisational development models look at an organisation with a focus on more tangible aspects of an organisation like processes, systems, tools, and people. Even the people aspect of organisation is rooted in the broader human resource management theme and is seldom defined in terms of “decision-makers”. But it is within an institutional structure that decision-makers of the organisation make decisions towards policy formulation and subsequently its execution. Conventional approach taken to develop an OD plan lacks a much-ignored micro-level nuance involving the decision-makers who make and execute a policy (the policymakers).

  • How do they make decisions?
  • What are the different types of interactions taking place during policy development? Who are the stakeholders involved in each such interaction?
  • What are the behavioral drivers and barriers that policy makers face while developing a policy?

CASE: VOLUNTARY MALE MEDICAL CIRCUMCISION (VMMC) POLICY-ZAMBIA.

One such policy that we worked on from the standpoint of policy-making behavior was the National Voluntary Male Medical Circumcision (VMMC) policy in Zambia. As part of the broader HIV prevention policy, VMMC is seen as an effective method to reduce infection rates within the population. VMMC program in Zambia, historically, has been donor funded by the likes of President’s Emergency Plan for AIDS Relief (PEPFAR), United States Agency for International Development (USAID), Bill and Melinda Gates Foundation (BMGF) to name a few. But with the donor support not expected to increase [4], such donor-led programs are being sought to be transitioned into government-led and owned programs. And the transition requires policy level support and warrants a multi-year organisational development plan to accompany the implementation of the policy. How a policy looks, what direction it takes, what clauses it encompasses is not a simple calculation involving where VMMC program is and where the program wants to be. For VMMC, the policy is designed and executed within an organisational setting involving MoH’s different levels (national, province and district), implementing partners (IPs) and donors. The policy formulation involves the National MoH, who are in consultation with the international bodies like WHO, and the donors like PEPFAR and Global Fund. Whereas policy execution is heavily dependent on MoH’s sub-national levels (province and district), implementing partner’s and to some extent the donors as well. The ministry’s organisation structure like many is also composed of processes, people, tools, and systems which facilitate the program’s operations. Hence all these stakeholders and components are an essential part while thinking of the future desired state of the VMMC policy.

An organisational development plan is in works to build MoH’s organisational readiness to facilitate this program transition. In our efforts, we adopted a combined approach, coupling behavior science research with the conventional situation analysis to identify and define a set of behaviorally informed organisational gaps in the OD plan. This led to a comprehensive understanding of organisational structure because this approach explored behavioral barriers existing at the policy-makers level and the stakeholder interactions where these barriers can be commonly found within the MoH organisation structure w.r.t VMMC. These behaviorally informed barriers diverge from the conventional tangible-resources focused strategic planning for organisational change. A behaviorally led organisational development takes into consideration the decision-makers, the resources, the context and the interactions involving the decision-makers and resources. For instance, in understanding the changes required in the service delivery aspect of VMMC policy, this approach understands the behavioral facets of decision-making of/between different stakeholders of MoH involved while making decisions either at a strategic level or at a tactical level in the context of specific service delivery goals/tasks. For example, a province level official while making strategic level decisions with the national level on service delivery might align targets and geography to improve policy mandate on program coverage. While at a tactical level province, knowing the ground level situation in the districts, he/she might gravitate to align targets in a way to improve numbers and individual performance than program performance resulting in conflicting priorities. Decision makers might also worry if they have got the necessary agency despite all the resources to execute what is asked thus trying to judge the probability of success. Such considerations alter how a stakeholder might be making the decisions, in expectation, during policy development itself.

Evidence-backed policy design practices have largely been directed at understanding end-user behaviors. The institutional decision-making approach aims to understand behavioral aspects in the policy design and development upstream recognizing that policy development involves decision makers harboring goals, emotions, biases, and heuristics too. Organisational development plans being designed across different countries to facilitate policy changes can be made more robust and relevant by adoption of such combined behavioral science and oragnisational science approach.

References:

  1. https://behavioralscientist.org/applying-behavioral-science-upstream-in-the-policy-design-process
  2. https://www.columbiapublicpolicyreview.org/2020/02/behavioral-science-and-policy-design-a-novel-approach-to-restore-trust-in-the-public-sector/
  3. The Rise and Spread of Behavioral Public Policy: An Opportunity for Critical Research and Self-Reflection
  4. Kates J, Wexler A, Lief E. Donor government funding for HIV in low- and middle-income countries in 2020. San Francisco: Kaiser Family Foundation and UNAIDS; 2021.

Final Mile brings unique and proven capabilities in addressing complex behavioral challenges. As one of the first Behavioral Science & Design consultancies, Final Mile has had the opportunity to bring these to practice in a wide variety of sectors and contexts. We have executed highly complex behavior change projects across a wide variety of areas covering Global Health (HIV, TB, Maternal Health, WASH), Financial Inclusion, Safety across Africa, Asia, Europe, and the US.

Final Mile is also building a pandemic playbook that can be used as a potential toolkit by policymakers and implementors in mitigating Covid19 and future such pandemics.

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