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Table 1 Framework for assessing what factors affect national agenda setting, adapted from the Shiffman and Smith framework

From: Access to infertility care services towards Universal Health Coverage is a right and not an option

Elements

Description

Factors shaping policy priorities

Actor power

The strength of the individuals and networks concerned with the issue

1. Policy community cohesion: the degree of coalescence in the network involved with the issue

2. Leadership: the presence of individuals capable of uniting the policy community, acknowledged as strong champions

3. Guiding institutions: effectiveness of organizations or co-ordinating mechanisms

4. Civil society mobilization: the extent to which grassroots organizations are mobilized to support action

Ideas

The ways in which those involved with the issue understand and portray it

1. Internal frame: the degree to which the policy community agrees on the definition of, causes and solutions to, the problem

2. External frame: public portrayals of the issue in ways that resonate with external actors, especially the political leaders who control resources

Context

The environment in which actors operate

1. Policy windows: political moments when conditions align favorably for an issue, presenting opportunities for advocates to influence decision makers

2. Global governance structure: the degree to which norms and institutions operating in a sector provide a platform for effective collective action

Issue characteristics

Features of the problem

1. Credible indicators: clear measures that show the severity of the problem, which can be used to monitor progress

2. Severity: the size of the burden relative to others

3. Effective interventions: the extent to which proposed means of addressing the problem is explained, cost effective, backed by scientific evidence, simple to implement and inexpensive

Outcome

Helps to judge how strongly the issue is on the agenda

Decision in the policy process that leads to change: e.g. allocation of resources should be broken down into financial, technical and human resources