Question

what are the barriers to implementing effective public health policy?

Answer 1

A barrier is an obstacle which prevents a given policy instrument being implemented, or limits the way in which it can be implemented. In the extreme, such barriers may lead to positive policy units being overlooked, and the ensuing techniques being plenty much less effective. For example, demand administration measures are possibly to be essential in large cities as approaches of controlling the increase of congestion and enhancing the environment. But at the identical time they are often unpopular, and cities can also be tempted to reject them sincerely because they will be unpopular. If that selection leads in flip to higher congestion and a worse environment, the method will be much less successful. The emphasis must therefore be on how to overcome these barriers, as a substitute than simply how to avoid them. ECOCITY gives a beneficial illustration of the ways in which such limitations arise, and of how barriers have been overcome.

1. Legal and institutional barriers

These consist of lack of criminal powers to put into effect a precise instrument, and felony duties which are split between agencies, limiting the potential of the metropolis authority to enforce the affected instrument. The survey of European cities in PROSPECTS indicates that land-use, road building and pricing are the policy areas most usually situation to felony and institutional constraints. Information measures are considerably less constrained than other measures.

2. Financial barriers

These include budget restrictions limiting the basic expenditure on the strategy, financial restrictions on particular instruments, and obstacles on the flexibility with which revenues can be used to finance the full range of instruments. PROSPECTS found that avenue building and public transport infrastructure are the two policy areas which are most often subject to economic constraints, with 80% of European cities declaring that finance used to be a fundamental barrier. Information provision is the least affected.

3. Political and cultural barriers

These contain lack of political or public acceptance of an instrument, restrictions imposed by means of pressure groups, and cultural attributes, such as attitudes to enforcement, which have an effect on the effectiveness of instruments. The surveys in PROSPECTS show that avenue constructing and pricing are the two policy areas which are most generally subject to constraints on political acceptability. Public transport operations and data provision are typically the least affected by acceptability constraints.

4. Practical and technological barriers

While cities view legal, monetary and political obstacles as the most serious which they face in imposing land use and transport coverage instruments, there may additionally additionally be sensible limitations. For land use and infrastructure these might also nicely encompass land acquisition. For administration and pricing, enforcement and administration are key issues. For infrastructure, administration and statistics systems, engineering format and availability of technology may also restriction progress. Generally, lack of key capabilities and know-how can be a extensive barrier to progress, and is aggravated via the rapid modifications in the kinds of policy being considered.

How can we overcome barriers in the longer term?

It is frequently harder to overcome legal, institutional and technological limitations in the short term. There is additionally the danger that some institutional and political barriers may get worse over time. However, strategies ideally be developed for implementation over a 15-20 yr timescale Many of these barriers will now not still observe twenty years hence, and motion can be taken to take away others. For example, if new rules would enable more high-quality gadgets such as pricing to be implemented, it can be provided. If break up duties make reaching consensus impossible, new buildings can be put in place. If finance for funding in new infrastructure is justified, the monetary rules can be adjusted. TIPP makes a range of recommendations for longer time period institutional change. Barriers must for that reason be dealt with as challenges to be overcome, no longer truly impediments to progress. A key aspect in a lengthy term method need to be the identification of ways of resolving these longer term barriers