Doctoral Dissertation Research: The Making and Circulation of a Policy in Bolivia

University Of California-Berkeley, Berkeley CA

Investigators

Abstract

Doctoral student Alissa Bernstein (University of California, Berkeley), with the supervision of Dr. Charles Briggs, will undertake research on the relationship between the making of public policy and its implementation. While the two processes generally are regarded as distinct phases, Bernstein will explore the possibility that they may be closely intertwined, informing each other as a circuit. This study will offer insights into how new policy ideas emerge and how they may alter entrenched practices and improve outcomes. To investigate these questions, Bernstein will conduct a twelve-month study of the planning, making, revising, and implementing of major health reform policy in Bolivia, Salud Familiar Communitaria Intercultural (SAFCI). The researcher will examine how this policy is shaped and possibly changed as it circulates within different sectors of the Bolivian health care system. Data will be gathered at two public clinics and two worker health insurance clinics. The researcher will employ a variety of social science methodologies, including ethnographic interviews, participant observation, and epidemiological analysis. As an institutional ethnography, the research will be carried out in offices, meetings, conferences, workshops, and clinics where policies may be generated, debated, circulated, revised, and implemented.The overarching research questions are: (1) Can the reform policy-making process be truly collaborative? If so, who is involved and how does this approach impact the form of policy that emerges? (2) How does the context of a particular sector or community shape the ways that policy is interpreted, rewritten, and implemented for use? (3) What are some of the measurable outcomes of reform policy implementation and what areas are facing problems or resistance? In addition to contributing to social science theory, findings from this research will have practical application, in the health field and beyond. This study is innovative in that it looks not just at policy outcomes, but also takes an original approach to understanding processes of policy formation. Though often marginalized in these debates about public policy, many observers argue that Latin America has recently generated some of the most creative ideas and undertaken significant pervasive transformations, which makes Bolivia an ideal site for pursuing these questions. Funding this research also supports the education of a graduate student.