Table 3.
Mechanisms of impact specific to policy dialogues
| Policy dialogue indicators | Clarification or definition | Relating question |
| ‘Theme—environment’ | ||
| Location | The location the policy dialogue takes place. | Was the room/location suitable? |
| Moderation/ facilitation |
How well the dialogue was moderated; this is key to having meaningful and comprehensive discussions. | How was the moderation? Who was moderating? Why was this person selected? |
| Technical/material conditions | Such as PowerPoint presentation, video, paper/report/information package provided, catering (lunch/snacks/reception). | How were technical/material conditions? |
| ‘Theme—content’ | ||
| High-priority issue | An issue of local, regional, national and international concern. | Was it a high-priority issue (for dialogue participants)? |
| Clear meeting objectives | This goes hand in hand with a clear vision of what outcomes and results would be expected. | Were clear meeting objectives set? |
| Information shared | A pre-circulated information package, including the agenda, evidence summaries, a list of policy directions to be discussed, related background information and an evaluation form. | Which information was shared with participants (in advance, during and after policy dialogue)? |
| Evidence used | Synthesis of high-quality research evidence used to identify needs and educate participants: policy dialogue discussions and participants need to be based on effective stakeholder and context analyses, part of which is evidence-based background information. | Was evidence used/presented in the meeting? |
| Agreement on outcomes and action plan | List of possible and tangible actions or steps. | Was agreement reached on outcomes and action plan? |
| Rules of engagement | The format of the meeting and rules of engagement (giving a clear overview of purpose, participants, design, method and materials). | Was there a formal or informal format? What was the set-up or rules? |
| Preparation of content | The materials created for the policy dialogue and the management of the event of the meeting overall. | Was the policy dialogue well-prepared? |
| Follow-up | The continuation of the policy dialogue, in terms of ongoing communication of next steps and engagement, to keep the momentum alive and renew or regenerate the project’s or programme’s goals.14 | Was there proper follow-up (on next actions, next meeting, evidence/information shared)? |
| ‘Theme—participants’ | ||
| Representation | The stakeholder groups represented or excluded. A mix of participants and stakeholders representing all perspectives and interests: representation of decision-makers, researchers and those affected by the issue under discussion (user/patients groups, formal and informal caregivers). | Which stakeholder groups were represented? Which were excluded? |
| Participation | Social participation requires all stakeholders in the participatory process to be able to adequately and fully exercise their roles. In order to do so, all stakeholders should be, as far as possible, on an equal footing with each other in terms of ability to have influence on the participation-based discussions.73 | Was there equal participation of stakeholders during the discussion? Who participated more? Who participated less? |
| Collaboration | The process of two or more people or organisations working together to complete a task or achieve a goal. | How was the collaboration between stakeholders? |
| Consensus | General agreement on something (by most participants). Five steps in the consensus-building process are: convening, clarifying responsibilities, deliberating, deciding and implementing agreements. | Was consensus reached between stakeholders on a certain issue? |
| Trust | Firm belief in the reliability (or ability) of someone, relational | Was there trust between stakeholders? |
| Mutual respect | Mutual respect is defined as a proper regard for the dignity of a person or position; due regard for each other’s feelings, wishes or rights. | Was there mutual respect? |
| Willingness to implement | Gore et al distinguish three types of commitment,74 namely: expressive commitment, institutional commitment and budgetary commitment. ‘Expressed commitment refers to verbal declarations of support for an issue by high-level, influential political leaders. Institutional commitment comprises the adoption of specific policies and organisational infrastructure in support of an issue. Finally, budgetary commitment consists of earmarked allocations of resources towards a specific issue relative to a particular benchmark. The combination of the three dimensions signals that a state has an explicit intention or policy platform to address this health area.’ | Was there willingness to implement a discussed strategy or action? If yes, which strategy and who showed this will to implement? Type of political commitment? (expressive/financial/institutional (ie, policy)?) How has COVID-19 influenced political will towards NCD care? |
| Leadership | The willingness to initiate, convoke or lead an action for or against the health reform policy.75 | Which stakeholder displayed the most leadership? |
| Urgency | The degree to which stakeholder claims call for immediate attention.76 | Which stakeholder displayed the most urgency? |
| Legitimacy | A generalised perception or assumption that the actions of an entity are desirable, proper or appropriate within some socially constructed system of norms, values, beliefs and definitions.76 | Which stakeholder displayed the most legitimacy? |
| Ownership | Act, right or degree of ownership (possession) and responsibility (taken by the resource/implementing organisation, community and/or beneficiaries) towards any programmes or activities | Which stakeholder had most ownership over the issue? |
NCD, non-communicable disease.