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Ideas and Policy Implementation : Understanding the Resistance against Free Health Care in Africa

Les Cahiers du CIRDIS | Collection Recherche | No 2014-01

Daniel BÉLAND, Ph.D. (University of Saskatchewan)
Valéry RIDDE, PhD (University of Montreal)

Abstract
The main objective of this article is to draw attention to the potential role of ideas in policy implementation, an issue that has been relatively neglected in the contemporary literature on ideas and public policy. First, the article presents a review of this literature, which stresses the limited attention to implementation among students of policy ideas. Next, the article illustrates its main claims about the role of ideas in policy implementation through a discussion of policy implementer resistance against the removal of health-care user fees currently taking place in sub-Saharan Africa. In addition to making a contribution to the study of ideas in public policy, the article helps fill a gap in the literature on health and policymaking in Africa, in which studies about policy implementation remain rare. It is hoped this exploratory article will trigger more research on the relationship between the ideas of actors and policy implementation processes, in Africa and well beyond.

Acknowledgments
The authors thank Bonnie Campbell, Bernard Taverne, Lucy Gilson and Pierre-Marc Daigneault for their comments and suggestions. Daniel Béland acknowledges support from the Canada Research Chairs Program and Valéry Ridde from the Canadian Institutes of Health Research (CIHR).