Local implementation of public health policies revealed by the COVID-19 crisis: the French case.

Publication date: Jun 23, 2023

Improving health system performance depends on the quality of health policy implementation at the local level. However, in general, the attention of researchers is mainly directed towards issues of health policy design and evaluation rather than implementation at the local level. The management of the COVID-19 crisis, especially in Europe, has particularly highlighted the complexity of implementing health policies, decided at the national or supranational level, at the local level. We conducted 23 semi-structured interviews with the main stakeholders in the management of the COVID-19 crisis in the second largest French region in order to identify the different actors and modes of coordination of the local implementation of health policies that this crisis management illustrates in a very visible way. Our methodology is complemented by a content analysis of the main guidelines and decisions related to this implementation. The analysis of these data allows us to identify three levels of implementation of health policies at the local level (administrative, organizational and operational). Interviews also reveal the existence of different types of coordination specific to each of these levels of local implementation of health policies. These results then make it possible to identify important managerial avenues for promoting global coordination of these three levels of implementation. Although research on health services emphasizes the existence of several levels of local implementation of health policies, it offers little in the way of definition or characterization of these levels. The identification in this study of the three levels of local implementation of health policies and their specific forms of coordination contribute to a more precise characterization of this implementation in order to promote, in practice, its global coordination.

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Concepts Keywords
Covid Coordination
French Covid
Global Crisis
Therapy Existence


Type Source Name
disease MESH COVID-19
disease IDO quality
pathway REACTOME Reproduction
drug DRUGBANK Indoleacetic acid
disease VO USA
disease IDO process
disease VO document
drug DRUGBANK Trestolone
disease IDO facility
drug DRUGBANK Etoperidone
disease VO effective
disease VO Gap
disease VO effectiveness
drug DRUGBANK Serine
drug DRUGBANK Spinosad
disease VO organ
drug DRUGBANK Etodolac
disease MESH substance abuse
disease IDO intervention
disease VO organization
disease VO time
drug DRUGBANK Hexadecanal
disease VO Ply
disease MESH retirement
disease MESH emergency
disease MESH panic
disease VO population
disease VO efficiency
drug DRUGBANK Nonoxynol-9
disease VO Equity
drug DRUGBANK Sulfasalazine
drug DRUGBANK Gold
drug DRUGBANK Coenzyme M
disease VO disorder treatment
disease MESH AIDS
drug DRUGBANK Diethylstilbestrol
drug DRUGBANK Calusterone

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