Stakeholder Analysis - World Health Organization

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HEALTH REFORMTOOLS SERIESGUIDELINES FOR CONDUCTING AStakeholderAnalysisA Partnershipsfor Health ReformPublicationIn collaboration with:Development Associates Inc. Harvard School of Public Health HowardUniversity International Affairs Center University Research Co., LLC.Abt Associates Inc. 4800 Montgomery Lane, Suite 60020814 Tel: 301-913-0500 Fax: 301-652-3916Bethesda, MDFunded by:The U.S. Agency for International Developmentwww.PHRproject.com

Health Reform Tools SeriesGuidelines forConducting aStakeholderAnalysisPrepared by:Kammi SchmeerAbt Associates Inc.Stakeholder Analysisi

MissionThe Partnerships for Health Reform (PHR) Project seeks to improve people’s health in low- andmiddle-income countries by supporting health sector reforms that ensure equitable access toefficient, sustainable, quality health care services. In partnership with local stakeholders, PHRpromotes an integrated approach to health reform and builds capacity in the following key areas:Better informed and more participatory policy processes in health sector reform;More equitable and sustainable health financing systems;Improved incentives within health systems to encourage agents to use and deliverefficient and quality health services; andEnhanced organization and management of health care systems and institutions tosupport specific health sector reforms.PHR advances knowledge and methodologies to develop, implement, and monitor healthreforms and their impact, and promotes the exchange of information on critical health reformissues.November 1999Recommended CitationSchmeer, Kammi. 1999. Guidelines for Conducting a Stakeholder Analysis. November 1999.Bethesda, MD: Partnerships for Health Reform, Abt Associates Inc.PHR is implemented by Abt Associates Inc., under Contract No. HRN-C-00-95-00024, Project No.936-5974.13, for the United States Agency for International Development (USAID), in collaboration withDevelopment Associates, Inc., Harvard School of Public Health, Howard University International AffairsCenter and University Research Co., LLC.Additional copies of this and other PHR publications can be requested from PHR’s Resource Centervia email at pub [email protected] or downloaded from the project’s website atwww.phrproject.com.iiStakeholder Analysis

Table of ContentsAcknowledgements . vIntroduction . 1Stakeholder Analysis at a Glance . 3Step 1: Planning the Process . 5Step 2: Selecting and Defining a Policy . 7Step 3: Identifying Key Stakeholders . 8Step 4: Adapting the Tools . 10Step 5: Collecting and Recording the Information . 13Step 6: Filling in the Stakeholder Table . 14Step 7: Analyzing the Stakeholder Table . 17Step 8: Using the Information . 20Bibliography . 27Annex A: Sample General List of Stakeholders . 29Annex B: Definitions of Stakeholder Characteristics and Instructions for Fillingin Stakeholder Table . 31Annex C: Sample Stakeholder Table . 33Annex D: Sample Stakeholder Interview Questionnaire . 35Annex E: Sample Information Transfer Reference Chart . 37Stakeholder Analysisiii

ivStakeholder Analysis

AcknowledgmentsI would like to thank Derick Brinkerhoff of Abt Associates Inc. for his guidance in the process ofdeveloping the stakeholder analysis in Ecuador and these guidelines. I would also like to thank PHR’scounterparts in India (Samarthan and the Society for Participatory Research in Asia (PRIA)) and Ecuador(BDO Stern and the Ministry of Health) for assisting in the development and implementation ofstakeholder analyses exercises in their respective countries. Their input was a valuable contribution toPHR’s experience in conducting stakeholder analyses, which led to the development of these guidelines.Stakeholder Analysisv

Introduction“Politics,” as much or more than technicalinformation, drives health sector reform. This is trueat the sector, institutional and facility levels, wherepolitics directly affects the ability of policymakersand managers to develop and implement necessaryreforms. Yet many policymakers and managers inthe health sector are not trained to deal with“politics” nor is there information available on howto manage the political process inherent to healthsector reform.In developing this document, Partnerships forHealth Reform (PHR) addresses one aspect ofmanaging the “politics” of the reform process: theneed for information on key players who have aninvestment in proposed reforms. Policy makers andmanagers can use stakeholder analysis to identifythese key players or “stakeholders;” predict whetherthey might support or block the implementation ofhealth reforms; and develop strategies to promotesupportive actions and decrease opposing actionsbefore attempting to implement major reform at thenational, regional, local, or facility level.The purpose of this document is to help policymakers, managers, and their working groupsconduct an “objective” and systematic process forcollecting and analyzing data about key healthreform stakeholders. It should be noted, however,that even with application of these guidelines andthe systematic methodology presented here,information produced by a stakeholder analysis isalways somewhat subjective since it is based onwhat stakeholders communicate to analysts. Theseguidelines, however, do include suggestions forchecking the consistency of answers and othermechanisms to ensure that information is obtainedand analyzed as objectively as possible.Stakeholder AnalysisThis document was developed based on athorough review of the stakeholder analysis, politicalmapping, and policy process literature, as well asactual PHR field experience in conductingstakeholder analyses. (Health reform stakeholderanalyses were conducted with PHR support inEcuador and India). The result is a document withinstructions and tools that are supported byacademic theory and real-life application.These guidelines present a methodology thatyields useful and accurate information on healthreform stakeholders. (This methodology can befollowed even when conducting a stakeholderanalysis with limited time or resources.) Theinformation resulting from the analysis can be usedto do the following:Provide input into other analyses (i.e.,strategic planning, institutionalassessment, broader political analyses);Develop action plans to increase supportfor a reform policy; orGuide a participatory, consensus-buildingprocess (by sharing the informationobtained with the stakeholders andencouraging discussion on how to addressthe concerns of the opposition).The application of these guidelines is intendedto result in policy makers and managers who aremore informed about the political environmentsurrounding their reforms and are better prepared totake action to ensure the full implementation ofhealth sector reforms.1

2Stakeholder Analysis

Stakeholder Analysis at a GlanceWhat is stakeholder analysis?Stakeholder analysis is a process ofsystematically gathering and analyzing qualitativeinformation to determine whose interests should betaken into account when developing and/orimplementing a policy or program.What are the steps instakeholder analysis?The following are the major steps in theprocess:Planning the processWho is a stakeholder? Actors (persons ororganizations) who have a vested interest in thepolicy that is being promoted are consideredstakeholders in the process. These stakeholders or“interested parties” can usually be grouped into thefollowing categories: international, public, nationalpolitical, commercial/private, nongovernmentalorganization (NGO)/civil society, labor, and users/consumers.Selecting and defining a policyWhich stakeholder characteristics areanalyzed? Characteristics such as knowledge of thepolicy, interests related to the policy, position for oragainst the policy, potential alliances with otherstakeholders, and ability to affect the policy process(through their power and leadership) are analyzed.The subsequent sections of this documentdescribe each of these steps in terms of suggestedactions and tools to be used to conduct stakeholderanalysis around a health reform policy or program.Why is this analysis useful? Knowing who thekey actors are, their knowledge, interests, positions,alliances, and importance related to the policyallows policy makers and managers to interact moreeffectively with key stakeholders and increasesupport for a given policy or program. By carryingout this analysis before implementing a policy orprogram, policy makers and managers can detectand act to prevent potential misunderstandings and/or opposition to the implementation of the policy orprogram. A policy or program will more likelysucceed if a stakeholder analysis, along with otherkey tools, is used to guide its implementation.Stakeholder AnalysisIdentifying key stakeholdersAdapting the toolsCollecting and recording the informationFilling in the stakeholder tableAnalyzing the stakeholder tableUsing the informationWhat can be achieved withstakeholder analysis?Stakeholder analysis yields useful and accurateinformation on health reform stakeholders. Thisinformation can be used to provide input into otheranalyses; to develop action plans to increase supportfor a reform policy; or to guide a participatory,consensus-building process.To increase support or build consensus forreform, policy makers and managers must takeadditional steps following the stakeholder analysis.They should use the information generated by thestakeholder analysis to develop and implementstrategic communication, advocacy, and negotiationplans or to hold consensus-building workshops.3

What resources does stakeholderanalysis require?The resources needed for conducting astakeholder analysis are: personnel time, travelmoney, access to a phone, copy machine andcomputer, and interview materials (paper and pens).The amount of resources needed will dependmainly on the number of stakeholders to beinterviewed and how much travel is required toconduct these interviews. As a reference point, anational-level stakeholder analysis that interviews35-40 stakeholders requires a four-person teamworking full-time for about two months, dependingupon how quickly the interview appointments aremade. The working group should consist of at leasttwo persons who are skilled interviewers,knowledgeable about the health sector, able toanalyze qualitative information, and computerliterate. For analyses involving a smaller number ofstakeholders, fewer resources are required.4Stakeholder Analysis

Steps for ConductingStakeholder AnalysisStep 1: Planning the ProcessDefine the purpose of the analysis andidentify uses for the resultsThe first step in conducting a stakeholderanalysis is to define the purpose of the analysis,identify the users of the information, and devise aplan for using the information. A discussion of theseissues should be led by the “sponsor,” or initiator, ofthe stakeholder analysis and should include thepotential users of the information.Information generated from stakeholder analysismay serve several purposes: to provide input intoother analyses; to inform the development of actionplans to increase support for a reform policy; or toguide a participatory, consensus-building process.Other activities, such as strategic planning,institutional assessments, or application of specificcomputerized programs like PolicyMaker,1 oftenrequire information on who the stakeholders are,what their positions are related to a policy, howimportant they are, and so forth. Since stakeholderanalysis generates this type of information, it wouldbe useful if such an analysis were conducted inconjunction with the aforementioned activities.Policy makers and managers may use theresults obtained through the stakeholder analysis toinform the development of their action plans. Theseplans should identify concrete, and possibly “behindthe scenes,” actions that the policy makers andmanagers will implement to increase stakeholdersupport.Finally, policy makers and managers may usethe results in open discussions with stakeholders inan effort to build consensus. Stakeholder analysisinformation can be used in this process to allow thestakeholders to see a reflection of where they arerelative to others and to encourage discussion onhow to address the oppositio