Making Policies Work
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Making Policies Work

First- and Second-order Mechanisms in Policy Design

Edited by Giliberto Capano, Michael Howlett, M Ramesh and Altaf Virani

Policy design efforts are hampered by inadequate understanding of how policy tools and actions promote effective policies. The objective of this book is to address this gap in understanding by proposing a causal theory of the linkages between policy actions and policy effects. Adopting a mechanistic perspective, the book identifies the causal processes that activate effects and help achieve goals. It thus offers a powerful analytical tool to both scholars and practitioners of public policy seeking to design effective policies.
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Chapter 5: How neglecting policy mechanisms can lead to policy failure: insights from public–private partnerships in Indias health sector

Altaf Virani and M Ramesh


Policy design involves deliberate decisions about the choice of policy instruments and their optimal configurations for producing desired policy outcomes. Understanding the causal logic through which instruments influence actors to behave in ways consistent with overarching policy goals is critical for success. public–private partnership (PPP) has emerged as a popular instrument due to its promise to combine the advantages of both the public and private sectors. However, PPPs can compound rather than overcome the shortcomings of both if not carefully designed. In this chapter, the authors review the experience of healthcare PPPs in India, and examine issues of policy coherence, contract design, policy capacity and regulation to identify common sources of failure. Based on the analysis, they highlight five levels of failure: goal definition, instrument selection, calibration, implementation and learning. We argue that policy failures are a result of failure to identify and leverage underlying causal mechanisms to design effective interventions.

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