This study describes the policymaking process and policy solutions enacted in the Kentucky Postsecondary Improvement Act of 1997 (or House Bill 1). The study employs both an historical recounting of the story of House Bill 1 and a narrative analysis of opinion-editorials and policymaker interviews to reveal and explain how political power comprised both the perennial problem of Kentuckys higher education policymaking and the tool with which conflicts over power distribution were resolved. The study uses three theoretical frameworks (the Multiple-Streams, Punctuated-Equilibrium, and Political Frame) to explore the rise of restructuring on Kentuckys policymaking agenda, its most contentious issue (separation of community college governance from the University of Kentucky), and how the conflict engendered by this issue was resolved. Use of rigorous investigative methods and theoretical frameworks resulted in understandings of not only what drove the policymaking effort but also the strategies that enabled the initiative to rise on Kentuckys policymaking agenda and to be enacted. The study concludes: (1) the presence of a policy entrepreneur increases the likelihood of a strong change effort (and to its success if that entrepreneur is the governor); (2) issue definition, or redefinition, is key to reform efforts; and (3) while prior higher education policy studies and K-12 reform may soften up and prepare the policy community for discussions of reform, they have not been shown to affect the proposal development or enactment phases of a higher education restructuring initiative. Additional insights emerged from looking at the Kentucky case, informed by those of Kentucky Education Reform Act (KERA) before it, and of similar initiatives in Ohio and Illinois. This review suggests: 1. The impetus and leadership for significant change to a higher education system will likely arise externally versus internally 2. Redefining the issues of higher education in a way that changes participants perspectives and positions is an important factor in building support and opposition to an initiative. 3. Restructuring efforts, either intentionally or unintentionally, will ultimately have to address perceived and/or real power imbalances among institutions and between institutions and state agencies. 4. Redistributing power within a higher education system constitutes a change, but not necessarily an improvement to the system. The study concludes that opportunity data, research, and rational arguments to inform policy development from academia to inform and influence elected officials occurs very early in the start of a reform initiative or even years prior. It also finds the opportunity for influence diminishes as debate over policy alternatives and enactment increases. This suggests reluctance on the part of academia to include elected officials in the issues of the campus may reduce opportunities for data, research and rational arguments to influence the opinions, policies, and decisions of elected leaders. The study recommends: (1) that academia should become more engaged, on a substantative and continuing level, with elected leaders, and (2) that researchers focus on how elected leaders form their ideas on higher education and how these influence and result in policy and political positions.

International air transport is a commercial business by nature but carries a political significance. It has been regulated under the Chicago regime which requires the sovereignty governments to negotiate and determine how airlines engage in the transnational operations regardless of the market demand. Policy makers will have to take into account all factors, whether at international, domestic, institutional and individual levels, in determining to what extent the market should be liberalised so as to protect their national interest, optimise the opportunities for their industry and society as a whole, while at the same time promote competition and facilitate international trade. Despite the vast research that has been done on the liberalisation of international air transport as well as China‘s aviation policy and its industry, little is known about the considerations of Chinese government when formulating its international air transport policy, e.g. what are the variables that have influenced the country‘s policy making process that leads to the policy per se. The focus of the existing literature fails to treat China‘s international air transport policy as a subject matter for an objective and comprehensive analysis, but rather takes the policy itself as an external stimulus that drives the radical changes of the industry. Consequently, China‘s policymaking process with respect to international air transport remains a black box and its international behaviour is considered unpredictable. Applying the Micro-Macro Linkage Approach to three case studies, i.e. China-the US, China-the Netherlands and China-the UK markets, this research analyses China‘s liberalisation policy with respect to international air transport. By examining the data gathered through qualitative methods such as historical files and record, observations, and interviews with those who have participated in the process of policymaking and have been personally involved in bilateral air services negotiations, this research aims at identifying the factors that have had an impact on the country‘s policymaking process, establishing whether these factors are evolving over the years and determining how they are interacting with each other in leading to the policy outcome, hence, shedding light on the country‘s international trade policymaking and its international behaviour. The research has revealed that China‘s international air transport policymaking is both a top-down and bottom-up process with industry regulator being the primary initiator, formulator and administrator of the industry-specific liberalisation policy. Its decision making process has become more transparent, plural, open for and subject to both external and internal influences at all levels. International environment including international conventions, laws and regulations have formed a framework within which the country has to operate to develop its overall national policy. Bilateral political and economic relationship has played a pivotal role in shaping the country‘s policy on that specific country-pair market. Domestic considerations such as national interest, benefits to the society, industry and consumers as a whole are the fundamental concerns in determining the policy scope, i.e. to what extent the market should be liberalised and the pace of such liberalisation. Stakeholders are increasingly proactive in its involvement in the policymaking process in an attempt to influence the policy makers to their own optimal benefits. Institutions and personal characteristics do shape individual policy makers‘ mindset and perceptions but only to the extent of affecting the negotiation outcome on the bilateral country-pair markets. These factors have been evolving over the years and are time- and circumstance-constrained, namely, some factors may function at one occasion at a certain time but not necessarily at another. This research is a meaningful endeavour in attempting to understand China‘s policymaking process with respect to international air transport as an international trade in services, which has just received growing interest in both academia and industry practitioners in recent years. It will contribute to the knowledge of the study of China and the study of international air transport at large.

During the last decade, there has been growing international interest in generating new knowledge regarding understanding, developing and evaluating mechanisms that support the use of research evidence by policymakers as a strategy to strengthen health systems in low-and middle-income countries (LMICs). This thesis contributes to this knowledge through three original scientific contributions that employ a mixed methods approach, with the goal of supporting the use of research evidence in the Colombian health system. Specifically, in the chapters I present: 1) the development of an analytical schema that explains the conceptualization of the Colombian government, research funder and universities of an evidence-informed health system; 2) two case studies that explain whether and how political factors influenced the role of research evidence in the agenda-setting and policy-development stages of two past health policy decisions in Colombia; and 3) a protocol for a randomized controlled trial evaluating the effectiveness of a multifaceted intervention in increasing the utilization of an evidence service and the intention to use synthesized research evidence by policy advisors and analysts at the Colombian Ministry of Health. As a whole, the chapters presented in this thesis provide substantive, methodological and disciplinary contributions to the field of health systems research and particularly to the study of efforts that aim to support evidence-informed policy in LMICs. They also help to provide insights that can be utilized to support a more nuanced approach to the use of research evidence in LMICs that takes into account the many factors that can influence health system policymaking. Ideally, this will help those engaged in developing mechanisms to support the use of research evidence in the policy process, and contribute to stronger health systems across the world. / Thesis / Candidate in Philosophy

Though it is often taken for granted with an assumed naturalness, settler colonial sovereignty relies on the settler state’s realization of Indigenous territorial dispossession, and the erasure of indigeneity. More than singular or historical events, dispossession and erasure are ongoing, and are best understood as contemporary, and structural, features of settler governance because of the continued existence of Indigenous nations. As a result, seemingly stable settler states (such as Canada) are in a constant state of insecurity, due to Indigenous nations’ competing claims of authority. As such, settler states are continually working to (re)produce their own sovereign authority, and legitimacy. This text argues that knowledge is central to the (re)production of settler sovereignty, and hence, settler colonialism. Understood this way, knowledge is both produced and also productive. What we ‘know’ is not only framed by the cosmologies and ontologies through which we make meaning of the world, but it also serves as an organizing tool, structuring what interventions we imagine to be possible. Focusing on government policymaking, this text documents the erasure of Indigenous knowledges, cosmologies, and imaginaries from settler colonial governance practices. It does so through an analysis of the Aboriginal Peoples’ Survey, the settlement of, and territorial allotment in, British Columbia and provincial land management policies such as the Forest and Range Evaluation Program. Using this empirical work, it argues that this erasure enables the reification of settler imaginaries over Indigenous territory, which in turn creates the conditions within which settler colonial authority is legitimized and sovereignty continually remade through policy interventions. While the text largely centres on territory in what is today Canada, it also offers a view into the way in which (settler) coloniality more broadly is continually upheld and remade. Indeed, when viewed through the lens of a global colonial order, the continual remaking of settler sovereignty enables the constitution of international and global politics. / Thesis / Doctor of Philosophy (PhD) / For many, Canada as a multicultural and inclusive country stretching from the Pacific to the Atlantic Oceans, and north to the Arctic circle is taken for granted. However, what we recognize as Canada in 2020 has only existed since the 1999 formation of the Territory of Nunavut, and even the territory that comprises Canada only came into formation with Newfoundland and Labrador’s 1949 entry into Confederation. This is to say that Canada in its current form is not natural. Rather, it was constructed over time through the incorporation and colonization of Indigenous lands and territories. This dissertation argues that despite an official discourse of reconciliation with Indigenous peoples, and the need to renew settler Canada’s ‘most important’ relationship, colonization remains ongoing. Looking to federal demographic statistics and provincial land use and management policy, it argues that settler authority being continually re-made through the government knowing Indigenous peoples and their territories in ways that legitimize colonization as the normal pursuit of “peace, order and good government.”

There have been an increasing number of calls emphasizing the need to use the best-available research evidence to inform health system policies and, in response, efforts have been made in many countries to develop and implement policy-support organizations (PSOs) to enhance the use of research in policymaking. However, there is a paucity of evidence regarding both the best approaches for the successful establishment of such organizations. Moreover, there are very few attempts to consider how approaches can be applied in particular contexts, and operationalized by policymakers and stakeholders in their efforts to support EIPM through the establishment of PSOs. This dissertation incorporates a mix of methodological approaches to address this gap. First, in chapter two, a critical interpretive synthesis was used to develop a conceptual framework that can guide the process of establishing a PSO or similar entities. The framework outlines the stages in the process of establishing a policy support organization and the contextual factors at the political-, research- and health-system level that influence this process. Second, in chapter three, the framework from the CIS was used to inform the design of a survey tool and interview guide used in a sequential mixed methods study to enrich the framework by soliciting insights from those with practical experience with developing and operationalizing PSOs in real-world contexts. Specifically, this study provides insights into the approaches and strategies for each stage in the establishment process for a PSO. Lastly, in chapter four, the findings from chapter two and three were used -- along with in-depth one-on-one semi-structured interviews with policymakers, researchers and stakeholders who are familiar with the Omani system -- to develop a model for an Omani knowledge translation department, which can be used in a future co-design process for activating the department. The dissertation chapters build on each other and make substantive, methodological, and theoretical contributions. Substantively this dissertation clarifies and defines key concepts that are essential to enable a rich understanding of the process of establishing a PSO. It highlights that the process of establishing such an organization is iterative and can be influenced by multiple contextual factors that affect the individual approach that has been used to support evidence-informed policymaking. Methodologically, this dissertation is the first study of PSOs that uses a mix of conceptual framework generation, insights from a wide range of fields such as organizational development, and empirical approaches that adopt mixed methods to derive fulsome answers to specific questions about establishing PSOs. Theoretically, this dissertation provides a conceptual framework that can be used to inform the process of establishing a PSO in different contexts. The theoretical constructs of this framework were verified and strengthened through direct application in subsequent studies in the dissertation. This dissertation has many implications for policy and research. Most importantly, for those interested in establishing a PSO, my findings provide a road map for identifying the most appropriate starting point and the factors that might influence the establishment process. In addition, leaders of existing PSOs can use my findings to expand or refine their scope of work. Given that this framework focuses only on PSOs in the health sector, an important next step for research will be to include other sectors and identify any additional insight that can enhance the framework I have developed. / Thesis / Doctor of Philosophy (PhD) / Health system policymaking is a challenging task because many factors need to be balanced in policy decisions (e.g., efficiency, equity, and politics). There have been an increasing number of calls emphasizing the need to use the best-available research evidence to inform health system policies and, in response, efforts have been made in many countries to develop and implement approaches to enhance the use of research in the policymaking process. In some instances, organizations have been given sole responsibility for supporting evidence-informed policy, but evidence is limited to inform the process of establishing these organizations. This dissertation addresses this gap in the literature by: I) developing a new conceptual framework for the process of establishing organizations that can support evidence-informed policymaking; ii) identifying approaches that can be used in this process; and iii) developing a model for a proposed Omani knowledge translation department using this framework.

In the U.S. Congress, the authorization-appropriation process is the formal model that establishes the separation between legislative and funding bills. Additionally, it determines the jurisdiction of the congressional committees that oversee those bills. However, a number of scholars have concluded that the authorization-appropriations dichotomy is substantially different in practice than the model suggests. Research in this area has shown that broad changes over the years have altered the roles of the authorization and appropriations committees. At different times, members of the appropriations committees have been regarded as guardians of the federal treasury, advocates of federal funds for their congressional district, or partisans in support of a political agenda (Adler, 2000). In addition to these roles, appropriators evidently have become more active in policymaking -- a role that traditionally has been the domain of the authorizing committees. To further explore the policymaking role of appropriators, this dissertation used a case study approach that traced appropriators' interactions with the executive branch, focusing on a federal agency and its links with the appropriations subcommittees that have oversight and funding jurisdiction over the agency's programs. Specifically, the study analyzed the relationship between the House and Senate Subcommittees on Labor, Health and Human Services, Education, and Related Agencies (L/ HHS) and the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) during the period from 1989-2009. Through an examination of critical incidents and contextual elements, this dissertation examined whether the Subcommittees on L/HHS increasingly have become significant players in shaping AHRQ's policies and direction. In addition, the dissertation examined the impacts on AHRQ and possible reciprocal [Agency] influences on the Subcommittees. This research has the potential to build on existing works related to the dynamics of the authorization-appropriations process. Moreover, this research could provide a conceptual framework for analyzing the roles that the other congressional appropriations subcommittees play in relation to the executive branch agencies under their jurisdictions. / Ph. D.

Introduction The main aim of the study was to explore the technical capacity of members of the 12 Sector Human Resource Development committees of the Human Resource Development Council in the management of evidence-based policymaking in the course of implementing the national and sector-specific Human Resource Development plans for all matters of national human resource development. The study set out to contribute to the urgency and growing importance of research evidence as the basis for making informed policy and practical decisions across the world. There is a significant research gap in understanding how members of the Human Resource Development committees, as policymakers in the context of this study, use research-based evidence in the course of developing Human Resource Development plans. There is limited understanding of the factors that may induce or constrain members of the committees to use research-based evidence in implementing the national and sector-specific Human Resource Development plans. Methodology The study adopted an exploratory, sequential, inductive mixed methods approach in addition to the deductive use of the Canadian Institutes of Health Research (CIHR) knowledge-to-action framework. The target participants for the study were the members of the 12 Sector Human Resource Development committees of the Human Resource Development Council who were asked to complete a questionnaire. The questionnaire elicited respondents’ perceptions about their capacity to adapt knowledge generated; identify inhibiting/ facilitating factors; assess and approve research evidence and sustainable use of research evidence. Qualitative data was collected through conducting interviews with the chairpersons of the committees. The scope of the in-depth interview questions covered respondents’ perceptions on the same key areas as in the questionnaire. This was to allow respondents to express their feelings during the in-depth discussions without any limitations. Findings The insights based on the perceptions of chairpersons and members of the committees in this current study have revealed the areas for possible improvement in managing evidence-based policies in the context of Botswana. Issues that emerged with respect to the perceptions of respondents to adaptation of research evidence included packaging and presenting research evidence; lengthy reports and use of complex language; lack of understanding of the policymaking context by researchers, and inversely, policymakers not understanding the research process; lack of collaboration and engagement between researchers and policymakers; and lack of implementation plans. Issues that related to the perceptions of respondents on factors that may inhibit or facilitate the use of research evidence entailed positive attitude towards evidence-based policies; development of policy briefs; difficulty in accessing research articles, databases and journals; building policymakers’ ability to search for relevant research evidence; insufficient time to read and evaluate research articles; lack of organisational support; and authority and decision-making power. Concerning respondents’ perceptions on assessing and approving research evidence, issues raised covered skills in interpreting the research evidence; policymakers being generalists; lack of appraisal criteria and guidelines; and training on appraising research evidence being more theoretical than practical. As for the strategic interventions suggested to sustain evidence-based policies, respondents highlighted the need for skills development for both researchers and policymakers; participation of policymakers in the research process; and provision of incentive schemes. Conclusions In conclusion, the findings of the current study show that all the sub-constructs of adaptation of research evidence, factors inhibiting or facilitating the use of research evidence, and assessing and approving the quality of research evidence are significantly and positively related to research evidence informing policy and practice. Overall, the insights emerging from this current study provide conceptual tools to use research evidence to inform policy and practice. The study sought to complement and advance the literature on the field of evidence-based policy management, essentially contributing to the research-policy interface in Botswana context. Botswana, as an emerging economy, is still grappling with understanding the dynamics of evidence-based policy management. There is still a need to initiate, develop and sustain evidence-based policy management through strategic interventions. The insights gained from the current study can be used as a basis for future research. / Educational Management and Leadership / Ph. D. (Educational Leadership and Management)

This study explores the global health diplomacy phenomenon by focusing on how and why health is integrated into foreign policy. Over the last decade or so, precipitated primarily by a growing concern about the need to strengthen global health security and deliver on the Millennium Development Goals, foreign policymakers have been paying more attention to health as a foreign policy concern and several countries have adopted formal global health policy positions and/or strategies. To elucidate a deeper and clearer understanding of how and why health is integrated into foreign policy, this thesis used a case study research design that incorporated literature and document review and interviews with twenty informants to conduct an in-depth analysis of the United Kingdom’s (UK) Health is Global: A UK Government Strategy 2008-13. Health is Global represents the first example of a formal national global health strategy developed using a multi-stakeholder process. Briefer background case reviews of three nations that are leaders in global health diplomacy - Brazil, Norway and Switzerland, were also conducted to inform the analysis of the in-depth case. Policy analysis included categorizing data into five areas: context (why?), content (what?), actors (who?), process (how?) and impact (so what?). The Multiple Streams Model of Policymaking and Fidler’s health and foreign policy conceptualizations - revolution, remediation and regression - were used to analyze the findings. Based on this analysis, the primary reason that the countries examined have decided to focus more on global health is self-interest - to protect national and international security and their economic interests. Investing in global health was also seen as a way to enhance a state’s international reputation. In terms of self-interest, Brazil was an outlier, however. International solidarity and health as a human right have been the driving forces behind its long-term investment in development cooperation to date. Investing in health for normative reasons was also a prevalent through weaker theme in the UK, Swiss and Norwegian cases. The study highlighted the critical role that policy entrepreneurs who cross the domains of international relations and health play in the global health policymaking process. In regards to advancing a conceptual understanding of global health diplomacy, the findings propose that the whole-of-government global health policymaking process is a form of global health diplomacy. The thesis elucidated factors that underpin this process as well as lessons for other nations, in particular, Canada. While ascertaining the impact of national global health strategies was not the main objective of this thesis, the study provided an initial look at the impact of these policy instruments and processes. Such impacts include better collaboration across government actors leading to enhanced policy coherence and a more strategic focus on global health. Finally, some have argued of late that the global health revolution is over due to the current world economic crisis. Considering the level of interest in whole-of-government global health strategies and the ever growing and sophisticated world-wide global health policy community, based on this thesis, the global health revolution is alive and well.

My research focuses on the experience of policy development and implementation. It draws on my involvement in a government policy taskforce, the development of an organisation’s strategy to the taskforce’s recommendations and the commissioning of frontline services. The research material is my personal experience contained in a number of narrative accounts of important happenings. These are then used as a basis to engage with literature and conversation with practitioners, academics and fellow researchers. It is from this iterative process that the argument develops. The approach is therefore qualitative and reflexive in nature. I have argued against the traditional separation between the content of research and methodology. This is on the basis that human experience does not distinguish between the two as we make sense of new emerging situations. The research has been heavily influenced by analogies drawn from complexity sciences as a way of increasing our understanding of ongoing human interaction, namely complex responsive processes of relating (Stacey et al, 2000). By paying careful attention to the experience of policy development and implementation over an extended period of time I am illuminating that the development of policy can often be seen in literature and in the techniques people use as an activity that is isolated from the work of frontline staff. For example, a policy group is formed, policy or a strategy is drafted and the work is then seen to be done. This can be demonstrated by paying attention to the modus operandi of how policy and strategy groups work and how performance criteria are established. When it comes to frontline practice, policy is often silent to the multitude of unfolding interconnected possibilities that present themselves to practitioners as they seek to go about their activities. The way that policy is often presented implies that there is linearity from policy to implementation. Drawing on Elias’s notion of Involvement and Detachment (1987) I am highlighting a paradoxical relationship between policy and implementation. In introducing the notion of paradox, there is a “vitality” that is required to prevent a collapse to one of the two ends of a continuum; for example a conscious or unconscious rejection of policy in favour of embracing frontline practice, or an over reliance on policy to blindly drive through organisational change. In spending three years looking at the policy and implementation I argue that it is more helpful to consider policy and implementation as a “flow”, rather than a series of discrete activities that are seen to be completed before moving to the next policy area. In looking at policy as something that occurs over a span of time (as opposed to an isolated bounded activity) there is an opportunity to prevent the collapse of the paradox outlined above. By accepting the concept of paradox and considering policy from a temporal perspective, rather than one that is a spatially bound system, the issue of policymaking practice can be considered. There are books and management experts that recommend that managers should “walk the walk”, and get closer to frontline activity. My research has sought to add clarity here, arguing for an experiential and temporal form of reflexivity of practice (as opposed to reflective practice). In this context working and being present with frontline practitioners, paying very careful attention to the experience of the unfolding contingent nature of activity influences the practice of policy making. This is a different experience from simply being present, and being seen to be present. It would be ironic for my research to be converted into a policy document with key elements extracted and condensed into bullet points to be applied like a rule. Instead my research is best kept alive in evoking stories and reminiscences between people as they make sense of their experience of policymaking and implementation together.

Le Mozambique est un ‘donor darling’ depuis l’indépendance en 1975, et plus particulièrement depuis les Accords de paix en 1992. En matière de conservation de la nature, des bailleurs de fonds internationaux prennent une part active à l’action publique, depuis la conception de la réglementation jusqu’à la gestion quotidienne de parcs nationaux. L’action publique est de fait transnationale : elle est sous-tendue par des narrations, des financements et des acteurs exogènes. Ce travail étudie ce phénomène au sommet de l’Etat, c’est à dire à l’échelle des élites administratives du ministère du tourisme (en charge des questions de conservation) et de deux parcs nationaux (Gorongosa et Limpopo). Grâce à une lecture sociologique de l’action publique, nous montrons combien les élites mozambicaines se situent dans une zone grise : elles s’attachent à mettre en œuvre les feuilles de route de bailleurs qui les rémunèrent (telle la Banque mondiale), mais elles affichent dans le même temps une loyauté vis à vis du parti-Etat Frelimo, au pouvoir depuis l’indépendance. Ainsi, leur maîtrise voire leur partage des visions du monde des bailleurs en matière de conservation va de pair avec leur inscription nationale : la mise en œuvre d’agendas pour partie exogènes n’est pas incompatible avec l’affirmation d’un périmètre des compétences de l’Etat. En d’autres termes, notre hypothèse consiste à penser l’action de ces élites comme participant certes de la transnationalisation de l’action publique, mais également de l’affirmation de l’Etat qui reste au centre du jeu, malgré ses faibles capacités. De manière a priori contre-intuitive, le processus de domination étatique peut se poursuivre sous un régime d’aide, lequel peut même donner lieu à un (re)déploiement de la souveraineté de l’Etat. / Mozambique is a donor darling since independence in 1975, and more particularly since the Peace Agreement in 1992. As far as nature conservation is concerned, international donors take part to policymaking, including law making and daily management of national parks. Policymaking is thus transnational: narrations, funding and exogenous actors underline it. This work analyses this phenomenon at the top of the state, that is taking specifically into consideration administrative elites working in the tourism ministry (which is in charge of conservation matters) and in two national parks (Gorongosa and Limpopo). Thanks to a sociological study of policymaking, we show how Mozambican elites are located in a grey zone: they respond to donors (such as the World Bank), which pay them, but they are at the same time bound to the party-state Frelimo, at the head of the country ever since independence. Their mastery of donors’ worldviews goes together with the affirmation of a state’s perimeter of competences. In other words, our hypothesis considers these elites as taking part to the transnationalisation of policymaking, but simultaneously as asserting the state as a central actor, in spite of its weak capacities. In a counter-intuitive way, the state domination process can take place in an aid regime, which can even give birth to a (re)deployment of state sovereignty.