Policy Transfer Literature

This chapter draws on literature from the fields of political science, public policy, and organisational management to outline a conceptual framework for policy transfer and learning based on Dolowitz and Marsh policy transfer framework (Dolowitz and Marsh 1996). This framework is then used to structure a review of policy transfer literature in the fields of hospital accreditation and how it transferred to LMICs.

Policy transfer and lesson-drawing are about the exchange of policies and/or practices already in operation in one jurisdiction to another. While some studies of transfer look at drawing lessons across-time, the main focus is about how practices can and may cross jurisdictions (Page 2000).

Literature touch on four related main issues as described by Page (2000): a) the operation of the policies or practices in the country from which lessons are to be drawn (the “exporter” jurisdiction); b) the identification of these policies or practices as worthy of emulation by other countries (the “importer” jurisdictions); c) the application, whether in modified form or not, of the policies or practices in the importer jurisdictions; and d) the operation of the policies in importer jurisdictions.

Policy transfer was defined by Dolowitz (2003) as “a process by which a policy and/or a program resulting from a political system is transferred in whole or in part and with a few adaptations, by the policy‐makers to another political system who have the responsibility of collating and analysing the information and insuring the drafting of a public policy”. As Rose (1991) identifies, transfer results as governments search for remedies to problems. Remedies may involve allocating more funds for an existing program, looking at how that nation dealt with a problem in the past, or searching elsewhere to determine how others have dealt with the problem (Stone 1999).

The emphasis of the policy transfer literature (Dolowitz and Marsh 1996) has tended to be on understanding the process by which policies and practices move from exporter to importer jurisdictions. The main object of the analysis is to throw light on decision making processes. This is not to say that the purpose is purely intellectual, an understanding of the process may also have direct practical implications — that some ways of transferring policies and practices are better or worse than others. The focus of this literature is on issues b) and c) — the processes of decision making in the importer jurisdictions.

On the other side, the term “lesson-drawing” can be conceptualized as a form of policy transfer, mostly the voluntary policy transfer (Rose 2006).Generally, a policy ‘lesson’ is defined as ‘more than a symbol invoked to sway opinion about a policy and more than a dependent variable telling a social scientist what is to be explained. A lesson is a detailed cause-and-effect description of a set of actions that government can consider in the light of experience elsewhere, including a prospective evaluation of whether what is done elsewhere could someday become effective here’ (Rose 1993).

The emphasis of the lesson-drawing literature (Rose 1993) is on understanding the conditions under which policies or practices operate in exporter jurisdictions and whether and how the conditions which might make them work in a similar way can be created in importer jurisdictions. Here one of the main objects is to engage in policy transfer — to use cross-national experience as a source of policy advice. However, the practical purposes are also supplemented by the academic theoretical objective of understanding the distinctive political, administrative, social, economic or cultural conditions that sustain cross-national policy differences. For example, to examine how French patterns of family policy might be applied to Greece generates an understanding of the way in which broader cultural values affect family policy in both nations (Hantrais 1997). In the lesson-drawing literature, the focus of the analysis is on issues a), c) and d): how policies operate in the exporter jurisdiction, how they may be applied in the importer jurisdiction and what modifications are needed to transpose between them.

Lesson-drawingimplies that political actors or decision makers in one country draw lessons from one or more other countries, which they then apply to their own political system (Dolowitz and Marsh 1996). Rose’s research in the 1990s show that the important features of the process of lesson-drawing are the circumstances surrounding the learning of lessons from other sources, the extent to which they are adopted, and, crucially, the impact they have on the new policy environment. His research is worthy in its descriptive understanding of policy development and can be used to explain certain aspects of the process of transfer. The research demonstrates who has relationships with whom and it can describe how these relations effect on the making of policy (for example, why some actors are influential and others are not). In addition, in 1993, he explores how lessons are drawn through policy-makers’ dissatisfaction with the status quo and decisions that a program elsewhere may be capable of being put into effect in their environment (Rose 1993). Furthermore, the decisions are based on searching for the means to pursue goals in a systematic and comprehensive manner, reviewing policy in the light of past experience and any other available information to make adjustments where necessary (Hill, 1997; Howlett and Ramesh 1995).

There are some variables that should be considered when we study policy learning and transfer. The variables covered in the literature are related to the very basic questions of who, what, why, and where policy transfer takes place based on the Dolowitz and Marsh framework (Table 3).

The first variable in the policy transfer literature is the question of “why” countries borrow, one from the other. Policy analysts deploy the policy transfer approach as a generic concept that encompasses quite different claims about why public organisations engage in policy learning. Typically, policy transfer analysts refer to three different processes of transfer: voluntary transfer or lesson-drawing; negotiated transfer or indirect coercive transfer; and direct coercive transfer (Dolowitz 1998, Rose 2006).