Political Processes

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Health and mental health are social matters, consequently ….. political matters

Governments and Democracy

Investments in health care are often used for political reasons instead of the good of the people.

Experience leaves little doubt that health reform is a highly political process. This is true in less developed countries as well as those in developed countries. It is also true that exporting the "experiences" from developed countries may not always be the best solutions for these less developed countries.

In many countries the very stability of the systems, for example in the US, or in the less developed countries of Nepal and Bangladesh, provide very limited political support for fundamental change. However, this may be a function more of the fact that nothing has been offer to them that is much better than what they have than the fact that the system is "stable."

Any new system that is offered to any country or organization must be worth the efforts needed to implement the system. If what is offered to these countries is merely structural changes without real changes in the outcomes, then there is very little reason to be sincere about making the changes (which is probably now the case with many international development projects).

Reform is more likely to occur if stakeholders can clearly see the benefits.

Information Systems provide information in which public policy can be made in an informed and intelligence manner....yet is this what it is all about? InHCc was told at one time by a major political leader of a country that the first order of business in politics [in his country] was destroying all the "good" projects of his opposition. "We cannot let the people think that the opposition party can implement projects that are successful." This political leader told the story of a very successful housing project that the previous administration had created. As soon as he (the political leader who I was speaking with) was "in power" he was able to "make this project fail." He stated that he then used the same ideas to create his own project so he would get the credit.

This building up and tiring down was depleting the resources of the country. New projects were started under a fanfare of publicity only to be quietly ignored a short time later. Very few projects in the long run were supported successfully.

The last thing that this type of politician wants is information.

Although this politician was one of the smartest men that I have known...and was surviving quite nicely in his environment, it was his environment that allowed and rewarded his destructive behavior.

Many times InHCc has heard the statement, "it will not work because of the politics."

However without Information, this form of politics will continue and there will be no opportunity to change the environment.

In order to bring about a restructuring of this type of environment greater emphasis must be placed on "information" rather than on "politics." With information it is far harder to "fool" the public. It is far harder for a politician to give funding to a clinic because the clinic's manager is a friend when it can be clearly shown that the funding is needed in other locations. With information, "beating the numbers" becomes more important.

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