Chapter 2
The Health Reform Cycle
1.
Introduction
In Chapter 1 we introduced the idea that health sector reform can be viewed as a cycle.
Now we want to analyze that process in more detail. In idealized form, the process of policy
change moves through a cycle of six stages—problems are defined, a causal diagnosis is made,
plans are developed, a political decision is made on reform initiatives, those reforms are then
implemented, and their consequences are evaluated. The cycle then begins again…
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