Multisectoral preventive health services: A retrospective policy analysis model for environmental health
1
Environmental and Occupational Studies, Cape Peninsula University of Technology, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Theoretically, public policies are perceived to be a tool for keeping society's essential needs central; however, in practice, this often fails to be the case.1-3 Disconnections between policy intentions and outcomes can lead to disease outbreaks, disasters, public discontent and costly litigations.4-5 This article explores how to accurately identify the sources and types of these gaps to address discrepancies. This article presents findings from doctoral research that tested a revised Analysis of Determinants of Policy Impact (ADEPT) model as a tool for identifying systemic inconsistencies in delivering preventive health services in a multisectoral local government setting. The model considers policy impact determinants (PIDs) influencing policy outcomes, such as goals, obligations, resources, and opportunities.1
METHODS:
The ADEPT model was tested in South Africa's Western Cape Province, involving five district municipalities (DMs) and six purposively selected local municipalities (LMs). A mixed-methods approach included structured questionnaires for sectoral participants (N = 11) from the selected LMs and environmental health practitioners (EHPs) (N = 135) from the DMs, along with 11 focus group interviews with EHPs at various job levels to get their lived experiences.6
RESULTS:
Results revealed a perceived lack of integration among legal mandates (mandate cognisance) governing environmental health, water provision, sanitation, and solid waste management and their execution. The study confirmed that the revised ADEPT model effectively identifies discrepancies between multisectoral policy intent and operational output at the local government level, which negatively impacts preventive health services at the origin.
CONCLUSIONS:
The findings highlight the need for greater collaboration among sectoral departments responsible for essential municipal services that contributes to health outcomes. The revised ADEPT model can help policymakers, decision-makers, and researchers to bridge the gap between policy intent and practice, that can support more aligned sectoral policies to achieve sustainable preventive health service delivery outcomes.
Theoretically, public policies are perceived to be a tool for keeping society's essential needs central; however, in practice, this often fails to be the case.1-3 Disconnections between policy intentions and outcomes can lead to disease outbreaks, disasters, public discontent and costly litigations.4-5 This article explores how to accurately identify the sources and types of these gaps to address discrepancies. This article presents findings from doctoral research that tested a revised Analysis of Determinants of Policy Impact (ADEPT) model as a tool for identifying systemic inconsistencies in delivering preventive health services in a multisectoral local government setting. The model considers policy impact determinants (PIDs) influencing policy outcomes, such as goals, obligations, resources, and opportunities.1
METHODS:
The ADEPT model was tested in South Africa's Western Cape Province, involving five district municipalities (DMs) and six purposively selected local municipalities (LMs). A mixed-methods approach included structured questionnaires for sectoral participants (N = 11) from the selected LMs and environmental health practitioners (EHPs) (N = 135) from the DMs, along with 11 focus group interviews with EHPs at various job levels to get their lived experiences.6
RESULTS:
Results revealed a perceived lack of integration among legal mandates (mandate cognisance) governing environmental health, water provision, sanitation, and solid waste management and their execution. The study confirmed that the revised ADEPT model effectively identifies discrepancies between multisectoral policy intent and operational output at the local government level, which negatively impacts preventive health services at the origin.
CONCLUSIONS:
The findings highlight the need for greater collaboration among sectoral departments responsible for essential municipal services that contributes to health outcomes. The revised ADEPT model can help policymakers, decision-makers, and researchers to bridge the gap between policy intent and practice, that can support more aligned sectoral policies to achieve sustainable preventive health service delivery outcomes.
| eISSN: | 2654-1459 |
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