Figure 5
The process of decision making – The source of actors influence over the implementation of an ITN subsidy scheme – 1998 – 2001. Source of influence figures adapted from; Gilson L., Doherrty J., Lake S., Mcintyre D., Mwikisa C and Thomas S.2003. The SAZA study: implementing health financing reform in South Africa and Zambia. Hlth Policy and Planning. 18 (1): 31–46. Political resource – described here as the influence that the stakeholder has on the ITN subsidy scheme through direct or indirect interaction with government officials. Government here is denoted as 'public institutions in which collective decisions are made into laws that affect the whole society; parliament, the executive, the bureaucracy, ministries or departments of state (Walt, 1994)'. Technical resource – described here as the inherent technical expertise that the stakeholder has that would be critical to the implementation of the policy or by virtue of the stakeholders position in relation to the implementation of the policy. For example the presence of the Tanzania Net Manufacturers in the country providing a market for mosquito nets. Financial resource – the stakeholders influence over the economic situation. For example, Promotional Service International conducting social marketing of ITNs in the remotest parts of the country, or DFID availing financial support towards social marketing initiatives. Number of ticks indicates relative level of influence derived from source: 3 ticks = high influence; no tick = no influence. For example the influence of the Chief Medical Officer derived from technical source was due to his authoritative position as the lead advisor in health within the Ministry of Health and as a Chairperson of the steering committee of the Tanzania National Voucher Scheme. While the influence of the Tanzania Net Manufacturers derived from technical source is their expertise in the local production of mosquito nets, hence the availability of the public health commodity within the country locally. Values/behaviours refers to the differing behaviours of the actors (e.g. rooted in clear principles or values, tactical and strategic, expressing commitment). For example the CSSC was highly committed to PPPs as a general health policy and was spearheading it so that it could be institutionalized; however it perceived that the ITN subsidy scheme had not adequately involved Faith Based Organizations at the grass root level