Public health policy at the frontline: a comparative perspective

Materialized, “real” policies are seldom if ever fully congruent with the politically agreed upon, “theoretical” policy decisions. As an implication, it is crucial to analyze implementation processes in order to understand whether policies adequately address the important problems they are designed to resolve. This collection of three papers combines and con-fronts top-down and bottom-up views on discretion, and illuminates the latter’s use and effects from differing angles and at different stages of the policy cycle. The first study of this collection asks how four European Union member states use their discretion to adapt EU veterinary drugs directives to domestic contexts during transposition – an unexplored phenomenon which the author labels “customization”. The second study analyzes how street-level bureaucrats implement policies at the frontline, refining the often taken-for-granted assertion that lacking resources negatively affect output performance. The third study explores the role of policy instruments for relatives’ refusal rates to organ donation, asking how context influ-ences the policies’ capacity to resolve the underlying policy problem. The studies presented here not only move forward the study of implementa-tion processes, but also illustrate the potential of recently developed qualitative comparative techniques to tackle the empirical challenges sur-rounding implementation research. “This is truly an excellent thesis; the applicant demonstrates very sharp research skills, both theoretically, empirically and methodologically. Her research combines robustness, sound designs, methodological innova-tiveness and transparent academic communication.” Benoît Rihoux, Université catholique de Louvain “Her papers are outstanding examples of doing justice to the complex and multifaceted ways policies are implemented and impact on target groups. (…) Ms. Thomann’s findings add new knowledge to the literatures on transposition, street-level implementation and effects of policy instruments.” Fritz Sager, University of Bern