Power analysis in health policy and systems research: a guide to research conceptualisation.

Power is a growing area of study for researchers and practitioners working in the field of health policy and systems research (HPSR). Theoretical development and empirical research on power are crucial for providing deeper, more nuanced understandings of the mechanisms and structures leading to social inequities and health disparities; placing contemporary policy concerns in a wider historical, political and social context; and for contributing to the (re)design or reform of health systems to drive progress towards improved health outcomes. Nonetheless, explicit analyses of power in HPSR remain relatively infrequent, and there are no comprehensive resources that serve as theoretical and methodological starting points. This paper aims to fill this gap by providing a consolidated guide to researchers wishing to consider, design and conduct power analyses of health policies or systems. This practice article presents a synthesis of theoretical and conceptual understandings of power; describes methodologies and approaches for conducting power analyses; discusses how they might be appropriately combined; and throughout reflects on the importance of engaging with positionality through reflexive praxis. Expanding research on power in health policy and systems will generate key insights needed to address underlying drivers of health disparities and strengthen health systems for all.

Political priority of oral health in India: analysis of the reasons for neglect.

OBJECTIVES: To examine the political priority of oral health in India and to understand the underlying reasons for the political support oral health receives. METHODS: The analysis is based on the political power framework developed by Shiffman and Smith and modified by Benzian et al. to examine the factors that contribute to the political priority of oral health in India. The framework comprises four main analysis categories, further subdivided into 11 dimensions. Based on the set of criteria, each dimension was analyzed and rated by assigning a score to assess to what extend the criteria were met. RESULTS: There is a good understanding on what defines an oral health problem, however, there is no consolidated and comprehensive approach to address oral diseases. Despite India's efforts to improve oral health-related research, its poor utilization in terms of public health and population-based approaches is apparent. The absence of a national surveillance system for oral health masks the severity and extent of the oral disease burden and limits the basis for advocacy on improving oral health to health decision makers. The fragmentation of actors and institutions and the absence of leaders uniting various actors in oral public health impede changes toward improving the oral health status of the population. CONCLUSIONS: Limited accessibility to oral health care, poor portrayals of the severity and extent of the burden, and inertia to address-related challenges are important factors contributing to the low political priority of oral health.