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Vertical policy coordination of COVID-19 testing in Sweden: an analysis of policy-specific demands and institutional barriers
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.ORCID iD: 0000-0001-6219-1402
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.ORCID iD: 0000-0002-3921-5522
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.ORCID iD: 0000-0002-3858-3454
2024 (English)In: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 38, no 9, p. 106-124Article in journal (Refereed) Published
Abstract [en]

Purpose

The build-up of large-scale COVID-19 testing required an unprecedented effort of coordination within decentralized healthcare systems around the world. The aim of the study was to elucidate the challenges of vertical policy coordination between non-political actors at the national and regional levels regarding this policy issue, using Sweden as our case.

Design/methodology/approach

Interviews with key actors at the national and regional levels were analyzed using an adapted version of a conceptualization by Adam et al. (2019), depicting barriers to vertical policy coordination.

Findings

Our results show that the main issues in the Swedish context were related to parallel sovereignty and a vagueness regarding responsibilities and mandates as well as complex governmental structures and that this was exacerbated by the unfamiliarity and uncertainty of the policy issue. We conclude that understanding the interaction between the comprehensiveness and complexity of the policy issue and the institutional context is crucial to achieving effective vertical policy coordination.

Originality/value

Many studies have focused on countries’ overall pandemic responses, but in order to improve the outcome of future pandemics, it is also important to learn from more specific response measures.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2024. Vol. 38, no 9, p. 106-124
Keywords [en]
COVID-19 testing, Decentralization, Vertical policy coordination, Sweden, Healthcare governance
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Infectious Medicine
Identifiers
URN: urn:nbn:se:uu:diva-526138DOI: 10.1108/jhom-09-2022-0278ISI: 001185925200001PubMedID: 38494177OAI: oai:DiVA.org:uu-526138DiVA, id: diva2:1848914
Part of project
Health system governance through patient and public involvement: What is the impact?, Forte, Swedish Research Council for Health, Working Life and Welfare
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-01578Available from: 2024-04-04 Created: 2024-04-04 Last updated: 2024-04-05Bibliographically approved

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Hallberg, AnnaWinblad, UlrikaFredriksson, Mio

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