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The significance of policy documents in municipal child health promotion

The Swedish National Institute of Public Health, Stockholm, Sweden, karin.guldbrandsson{at}ki.se, Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden

Henry Bäck

School of Public Administration, Gothenburg University, Gothenburg, Sweden

Sven Bremberg

The Swedish National Institute of Public Health, Stockholm, Sweden, Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden

Aims: To investigate municipal utilization of policy documents in child health-promoting activities with reference to document types, substance in the documents and timing in the policy process. Methods: Fifty semi-structured interviews were performed using the snowball method, and content analyses of written documentation were made. Data were categorized by means of a policy process matrix, and nine case studies were written. Triangulation was used as a validating method, and the coding reliability was assessed. Statements related to various policy documents were categorized according to document types, substance in the documents, and timing in the policy process. Results: Various policy documents were spontaneously mentioned by 33 of 50 interviewees, in eight of nine case studies, and in all stages of the policy process. Well-defined statements concerning which content in the policy documents that actually impacted on the policy process development were uncommon. Conclusions: This study shows that policy documents are present in policy processes related to child health-promoting activities in Swedish municipalities. As Swedish municipalities are autonomous and not forced to pursue governmental recommendations, this probably demonstrates that policy documents are significant in the development of such processes.

Key Words: Case studies • children • health promotion • municipal government • public health policy

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