Primary Healthcare Policy Implementation in Plateau State, Nigeria, 1990-2010

INTRODUCTION

Background to the Study

One of the bedrocks of the formation of modern state is to enhance the welfare of the citizenry. Government, as the foremost agent of the state, is saddled with the responsibility of transforming this noble goal into reality (Agbaje and Adebanwi, 2003). As a means of achieving this, public policies are formulated and implemented. The quality of public policy output, in its formulation and implementation, depends on a number of interacting and intervening variables which include the content of the policy, the political leadership, nature of bureaucracy, various groups competing for values and resources as well as the given political economy.  Against this backdrop, policy failure has been a source of concern for social scientists and, despite that, there are still no clear explanation for why some executed policies are not achieving intended goals. In the 1970s, the works of Pressman and Wildavsky (1973) marked the beginning of policy studies that dealt specifically with policy implementation. They examined why well-designed federal policies fail to be implemented in local contexts. The usual response of researchers is to blame it on bad execution. The implementation gap (Brewer and de P, 1999) became the focus of this area of policy studies.  Despite the ample amount of implementation studies, the issue persists.  Browne and Wildavsky (1984) states that, after many years of research on public policy implementation, ―we know surprisingly little. Hargrove (1975) refers to the study of implementation as the ―missing link in policy analysis. More than three decades later, Sabatier (2007) stated that implementation ―continues to be the missing link in public policy theories. As a consequence of this, better understanding of issues influencing the way policies are put into practice is still required.