As you can see from the health policy triangle, actors are at the centre of the health policy framework. Actor may be used to denote individuals (a particular statesmen - Nelson Mandela, the ex-President of South Africa, for example), organizations such as the World Bank or multinational companies such as Shell, or even the state or government. However, is it important to recognize that this is a simplification. Individuals cannot be separated from the organizations within which they work and any organization or group is made up of many different people, not all of whom speak with one voice and whose values and beliefs may differ.
In international relations it has been customary to talk about non-state actors (actors outside government). Political scientists talk about interest or pressure groups. In the development literature these groups are usually referred to as civil society organizations (organizations which fall between the state and the individual or household). What differentiates all these actors from government or state actors is that they do not seek formal political power for themselves, although they do want to influence those with formal political power.
Sometimes many different groups get together to demonstrate strong feelings about particular issues-these are called social movements or people`s movements. for example, the activities of many different groups in the 1980s led to major political change in the socialist regimes of eastern Europe. Many social movements are struggles for independence, autonomy or against particular political regimes (e.g. the Zapatista movement in Chiapas province in Mexico is part of a movement all over Latin America to preserve the rights of indigenous people).
Actors may try to influence the policy process at the local, national, regional or international level. Often they become parts of networks, sometimes described as partners, to consult and decide on policy al all of these levels. At the local level, for example, community health workers may interact with environmental officers, teachers in local schools, even local businesses. At the other end of the spectrum, actors may be linked with others across state borders, for example, they may be members of inter-governmental networks or they may be part of policy or discourse communities - networks of professionals who get together at scientific meetings or collaborate on research projects.
To understand how much actors influence the policy process means understanding the concept of power, and how it is exercised. Actors may seek to influence policy, but the extent to which they will be able to do so will depend, among other things, on their perceived or actual power. Power may be characterized by a mixture of individual wealth, personality, level of or access to knowledge, or authority, but it is strongly tied up with thr organization and structures (including networks) within which the individual actor works and lives. Sociologists and political scientists talk about the interplay between agency and structure, presenting the notion that the power of actors (agents) is intertwined with the structures (organizations) they belong to.
Reference :
Buse,K., Mays,N.,Walt,G.,2005, Making Health Policy, Open University Press
Buse,K., Mays,N.,Walt,G.,2005, Making Health Policy, Open University Press
