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Policymaking 'under the radar': a case study of pesticide regulation to prevent intentional poisoning in Sri Lanka.


ABSTRACT:

Background

Suicide in Sri Lanka is a major public health problem and in 1995 the country had one of the highest rates of suicide worldwide. Since then reductions in overall suicide rates have been largely attributed to efforts to regulate a range of pesticides. The evolution, context, events and implementation of the key policy decisions around regulation are examined.

Methods

This study was undertaken as part of a broader analysis of policy in two parts-an explanatory case study and stakeholder analysis. This article describes the explanatory case study that included an historical narrative and in-depth interviews.

Results

A timeline and chronology of policy actions and influence were derived from interview and document data. Fourteen key informants were interviewed and four distinct policy phases were identified. The early stages of pesticide regulation were dominated by political and economic considerations and strongly influenced by external factors. The second phase was marked by a period of local institution building, the engagement of local stakeholders, and expanded links between health and agriculture. During the third phase the problem of self-poisoning dominated the policy agenda and closer links between stakeholders, evidence and policymaking developed. The fourth and most recent phase was characterized by strong local capacity for policymaking, informed by evidence, developed in collaboration with a powerful network of stakeholders, including international researchers.

Conclusions

The policy response to extremely high rates of suicide from intentional poisoning with pesticides shows a unique and successful example of policymaking to prevent suicide. It also highlights policy action taking place 'under the radar', thus avoiding policy inertia often associated with reforms in lower and middle income countries.

SUBMITTER: Pearson M 

PROVIDER: S-EPMC4287191 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Policymaking 'under the radar': a case study of pesticide regulation to prevent intentional poisoning in Sri Lanka.

Pearson Melissa M   Zwi Anthony B AB   Buckley Nicholas A NA   Manuweera Gamini G   Fernando Ravindra R   Dawson Andrew H AH   McDuie-Ra Duncan D  

Health policy and planning 20131220 1


<h4>Background</h4>Suicide in Sri Lanka is a major public health problem and in 1995 the country had one of the highest rates of suicide worldwide. Since then reductions in overall suicide rates have been largely attributed to efforts to regulate a range of pesticides. The evolution, context, events and implementation of the key policy decisions around regulation are examined.<h4>Methods</h4>This study was undertaken as part of a broader analysis of policy in two parts-an explanatory case study  ...[more]

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