Frameworks, theories and models used in the development of health policies: A systematic review of systematic reviews

Background: Health policies are established to address a specific health need, however, are not always the result of a rational process of evaluation or developed using established policy frameworks, theories or models (FTMs). Greater utilisation of FTMs in health policy making may provide further insight into policy development and overcome barriers to policy inaction. Objective: The present review aimed to analyse the FTMs and their components underpinning health policy development, and health settings to which they are applied. Method: A systematic review was conducted following the PRISMA guidelines. Several databases were searched using keywords and MeSH terms. Quality appraisal was undertaken using the AMSTAR tool. Results: From 1059 citations, 18 systematic reviews were identified. Twenty-eight FTMs were identified with 15 key components, with policy actors (85 %) and policy context (71 %) being most frequently mentioned. Policy FTMs were applied predominantly in health equity, population and public health (n = 16), sexual, reproductive and women's health (n = 14), HIV (n = 12), and physical activity, obesity prevention and nutrition (n = 12). Conclusion: The utilisation of health policy FTMs in the development of health policy may allow more targeted and relevant health policies to be developed. Further research into the critical components of health policy making may assist in developing a policy framework specific to health policy development.