Submission ID 131836
| Issue/Objective | Norwegian municipalities are responsible for priority setting and decision making in health and care services but lack a formalized national system for systematically introducing or discontinuing initiatives. This appears to contribute to variation in decision making practices and underscores the need to map how decisions are made in order to identify unmet needs at both practice and system levels. This study explores how priorities are set and decisions to implement or de implement initiatives are made in municipal health and care services. The study is relevant to Theme 1 through its focus on governance and prioritization, and to Theme 3 through its focus on implementation and decision making in complex real world settings. |
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| Methodology/Approach | Semi-structured individual interviews were conducted with municipal directors responsible for health and care services and/or public health. A purposeful sampling strategy was used to recruit 15 decision-makers from municipalities of varying size and geographical context, including both urban and rural settings. Data was collected through digital interviews conducted between December 2025 and February 2026. Data analysis was conducted using a framework analysis informed by implementation science, drawing on the ICON framework. |
| Results | Preliminary analysis indicates both shared patterns and large variation in how municipalities approach prioritization and decision making. Across small and large municipalities, decisions appear to be shaped not only by local context, resource availability, organizational capacity, and feasibility considerations, but also by the obligation to comply with national legislation, regulations, and policy frameworks. Decision making appears to rely on professional experience. At the same time, the early findings suggest varied use of systematic decision support tools and research evidence. These results are indicative, based on ongoing analysis. |
| Discussion/Conclusion | Preliminary findings suggest variation in municipal decision making shaped, among other factors, by local context and capacity, national regulatory obligations, and professional experience, with uneven use of systematic decision support and research evidence. The study will inform the development of a national survey on municipal prioritization, to be distributed across Norway and targeting multiple decision making levels, including senior leaders and advisors responsible for preparing decision making briefs. Full qualitative results will be presented and discussed at the conference. |
| Presenters and Affiliations | Hanna Eikås Klem Norwegian Institute of Public Health Hanna Eikås Klem Norwegian Institute of Public Health Maria Bjerk Norwegian Institute of Public Health Heather Melanie R Ames Norway |
