Negotiated compliance at the street level: Personalizing immunization in England, Israel and Sweden

• 成果类型: Article
• 署名作者: Gofen, Anat; Blomqvist, Paula; Needham, Catherine E.; Warren, Kate; Winblad, Ulrika
• 署名单位: Hebrew University of Jerusalem; Uppsala University; University of Birmingham; Uppsala University
• 刊物名称: PUBLIC ADMINISTRATION
• ISSN/ISSBN: 0033-3298
• DOI: 10.1111/padm.12557
• 发表日期: 2019
• 页码: 195-209
• 关键词: vaccination coverage; mmr vaccination; public-service; bureaucracy; parents; ORGANIZATIONS; acceptance; hesitancy; attitudes; DECISION

摘要

Often portrayed as behaviour that is inconsistent with policy goals, public noncompliance poses a significant challenge for government. To explore what compliance efforts entail on the ground, this study focuses on childhood immunization as a paradigmatic case where a failure to ensure compliance poses a public health risk. The analysis draws on 48 semi-structured interviews with frontline nurses and regional/national public health officials in England (N =15), Sweden (N =17) and Israel (N =16), all of which have experienced periodic noncompliance spikes, but differ in direct delivery of vaccination provision. Compliance efforts emerged as a joint decision-making process in which improvisatory practices of personalized appeals are deployed to accommodate parents' concerns, termed here street-level negotiation'. Whereas compliance is suggestive of compelling citizens' adherence to standardized rules, compliance negotiation draws attention to the limited resources street-level workers have when encountering noncompliance and to policy-clients' influence on delivery arrangements when holding discretionary power over whether or not to comply.