Agenda-setting Analysis for Health Literacy Promotion Using Kingdon’s Model: A Descriptive-comparative Study

Background: Health literacy has been attractive to policymakers since its inception. This study analyzed the agenda-setting process of health literacy-promoting policies in 7 selected countries using Kingdon’s multiple streams model. Methods: This descriptive-comparative study was conducted using Kingdon’s multiple streams model. This model has three streams: problem stream, policy stream and politics stream. They influence the public policymaking process and policy change occurs when these streams converge in a policy window. We selected the USA, Australia, South Africa, Chile, Turkey, Thailand and the Islamic Republic of Iran as samples. The content analysis of available policy documents, reports, and comparative tables was used. Results: Extensive studies were the main driver of the problem stream. Numerous conferences and health promotion programs were drivers of the policy stream. The desire and contribution of key persons and national authorities, the government’s serious commitment, and political stability strengthened the politics stream. Ultimately, the simultaneous strengthening of three streams brought the issue onto the agenda. Conclusion: Although Kingdon’s model considered three streams separately, they are not separate. As the findings show, the first step towards bringing health literacy to the agenda is understanding and introducing the issue at the policy space and community level. This strategy will further encourage policymakers to develop solutions. Drawing the support of influential people will also be very useful in this regard.