Table 2 Conceptual framework of political economy elements

Institutions

‘Institutions’ refer to two different things: the formal institutions (for example organisations such as the WHO or institutions like government agencies); or the rules, structures, norms, authority and values of such an organisation or institution that structure or influence the way it makes decisions or acts [7, 51, 52, 63].

Institutional or structural power: Power that allows certain actors to shape, or engage in, rules and institutional practices/arrangements or make the rules themselves. This type of power can be drawn from underlying economic and institutional structures and processes that place certain actors in positions of power [22, 34, 37].

Interests

Stakeholder ‘interests’ refer to the objectives and goals of different actors, and what they see as important [7, 51, 52, 63].

Actor power: refers to which actors directly influence policy and decision making, and mechanisms through which this occurs [34, 52, 61]. Also known as instrumental power.

Ideas

‘Ideas’ refer to how policy actors understand or frame an issue, shaped by their values, beliefs and ideologies. It includes not just the actors’ perceptions but also concepts and theories communicated by the actors in the discourse around the policy process [7, 51, 52, 63].

Discursive power: The power to shape and influence the policy process through discourse and language. It is a power exercised through different vehicles, i.e., the media or political lobbying or debate. It can focus on the framing of the policy issue, or the actors involved; or utilise the influence of broader norms (i.e., political or societal) [19]. Also known as ideological power.