Negotiated compliance at the street level: Personalizing immunization in England, Israel and Sweden
| Author | Kate Warren,Anat Gofen,Catherine E. Needham,Ulrika Winblad,Paula Blomqvist |
| Date | 01 March 2019 |
| Published date | 01 March 2019 |
| DOI | http://doi.org/10.1111/padm.12557 |
ORIGINAL ARTICLE
Negotiated compliance at the street level:
Personalizing immunization in England, Israel
and Sweden
Anat Gofen
1
| Paula Blomqvist
2
| Catherine E. Needham
3
|
Kate Warren
3
| Ulrika Winblad
4
1
School of Public Policy and Government,
Hebrew University of Jerusalem, Jerusalem,
Israel
2
Department of Political Science, Uppsala
University, Uppsala, Sweden
3
Health Services Management Centre,
University of Birmingham, Birmingham, UK
4
Department of Public Health and Nursing
Sciences, Uppsala University, Uppsala, Sweden
Correspondence
Anat Gofen, Hebrew University of Jerusalem,
School of Public Policy and Government,
Mount Scopus, Jerusalem, 91905 Israel.
Email: anat.gofen@mail.huji.ac.il
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.
1|INTRODUCTION
Often portrayed as behaviours consistent with policy aims, public compliance with policy is essential to the success
of implementation (Bardach and Kagan 1982; May 2004; Weimer 2006; Weaver 2014, 2015). Noncompliance with
policy is conventionally considered a ‘negative’reaction by policy-targets, which follows the introduction of a policy,
and is therefore mainly considered as an implementation problem that should be corrected by the administration
(Baggott 1986; May 2004; Weimer 2006). Thus, the current literature tends to employ a ‘top-down’perspective on
the formal instruments implemented by government in response to noncompliance (Gofen 2015). Moreover, in the
context of citizens-targets, the current literature often refers to well-documented compliance barriers and
Received: 17 April 2018 Revised: 9 August 2018 Accepted: 17 September 2018
DOI: 10.1111/padm.12557
Public Administration. 2019;97:195–209. wileyonlinelibrary.com/journal/padm © 2018 John Wiley & Sons Ltd 195
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