alternatives, and public policies3 posits that government agendas are influenced by both visible and hidden participants and participant involvement are in three streams, components, or processes: problems, policies, and politics. The problems catapulted into national or locality attention usually results from the efforts of visible participants. However, problems can also be brought into national or locality attention with the emergence of a focusing event or a change in statistics or indicator. It must be emphasized, however, that each of the streams (or components or processes) can serve as an impetus that can lead to the consideration of an agenda. Likewise, each of the three streams (or components/processes) can also serve as a constraint that can lead to the non-consideration of an agenda. Government action responds to or remedies the problems brought into national or local attention. In addressing problems, policies are formulated. The political stream can influence both the agenda setting and policy. Agenda refers to the list of subjects to which government and those around are focused on. Events and problems create a policy window in which policy proposals or felt-problems can be elevated as a government agenda. In the window, both visible and invisible participants invest resources to put problems or proposed policies into national or local prominence so they can be adopted as government agendas.
Understanding the process of agenda-setting is important because health reforms can only be facilitated if one has a clear understanding of the processes involved in the emergence and implementation of a policy. Government time and resources are limited and not all agenda can be considered or adequately considered. If a health concern is not even considered as an agenda, a concern cannot even be considered as a possible concern area for formulating policies. In the language of the Kingdon model, the particular concern is still a decision agenda or an agenda