Toward a framework of ambiguity: a qualitative understanding of healthcare policy design and governance mechanism in China.

INTRODUCTION

This study explores the strategic and deliberate usage of ambiguity in Chinese public health policy as a governmental instrument.

METHODS

By analyzing 128 official public policy documents and 30 participant interviews as primary evidence, this study developed a three-tier coding instrument to capture the underlying categorizations, strategic functions, and behavioral responses.

RESULTS AND DISCUSSION: The findings of this study indicate that ambiguity, categorized into five types-"Elasticating," "Generalizing," "Overloading," "Substituting," and "Intensifying"-with "Elasticating" being the most predominant, facilitated the diffusion of accountability, the shifting of responsibility, and the flexibility of interpretation. This research makes a significant contribution to the field of public health governance by redefining policy ambiguity as a complex, integrated mechanism of problem-solving that is rooted in the behavioral, institutional, and bureaucratic contexts of public health operations in China, rather than as a systematic failure.