Abstract
Background: Intersectoral action is often presented as essential in the promotion of population health and health
equity. In Norway, national public health policies are based on the Health in All Policies (HiAP) approach that
promotes whole-of-government responsibility. As part of the promotion of this intersectoral responsibility, planning
is presented as a tool that every Norwegian municipality should use to integrate public health policies into their
planning and management systems. Although research on implementing the HiAP approach is increasing, few
studies apply a planning perspective. To address this gap in the literature, our study investigates how three Norwegian
municipalities experience the use of planning as a tool when implementing the HiAP approach.
Methods: To investigate planning practices in three Norwegian municipalities, we used a qualitative multiple case
study design based on face-to-face interviews. When analysing and discussing the results, we used the dichotomy
of instrumental and communicative planning approaches, in addition to a collaborative planning approach, as the
theoretical framework.
Results: The municipalities encounter several dilemmas when using planning as a tool for implementing the HiAP
approach. Balancing the use of qualitative and quantitative knowledge and balancing the use of structural and
processual procedures are two such dilemmas. Other dilemmas include balancing the use of power and balancing
action and understanding in different municipal contexts. They are also faced with the dilemma of whether to place
public health issues at the forefront or to present these issues in more general terms.
Conclusion: We argue that the dilemmas experienced by the municipalities might be explained by the difficult task
of combining instrumental and communicative planning approaches because the balance between them is seldom
fixed.