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“Evidence-Informed Health Policymaking
Teaching Evidence Assimilation for
Collaborative Healthcare
New York Academy of Medicine, 7 August 2014
Andy Oxman, Global Health UnitNorwegian Knowledge Centre for the Health Services
What is evidence?
“Evidence concerns facts (actual or asserted) intended for use in support of a conclusion.”– A fact is something known by experience or
observation.– Evidence is used to support a conclusion; it is
not the same as the conclusion.
What is the role of evidence in policy and practice?• The role of evidence is to inform policy and practice• Evidence is essential, but not sufficient• Judgements are needed, including judgements about
confidence (the certainty of the evidence), what to expect in a specific setting, equity and trade-offs
What is evidence-informed health policymaking?
• An approach to policy decisions that aims to ensure that decision making is well-informed by the best available research evidence
• Characterised by access to, and appraisal of, evidence as an input into the policymaking process that is– Systematic to ensure that relevant research is
identified, appraised and used appropriately– Transparent so that others can examine what
research evidence was used to inform policy decisions, as well as the judgements made about the evidence and its implications
Comments or questions about what evidence, its role in policymaking or
what evidence-informed health policy is?
Determinants of EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to research
Generation of relevant and reliable research
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to research
Generation of relevant and reliable researchPriority setting Capacity building Public understanding Monitoring and
evaluation
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to research
Generation of relevant and reliable researchPriority setting Capacity building Public understanding Monitoring and
evaluation
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to research
Generation of relevant and reliable researchPriority setting Capacity building Public understanding Monitoring and
evaluation
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to research
Generation of relevant and reliable researchPriority setting Capacity building Public understanding Monitoring and
evaluation
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to research
Generation of relevant and reliable researchPriority setting Capacity building Public understanding Monitoring and
evaluation
Strategies to facilitate EIHP
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to researchClearing houses Policy briefs Rapid response services Capacity building
Generation of relevant and reliable research
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to researchClearing houses Policy briefs Rapid response services Capacity building
Generation of relevant and reliable research
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to researchClearing houses Policy briefs Rapid response services Capacity building
Generation of relevant and reliable research
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to researchClearing houses Policy briefs Rapid response services Capacity building
Generation of relevant and reliable research
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use research
Access to researchClearing houses Policy briefs Rapid response services Capacity building
Generation of relevant and reliable research
Strategies to facilitate EIHP
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use researchExperience Training re the value of
evidence Examples / stories Informing and engaging stakeholders
Access to research
Generation of relevant and reliable research
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement change
Interest and motivation to use researchExperience Training re the value of
evidence Examples / stories Informing and engaging stakeholders
Access to research
Generation of relevant and reliable research
Strategies to facilitate EIHP
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement changeTechnical support Capacity building Design of implementation
strategiesEvaluation of
implementation strategies
Interest and motivation to use research
Access to research
Generation of relevant and reliable research
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement changeTechnical support Capacity building Design of implementation
strategiesEvaluation of
implementation strategies
Interest and motivation to use research
Access to research
Generation of relevant and reliable research
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Ability to use research and implement changeTechnical support Capacity building Design of implementation
strategiesEvaluation of
implementation strategies
Interest and motivation to use research
Access to research
Generation of relevant and reliable research
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Policy dialogues Political structures and processes Requirements for evaluation Evaluation
Ability to use research and implement change
Interest and motivation to use research
Access to research
Generation of relevant and reliable research
Strategies to facilitate EIHP
An environment that is supportive of evidence-informed health policymaking
Policy dialogues Political structures and processes Requirements for evaluation Evaluation
Ability to use research and implement change
Interest and motivation to use research
Access to research
Generation of relevant and reliable research
There are many reasons why decision makers may not access
and use high quality health system and public health evidence.
Strategies to address each of those are needed.
“Both politically, in terms of being accountable to those who fund the system, and also ethically, in terms of making sure that you make the best use possible of available resources,
evaluation is absolutely critical.”
Dr Julio Frenk, Minister of Health, Mexico
Final message
• Both policymakers and researchers must continue struggling to help ensure that judgments about health policies are well informed by research evidence
• The alternative is to acquiesce to poorly informed health policies
Informing Judgment: Case Studies of Health Policy and Research in Six Countries.Milbank Memorial Fund, September 2001http://www.milbank.org/2001cochrane/010903cochrane.html
Comments or questions?
