scholarly journals Evidence and the health policy process: from traditional evidence hierarchy to inclusive and multi-source methodology

2013 ◽  
Vol 2 (3) ◽  
pp. 106
Author(s):  
Francesca Celletti ◽  
Anna Wright ◽  
Eric Buch ◽  
Badara Samb
Keyword(s):  
Health Policy ◽  
Clinical Medicine ◽  
Health Sector ◽  
Policy Decision ◽  
Evidence Base ◽  
Policy Outcomes ◽  
Evidence Based ◽  
Political Issues ◽  
Effective Interventions ◽  
Wide Range

Calls for evidence-based health policy have gathered force as an extension of the movement for evidence-based medicine. In clinical medicine, major investment has been made in efforts to systematize the collection and analysis of data and distinguish effective interventions from those that are less likely to work. In contrast, there is little consensus on what data are needed and what research methods are suitable and acceptable to produce a robust evidence base for social policy in the health sector. Evidence gathering for health policy must synthesise diverse sources, recognise the extent to which context influences policy outcomes, accommodate potentially conflicting interests and be flexible enough to respond to the time and resources pressures that are at play. Despite the challenges, there is scope for the development of a methodology that can draw on a wide range of evidence sources while retaining sufficient scientific rigour. These sources should extend from data generated using causal methods (randomized controlled trials) to information that can shed light on the many contextual and political issues that are also pertinent to health policy decision making.  

Dissemination and Implementation Research in Health

2017 ◽  
Keyword(s):  
Evidence Base ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Collaborative Partnerships ◽  
Social Service Agencies ◽  
Effective Interventions ◽  
Health Related Research ◽  
Health Related ◽  
Dissemination And Implementation Research ◽  
Policies And Programs

Fifteen to twenty years is how long it takes for the billions of dollars of health-related research to translate into evidence-based policies and programs suitable for public use. Over the past 15 years, an exciting science has emerged that seeks to narrow the gap between the discovery of new knowledge and its application in public health, mental health, and health care settings. Dissemination and implementation (D&I) research seeks to understand how to best apply scientific advances in the real world, by focusing on pushing the evidence-based knowledge base out into routine use. To help propel this crucial field forward, leading D&I scholars and researchers have collaborated to put together this volume to address a number of key issues, including: how to evaluate the evidence base on effective interventions; which strategies will produce the greatest impact; how to design an appropriate study; and how to track a set of essential outcomes. D&I studies must also take into account the barriers to uptake of evidence-based interventions in the communities where people live their lives and the social service agencies, hospitals, and clinics where they receive care. The challenges of moving research to practice and policy are universal, and future progress calls for collaborative partnerships and cross-country research. The fundamental tenet of D&I research—taking what we know about improving health and putting it into practice—must be the highest priority. This book is nothing less than a roadmap that will have broad appeal to researchers and practitioners across many disciplines.

scholarly journals Evidence-based mental health policy: Acritical appraisal

2003 ◽  
Vol 183 (2) ◽  
pp. 105-113 ◽  
Author(s):  
Brian Cooper
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Policy ◽  
Health Planning ◽  
Mental Health Policy ◽  
Evidence Base ◽  
Service Evaluation ◽  
Current Evidence ◽  
Evidence Based ◽  
Evidence Based Health Care

BackgroundArguments for and against evidence-based psychiatry have mostly centred on its value for clinical practice and teaching. Now, however, use of the same paradigm in evaluating health care has generated new problems.AimsTo outline the development of evidence-based health care; to summarise the main critiques of this approach; to review the evidence now beingemployed to evaluate mental health care; and to consider how the evidence base might be improved.MethodThe following sources were monitored: pub ications on evidence-based psychiatry and health care since 1990; reports of randomised trials and meta-analytic reviews to the end of 2002; and official British publications on mental health policy.ResultsAlthough evidence-based health care is now being promulgated as a rational basis for mental health planning in Britain, its contributions to service evaluation have been distinctly modest. Only 10% of clinical trials and meta-analyses have been focused on effectiveness of services, and many reviews proved inconclusive.ConclusionsThe current evidence-based approach is overly reliant on meta-analytic reviews, and is more applicable to specific treatments than to the care agencies that control theirdelivery. A much broader evidence base is called for, extending to studies in primary health care and the evaluation of preventive techniques.

scholarly journals Implementation of evidence-based health promotion and disease prevention interventions: theoretical and practical implications of the concept of transferability for decision-making and the transfer process

2021 ◽  
Vol 64 (5) ◽  
pp. 534-543
Author(s):  
Tamara Schloemer ◽  
Freia De Bock ◽  
Peter Schröder-Bäck
Keyword(s):  
Health Promotion ◽  
Disease Prevention ◽  
Transfer Process ◽  
Evidence Base ◽  
Decision Makers ◽  
Evidence Based ◽  
Policy And Practice ◽  
Effective Interventions ◽  
Prevention Interventions ◽  
Practical Implications

AbstractEvidence-based health promotion and disease prevention require incorporating evidence of the effectiveness of interventions into policy and practice. With the entry into force of the German Act to Strengthen Health Promotion and Prevention (PrävG), interventions that take place in people’s everyday living environments have gained in importance. Decision-makers need to assess whether an evidence-based intervention is transferable to their specific target context. The Federal Centre for Health Education (BZgA) recommends that transferability of an intervention should be clarified before any decision to implement it. Furthermore, transferability needs to be finally determined after an evaluation in the target context. In this article, we elaborate on theoretical and practical implications of the concept of transferability for health promotion and disease prevention based on the Population–Intervention–Environment–Transfer Models of Transferability (PIET-T). We discuss how decision-makers can anticipate transferability prior to the intervention transfer with the help of transferability criteria and how they can take transferability into account in the further process. This includes the steps of the analysis of a health problem and identification of effective interventions, the steps of the initial transferability assessment and identification of the need for adaptation, and the steps of the implementation and evaluation. Considering transferability is a complex task that comes with challenges. But it offers opportunities to select a suitable intervention for a target context and, in the transfer process, to understand the conditions under which the intervention works in this context. This knowledge helps to establish an evidence base, which is practically relevant.

A Draconian Law: Examining the Navigation of Coalition Politics and Policy Reform by Health Provider Associations in Karnataka, India

2021 ◽  
Author(s):  
Arima Mishra ◽  
Maya Annie Elias ◽  
Veena Sriram
Keyword(s):  
Health Policy ◽  
Health Sector ◽  
Policy Outcomes ◽  
Middle Income ◽  
Trade Associations ◽  
Middle Income Countries ◽  
Coalition Politics ◽  
Comprehensive Picture ◽  
Depth Interviews ◽  
Low And Middle Income

Abstract A comprehensive picture of provider coalitions in health policymaking remains incomplete due to the lack of empirically driven insights from low- and middle-income countries. We examine the politics of provider coalitions in the health sector in Karnataka, India, by investigating policy processes during 2016–2018 to develop amendments to the Karnataka Private Medical Establishments Act. Through this case, we explore how provider associations function, coalesce, and compete, and the implications of their actions on policy outcomes. We conducted in-depth interviews, document analysis, and non-participant observations of two conferences organized by associations. We find that provider associations played a major role in drafting the amendments and negotiated competing interests within and between doctors’ and hospital associations. Despite the fragmentation, the associations came together to reinterpret the intentions of the amendments as being against the interests of the profession, culminating in a statewide protest and strike. Despite this show of strength, provider associations only secured modest modifications. This case demonstrates the complex and unpredictable influence of provider associations in health policy processes in India. Our analysis highlights the importance of further empirical study of the influence of professional and trade associations across a range of health policy cases in low- and middle-income countries.

Spit guards, ethical policing and the need for an evidence-based approach

2018 ◽  
Vol 17 (3) ◽  
pp. 145-155 ◽  
Author(s):  
Peter Joyce ◽  
Wendy Laverick
Keyword(s):  
Police Officers ◽  
Grey Literature ◽  
Primary Source ◽  
Evidence Base ◽  
Evidence Based ◽  
Content Type ◽  
Secondary Sources ◽  
Advantages And Disadvantages ◽  
Wide Range ◽  
The Uk

Purpose The purpose of this paper is to assess the advantages and disadvantages of the use of spit guards by police forces in the UK and to make recommendations regarding an evidence-based approach to decisions related to the use of such equipment. Design/methodology/approach The paper is based upon an examination of a range of primary source material, secondary sources and grey literature. Findings Although the use of spit guards can be justified by factors that include the need to protect police officers from contracting serious infectious diseases, there are a number of problems that concern ethical policing and human rights. Concerns arise when spit guards are deployed against vulnerable individuals, are used offensively rather than defensively and when such equipment is deployed disproportionately against persons from Black and Minority Ethnic (BME) communities. Additionally, the image of the police may suffer if spit guards are accompanied by the use of excessive force which may be perceived as an abuse of police power. Practical implications The paper makes recommendations that a comprehensive evidence base is required to assist practitioners to make informed decisions regarding the deployment of spit guards. This evidence base should include the extent to which officers are spat at, medical evidence relating to spitting and the transmission of serious diseases, the views of the public concerning the deployment of spit guards and estimations as to whether such equipment will deter spitting by suspects of crime. Originality/value This paper provides an original academic contribution to the ongoing debate on the use of spit guards within policing. In particular, it brings together a wide range of material that relates to this topic and presents it as a coherent set of arguments located in a single source.

scholarly journals UPDATE HEALTH POLICY DECISION MAKING IN SAFE MOTHERHOOD REGIONAL ISSUE

2019 ◽  
Vol 1 (2) ◽  
pp. 9-13
Author(s):  
Sardjana Atmadja ◽  
Gulam Gumilar
Keyword(s):  
Decision Making ◽  
Health Policy ◽  
Maternal Health ◽  
Health Services ◽  
Policy Decision ◽  
Developed Countries ◽  
Safe Motherhood ◽  
Wide Range ◽  
Health Policy Decision ◽  
Policy Decision Making

More than a half million women die every year because of complications related to pregnancy and child birth. Nearly all these deaths take place in developing countries. The disparity between maternal death rates in developing and developed countries is greater than for any other common category of death. Poor maternal health during pregnancy is directly linked to poor health in the infant. Therefore, a mother’s health and survival continues to be critically important throughout a child’s life. Pregnant women and children suffer first and most under poor socioeconomic conditions. To reduce maternal and morbidity in half by the 2000, the safe motherhood initiative was launched. The success of safe motherhood initiative depends on the active participation of a wide range of individuals and organizations who can contribute ideas, skills, and funds, because the problem stems not only from inadequate health services, but mostly also from the social, cultural, and economic environment in which women live. Health policy decision making in safe mother-hood at least should be based on the assessment of Maternal Health situation and health services and the assessment of socio- cultural aspects of safe motherhood of each region.

scholarly journals We Need to Talk About Corruption in Health Systems

2018 ◽  
Vol 8 (4) ◽  
pp. 191-194 ◽  
Author(s):  
Eleanor Hutchinson ◽  
Dina Balabanova ◽  
Martin McKee
Keyword(s):  
Health Policy ◽  
Health Sector ◽  
International Health ◽  
Policy Discourse ◽  
Victim Blaming ◽  
Holistic View ◽  
Considerable Evidence ◽  
What Works ◽  
Wide Range ◽  
International Health Policy

The health sector consistently appears prominently in surveys of perceived corruption, with considerable evidence that this has serious adverse consequences for patients. Yet this issue is far from prominent in the international health policy discourse. We identify five reasons why the health policy community has been reluctant to talk about it. These are the problem of defining corruption, the fact that some corrupt practices are actually ways of making dysfunctional systems work, the serious challenges to researching corruption, concerns that a focus on corruption is a form of victim blaming that ignores larger issues, and a lack of evidence about what works to tackle it. We propose three things that can be done to address this situation. First, seek consensus on the scale and nature of corruption. Second, decide on priorities, taking account the importance of the particular problem and the feasibility of doing something about it. Third, take a holistic view, drawing on a wide range of disciplines.

scholarly journals Allocating resources to support universal health coverage: development of a geographical funding formula in Malawi

2020 ◽  
Vol 5 (9) ◽  
pp. e002763
Author(s):  
Finn McGuire ◽  
Paul Revill ◽  
Pakwanja Twea ◽  
Sakshi Mohan ◽  
Gerald Manthalu ◽  
...  
Keyword(s):  
Service Delivery ◽  
Universal Health Coverage ◽  
Current System ◽  
Health Sector ◽  
Cost Effective ◽  
Local Health ◽  
Health Coverage ◽  
Effective Interventions ◽  
Wide Range ◽  
Universal Health

BackgroundUniversal health coverage (UHC) requires that local health sector institutions—such as local authorities—are properly funded to fulfil their service delivery commitments. In this study, we examine how formula funding can align sub-national resource allocations with national priorities. This is illustrated by outlining alternative options for using mathematical formula to guide the allocation of national drug and service delivery budgets to district councils in Malawi in 2018/2019.MethodsWe use demographic, epidemiological and health sector budget data with information on implementation constraints to construct three variant allocation formulae. The first gives an equal per capita allocation to each district, and is included as a baseline to compare alternatives. The second allocates funds to districts using estimates of the resources required to provide Malawi’s essential health package of priority cost-effective interventions to the full population in need of each intervention. The third adjusts these estimates to reflect a practicable level of attainable coverage for each intervention, based on the current configurations of health services and demand for interventions.FindingsCompared with current district allocations, not underpinned by an explicit formula, the formulae presented in this study suggest sizeable shifts in the allocations received by many districts. In some cases, the magnitude of these shifts exceed 50% reductions or doubling of district budgets. The large shifts illustrate inequities in the current system of budget allocation and the potential improvements possible.ConclusionThe use of mathematical formulae can guide the efficient and equitable allocation of healthcare funds to local health authorities. The formulae developed were facilitated by the existence of an explicit package of priority interventions. The approach can be replicated in wide range of countries seeking to achieve UHC.

scholarly journals Application of Big Data to Support Evidence-Based Public Health Policy Decision-Making for Hearing

2020 ◽  
Vol 41 (5) ◽  
pp. 1057-1063 ◽  
Author(s):  
Gabrielle H. Saunders ◽  
Jeppe H. Christensen ◽  
Johanna Gutenberg ◽  
Niels H. Pontoppidan ◽  
Andrew Smith ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Big Data ◽  
Health Policy ◽  
Public Health Policy ◽  
Policy Decision ◽  
Evidence Based ◽  
Health Policy Decision ◽  
Policy Decision Making ◽  
Support Evidence

scholarly journals Science at the Heart of Psychotherapy: A Review of Three Evidence-Based Treatments

2016 ◽  
Vol 28 (1) ◽  
pp. 25
Author(s):  
Victoria Brady ◽  
Victoria Taylor ◽  
Simon Rego
Keyword(s):  
Dialectical Behavior Therapy ◽  
Evidence Base ◽  
Background Information ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Medical Problems ◽  
Acceptance And Commitment ◽  
Wide Range ◽  
Evidence Based Treatments ◽  
Cost Efficient

Changes in the U.S. healthcare system over the past fewdecades have led to a transformation of the mental healthfield. The demand for accountability and the need for effective,cost-efficient treatments have spurred the movementtoward evidence-based practices. Today, a number of empiricallybased psychotherapies exist that have proven efficaciousin the treatment of a wide range of physical and psychologicaldisorders. Despite the strong evidence base for these treatments,their dissemination and implementation have beenslow. The intention of the present article is to summarize themajor characteristics of three types of psychotherapy (cognitivebehavioral therapy, acceptance and commitment therapy,and dialectical behavior therapy) that have received muchempirical support and have demonstrated applicability to awide range of both mental and medical problems. For eachtreatment, some background information is provided, alongwith the theoretical underpinnings of the treatment, a summaryof the current state of the evidence, and limitations andcriticisms in the literature.

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