Four normative perspectives on public health policy-making and their preferences for bodies of evidence

Abstract

Calls for evidence-informed public health policy-making often ignore that there are multiple, and often competing, bodies of potentially relevant evidence to which policy-makers have recourse in identifying policy priorities and taking decisions. In this paper, we illustrate how policy frames may favour the use of specific bodies of evidence. For the sixth Dutch Public Health Status and Foresight report (2014), possible future trends in population health and healthcare expenditure were used as a starting point for a deliberative dialogue with stakeholders to identify and formulate the most important societal challenges for the Dutch health system. Working with these stakeholders, we expanded these societal challenges into four normative perspectives on public health. These perspectives can be regarded as policy frames. In each of the perspectives, a specific body of evidence is favoured and other types of evidence are neglected. Crucial outcomes in one body may be regarded as irrelevant from other perspectives. Consequently, the results of research from a single body of evidence may not be helpful in the policymaking processes because policy-makers need to account for trade-offs between all competing interests and values. To support these policy processes, researchers need to combine qualitative and quantitative methodologies to address different outcomes from the start of their studies. We feel it is time for the research community to repoliticise the idea of evidence use and for policy-makers to demand research that helps them to account for all health-related policy goals. This is a prerequisite for real evidence-informed policy-making.

Paraguay’s approach to biotechnology governance: a comprehensive guide

“…Moreover, regulatory systems have often been implemented on a “piece-by-piece” basis ( McLean et al, 2002 ) in response to the urgent needs of the moment, and are more reactive than preventive systems. An inventory and evaluation of priorities, policies, existing regulatory regimes, and scientific and technical means is ideally a prerequisite to the development and implementation of policies and regulations ( McLean et al, 2002 ; Schoemaker et al, 2020 ). However, building such a system and making it operational is complicated by the fact that there is no single best approach nor standard that reflects cultural, political, financial, and scientific heterogeneity.…”

The Concepts of Women’s Empowerment in Child Malnutrition Programs in Luangprabang Province, Lao People’s Democratic Republic

“…However, the coexistence of diverse approaches aimed at a shared objective incite those whose vision of the activities deployed diverge to appraise their preconceived ideas. This effect can in itself be a determinant of empowerment as it promotes a more comprehensive understanding of the complexity of the topic of interest [54][55][56].…”

The lesson learned from COVID-19 and the climate crisis is not to let experts decide on policies: a response to Robert C. Schmidt

“…Moreover, there are usually different disciplines that have a contribution to make, both on problem definitions and possible solutions. Hence, there usually is not “one” scientific evidence but rather a variety of (often competing) evidences that has to be dealt with and needs to be integrated if it is to inform political decision-making (Schoemaker et al 2020 ). Furthermore, even a clear scientific problem definition does not automatically produce a “first best” policy solution to solve the problem.…”