Policy maker’s way of treating evidence

With the growing concept of evidence-based medicine, the focus on evidence-based or evidence-informed policy came into existence in the 1990s. Even though EBP is highly encouraged in all areas including healthcare, only a few examples of linking research results and policy change can be found (Buse et al., 2012, pp. 169-189). Studies have focused more on the use of scientific research in policy-making in comparison to other evidence. Research is either used directly or as a process of enlightenment by policymakers.  The problem-solving model states that research can identify a problem and can also produce policy solutions and argues that due to differences in working modality and understanding a problem, policymakers may use the research findings in a way that the researchers might not approve (Buse et al., 2012, pp. 169-189). Up to 40% of direct use of evidence has been recorded in studies and the use is in context or the problem stream (Innvaer, Vist, Trommald, & Oxman, 2002). One case story from Vietnam shows that after an NGO presented a report on mental health issues as a burden and also included the way that the information can be used in a policy, the findings were used in policy formulation as a context (Harpham & Tuan, 2006). Whereas, the enlightenment model suggests that most of the research gives a new way of thinking rather than a solution to an issue (Buse et al., 2012) that can hardly be tracked. 60% of self-reported use of evidence as enlightenment was claimed by the policy/decision makers (Innvaer et al., 2002).

Policymakers often ignore research because of the time constraint when they are in need to take immediate action and avoid the research findings that suggest a structural change in institutions and societies. Basically, the evidence generated from research that is difficult to understand, lacks effective summaries, lacks analysis of policy implications, is irrelevant to the country, is donor-driven, has limited access to research findings, are not taken into consideration by them (Buse et al., 2012). Such evidences are ignored because the policies are driven by ideology, value judgments, economy, political expediency, and intellectual fashion (Black, 2001). This further imply that they might ignore the new thinking bought by the research if it does not fit their ideology or is outside their political limit of the country. They also limit the use of research if they do not get the information that they want. They find researchers as naïve, jargon-ridden, and irresponsible to practical realities (Innvaer et al., 2002). According to the cynical model of the relation between research and policy, policymakers should be able to trust the researches to be able to use them which is only possible only if they have participated in the research process in some way (Buse et al., 2012) So, if the policymakers and researchers are in the same network and there is the involvement of policymakers in some stages of research, the findings are more likely to be used (Harpham & Tuan, 2006).

Evaluation findings also equally serve as evidence and are equally important for policymakers since it uses research methodologies and produces legitimacy for policy making (Buse et al., 2012). The evidence from the evaluation is used by the policymakers to establish legitimacy for new policy including identifying ways to implement policy at the local level. Moreover, they take evidence from evaluation as a way to learn lessons (Cameron et al., 2011).  Evaluation is a continuous process to assess whether or not the policy initiatives are meeting the intended objective, it can aid in any stage of the policy process (Buse et al., 2012). Through the evaluation results, policymakers decide whether to continue the policy initiative or to halt the implementation of any unintended results are seen. For example, in Nepal Diclofenac which was widely used in veterinary care was banned in 2006 because the death of vultures increased when they ate the dead animals (Nambirajan, Muralidharan, Roy, & Mononmani, 2018). Also, minor changes can be bought utilizing the evidence. 

To wrap up, we can say that there still exists a policy evidence gap due to a number of reasons like inappropriateness, the urgency to act, political limitation, and difference in the opinion of policymakers and researchers. Perceptions, values, presumptions, experiences, and ideologies of the policy makers somehow create a bias in the utilization of research findings. Most of the policymakers treat research findings as knowledge-gaining parts and few of them use some of the evidence in agenda setting along with identifying alternatives. Apart from scientific and/or academic research, evidence from the evaluation is more frequently used for policy change. However, policymakers do not completely rely on the evidence for policy formulation.

References

1. Black, N. (2001). Evidence based policy: proceed with care. BMJ, 323(7307), 275-279. doi:10.1136/bmj.323.7307.275
2. Buse, K., Mays, N., & Walt, G. (2012). Making health policy (2nd ed.). Maidenhead: McGraw-Hill.
3. Cameron, A., Salisbury, C., Lart, R., Stewart, K., Peckham, S., Calnan, M., . . . Thorp, H. (2011). Policy makers’ perceptions on the use of evidence from evaluations Evidence & Policy: A journal of research, debate and practice, 7(4), 429-447. doi: https://doi.org/10.1332/174426411X603443
4. Harpham, T., & Tuan, T. (2006). From research evidence to policy: Mental health care in Viet Nam. Bull World Health Organ, 84(8), 664-668. doi:10.2471/blt.05.027789
5. Innvaer, S., Vist, G., Trommald, M., & Oxman, A. (2002). Health policy-makers’ perceptions of their use of evidence: a systematic review. Journal of Health Services Research and Policy, 7(4), 239-244. doi:10.1258/135581902320432778
6. Nambirajan, K., Muralidharan, S., Roy, A. A., & Mononmani, S. (2018). Residues of diclofenac in tissues of vultures in India: a post ban scenario. Archives of Environmental Contamination and Toxicology, 74(2), 292-297. doi:https://doi.org/10.1007/s00244-017-0480-z