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Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review

Author

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  • Marco Liverani
  • Benjamin Hawkins
  • Justin O Parkhurst

Abstract

Background: There is increasing recognition that the development of evidence-informed health policy is not only a technical problem of knowledge exchange or translation, but also a political challenge. Yet, while political scientists have long considered the nature of political systems, the role of institutional structures, and the political contestation of policy issues as central to understanding policy decisions, these issues remain largely unexplored by scholars of evidence-informed policy making. Methods: We conducted a systematic review of empirical studies that examined the influence of key features of political systems and institutional mechanisms on evidence use, and contextual factors that may contribute to the politicisation of health evidence. Eligible studies were identified through searches of seven health and social sciences databases, websites of relevant organisations, the British Library database, and manual searches of academic journals. Relevant findings were extracted using a uniform data extraction tool and synthesised by narrative review. Findings: 56 studies were selected for inclusion. Relevant political and institutional aspects affecting the use of health evidence included the level of state centralisation and democratisation, the influence of external donors and organisations, the organisation and function of bureaucracies, and the framing of evidence in relation to social norms and values. However, our understanding of such influences remains piecemeal given the limited number of empirical analyses on this subject, the paucity of comparative works, and the limited consideration of political and institutional theory in these studies. Conclusions: This review highlights the need for a more explicit engagement with the political and institutional factors affecting the use of health evidence in decision-making. A more nuanced understanding of evidence use in health policy making requires both additional empirical studies of evidence use, and an engagement with theories and approaches beyond the current remit of public health or knowledge utilisation studies.

Suggested Citation

  • Marco Liverani & Benjamin Hawkins & Justin O Parkhurst, 2013. "Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-9, October.
  • Handle: RePEc:plo:pone00:0077404
    DOI: 10.1371/journal.pone.0077404
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    1. Zoltán Kaló & Adrian Gheorghe & Mirjana Huic & Marcell Csanádi & Finn Boerlum Kristensen, 2016. "HTA Implementation Roadmap in Central and Eastern European Countries," Health Economics, John Wiley & Sons, Ltd., vol. 25(S1), pages 179-192, February.
    2. Weldon, Isaac & Parkhurst, Justin, 2022. "Governing evidence use in the nutrition policy process: evidence and lessons from the 2020 Canada food guide," LSE Research Online Documents on Economics 112430, London School of Economics and Political Science, LSE Library.
    3. Kyung-Eun (Anna) Choi & Lara Lindert & Lara Schlomann & Holger Pfaff, 2022. "“I’ll leave that to the case managers.” Healthcare Service Providers‘ Perceptions of Organizational Readiness for Change in a Randomized Controlled Trial—A Qualitative Analysis Exploring Implementatio," IJERPH, MDPI, vol. 19(9), pages 1-17, May.
    4. Schoemaker, Casper G. & van Loon, Jeanne & Achterberg, Peter W. & van den Berg, Matthijs & Harbers, Maartje M. & den Hertog, Frank R.J. & Hilderink, Henk & Kommer, Geertjan & Melse, Johan & van Oers, , 2019. "The Public Health Status and Foresight report 2014: Four normative perspectives on a healthier Netherlands in 2040," Health Policy, Elsevier, vol. 123(3), pages 252-259.
    5. Ria Christine Siagian & Dumilah Ayuningtyas, 2019. "Gap analysis for drug development policy-making: An attempt to close the gap between policy and its implementation," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-13, August.
    6. Huckel Schneider, Carmen & Milat, Andrew J. & Moore, Gabriel, 2016. "Barriers and facilitators to evaluation of health policies and programs: Policymaker and researcher perspectives," Evaluation and Program Planning, Elsevier, vol. 58(C), pages 208-215.
    7. Schwarzman, Joanna & Bauman, Adrian & Gabbe, Belinda J. & Rissel, Chris & Shilton, Trevor & Smith, Ben J., 2022. "How practitioner, organisational and system-level factors act to influence health promotion evaluation capacity: Validation of a conceptual framework," Evaluation and Program Planning, Elsevier, vol. 91(C).
    8. Edwards, Rachael C. & Kneale, Dylan & Stansfield, Claire & Lester, Sarah, 2024. "What are the mechanisms driving the early stages of embedded researcher interventions? A qualitative process evaluation in English local government," Social Science & Medicine, Elsevier, vol. 340(C).
    9. Kathryn Oliver & Warren Pearce, 2017. "Three lessons from evidence-based medicine and policy: increase transparency, balance inputs and understand power," Palgrave Communications, Palgrave Macmillan, vol. 3(1), pages 1-7, December.
    10. Temitope Fisayo, 2021. "Science in action? A critical view of UK blood donation deferral policy and men who have sex with men," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(4), pages 1207-1222, July.
    11. P Th Houngbo & H L S Coleman & M Zweekhorst & Tj De Cock Buning & D Medenou & J F G Bunders, 2017. "A Model for Good Governance of Healthcare Technology Management in the Public Sector: Learning from Evidence-Informed Policy Development and Implementation in Benin," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-22, January.
    12. Béné, Christophe, 2022. "Why the Great Food Transformation may not happen – A deep-dive into our food systems’ political economy, controversies and politics of evidence," World Development, Elsevier, vol. 154(C).
    13. Cyr, Pascale Renée & Jain, Vageesh & Chalkidou, Kalipso & Ottersen, Trygve & Gopinathan, Unni, 2021. "Evaluations of public health interventions produced by health technology assessment agencies: A mapping review and analysis by type and evidence content," Health Policy, Elsevier, vol. 125(8), pages 1054-1064.
    14. Ryan Petteway & Mahasin Mujahid & Amani Allen & Rachel Morello-Frosch, 2019. "Towards a People’s Social Epidemiology: Envisioning a More Inclusive and Equitable Future for Social Epi Research and Practice in the 21st Century," IJERPH, MDPI, vol. 16(20), pages 1-21, October.
    15. Diana Arnautu & Christian Dagenais, 2021. "Use and effectiveness of policy briefs as a knowledge transfer tool: a scoping review," Palgrave Communications, Palgrave Macmillan, vol. 8(1), pages 1-14, December.

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