Health policy evaluation

This chapter defines and contextualises evaluation, first in general public policy terms, and then specifically with regard to health policy. It outlines the many challenges inherent to the evaluation of health policy. It introduces these in relation to the evaluation of clinical practices through a critical discussion of evidence-informed policy. This, in turn, reveals the significant epistemological challenges central to health policy evaluation. The chapter further introduces the main types of evaluation that have been used in the health field to inform policy, their strengths and weaknesses, and where they are most applicable. These include before and after, interrupted time series, additionality, regression discontinuity, natural experiments, quasi-experimental, experimental, and realist approaches. The chapter distinguishes between how policy is evaluated (evaluation of policy) and the role of evaluation in policy (evaluation as an instrument of policy).