SUPPORT Tools for evidence-informed health Policymaking (STP) 1: What is evidence-informed policymaking?

To improve health and reduce health inequalities, public policymakers need to find the best solutions to the most burdensome health problems, the best ways to fit these solutions into complex and often overstretched and underresourced health systems, and the best ways to bring about the desired changes in health systems. Systematic reviews can inform public policymaking by providing research-based answers to these questions. Public policymakers can encourage more informed policymaking by asking to see systematic reviews on priority issues, commissioning reviews when none exists, and placing more value on such work in their deliberations and in their interactions with stakeholders. Donors and international agencies can encourage more informed public policymaking by supporting national and regional efforts to undertake reviews and assess their local applicability, and by supporting regional or worldwide efforts to coordinate review and assessment processes.

This article is the Introduction to a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Knowing how to find and use research evidence can help policymakers and those who support them to do their jobs better and more efficiently. Each article in this series presents a proposed tool that can be used by those involved in finding and using research evidence to support evidence-informed health policymaking. The series addresses four broad areas: 1. Supporting evidence-informed policymaking 2. Identifying needs for research evidence in relation to three steps in policymaking processes, namely problem clarification, options framing, and implementation planning 3. Finding and assessing both systematic reviews and other types of evidence to inform these steps, and 4. Going from research evidence to decisions. Each article begins with between one and three typical scenarios relating to the topic. These scenarios are designed to help readers decide on the level of detail relevant to them when applying the tools described. Most articles in this series are structured using a set of questions that guide readers through the proposed tools and show how to undertake activities to support evidence-informed policymaking efficiently and effectively. These activities include, for example, using research evidence to clarify problems, assessing the applicability of the findings of a systematic review about the effects of options selected to address problems, organising and using policy dialogues to support evidence-informed policymaking, and planning policy monitoring and evaluation. In several articles, the set of questions presented offers more general guidance on how to support evidence-informed policymaking. Additional information resources are listed and described in every article. The evaluation of ways to support evidence-informed health policymaking is a developing field and feedback about how to improve the series is welcome.

Conceptual, methodological, and practical issues await those who seek to understand how to make better use of health services research in developing public policy. Some policies and some policymaking processes may lend themselves particularly well to being informed by research. Different conclusions about the extent to which policymaking is informed by research may arise from different views about what constitutes health services research (is it citable research or any professional social inquiry that can aid in problem solving?) or different views about what constitutes research use (is it explicit uses of research only, or does it also include tacit knowledge or the positions of stakeholders when they are informed by research and are influential in the policymaking process?). Some conditions may favor the use of research in policymaking, like sustained interactions between researchers and policymakers. Results from an exploratory study on the use of health services research by Canadian provincial policymakers illustrate these issues.