GETTING RESEARCH INTO POLICY IN PUBLIC HEALTH
Getting Research into Policy in Public Health (GRIP‐Health) is a five year research project hosted at the London School of Hygiene and Tropical Medicine (LSHTM). It aims to aim to improve the practice of evidence informed health policy through the application of political, institutional, and sociological analysis. Specifically we are undertaking policy analysis oriented research to explore how, why and when national ministries of health use research evidence in the process of health policy‐making, with a particular focus on the the political and institutional factors that help or hinder the utilisation of relevant scientific evidence.
Drawing on multiple disciplines, including political science (in particular policy analysis and public administration), sociology, and development studies, GRIP‐Health investigates two key factors which determine evidence use in health policy: the politicisation of the health issues and the institutional structures through which evidence is incorporated into the policy making process.
An Institutional Approach to Analysing Evidence Use in Health Policy Processes
We use a broad definition of institutions that denotes the contextual factors influencing policy decision‐making. Institutional structures include the rules, norms and procedures that shape policy decision‐making and provide the mechanisms through which governments function in their identification and use of evidence. For the purpose of our comparative research, the focus of the analysis will be on national ministries of health (MoH) and other national or regional level authorities which we define here as the ‘stewards of health policy’.
Three levels of institutional analysis – cultural, political and administrative – will be distinguished, each providing a different institutional perspective and each associated with a different set of questions.
Our empirical research will compare six country case studies – Cambodia, Colombia, England, Ethiopia, Germany and Ghana (local approval permitting) – which are characterized by a range of different political structures, public health systems, and epidemiological trends. Selection criteria for these countries included variables such as geography, national income level, nature of representation, the level of government effectiveness and the degree of centralisation of the state in terms of its constitutional structure. Within these countries we will undertake policy process tracing to understand how policy decisions were made for a set of recent health policy decisions.
A systematic review of the literature on politicisation of health issues and institutional responses to evidence use was conducted from 2012‐2013 (results published in PLOS‐One: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0077404). We then developed a theoretical framework and a series of research questions to inform the country case studies, drawing on institutional theory and comparative policy studies. In 2014 we will begin field work in each of our case study countries. One task of our research will focus on identifying key decision making structures in each setting, and a short list of recent health issues for our health policy process tracing. The selection of local health issues to study in each country will include a recent decision where evidence was believed to be used well, a recent case where evidence use was seen to be problematic, and finally a health issue that is has been subject to policy attention in all six countries.
The second task will be to undertake policy process tracing around the selected health decisions. We will investigate how evidence, alongside other inputs, makes its way through the policy process, within the nested structure of relevant institutions illustrated above. We will particularly investigate and analyse the role of ministry of health structures and institutional bodies, rules, and norms, in shaping the use of evidence within these processes.
Our primary data collection methods will involve documentary analysis and interviews with policy stakeholders. Through direct purposive and snowball sampling we will identify interviewees representing government sectors (e.g. civil servants, legislators, ministry officials), civil society organisations (e.g. NGOs, academics, and other stakeholders contributing to policy debates) and international agencies (e.g. aid agencies or development partners where appropriate).
Impact, Feedback, and Goals
The GRIP‐Health programme is committed to rigorous, transparent, and unbiased uses of evidence to inform policy, while equally committed to ensuring that policy decisions represent the values and needs of local citizens. As such, our strategy for impact and ultimate goal is to provide information and findings that are practically useful to local Ministries of Health. We believe the best way to achieve this for long term sustainable change is to build the capacity of Ministries of Health to establish the institutional agencies and rules that can ensure improved evidence utilisation within the realities of local political contexts.
The GRIP‐Health project is supported by a grant from the European Research Council (Project ID# 282118).
More information can be found at www.lshtm.ac.uk/groups/griphealth
Key project areas
- Public policy
- Evidence-based policymaking
- Health-related public controversies
- Six countries comparative analysis of the institutions underpinning evidence-based policymaking; documentary analysis and fieldwork through semi-structured interviews
- Cambodia, Colombia, England, Ethiopia, Germany and Ghana
- Justin O. Parkhurst
- European Research Council (ERC)
LSHTM Staff Involved