An integrated framework to guide evidence-informed public health policymaking

Abstract

Evidence-informed policymaking emphasizes that policy decisions should be informed by the best available evidence from research and follow a systematic and transparent approach. For public health policymaking we can learn from existing practices of transparent, evidence-informed decision-making for clinical practice, medicines, and medical technology. We review existing evidence-to-decision frameworks, as well as frameworks and theories for policymaking to address the political dimension of policymaking, and use this analysis to propose an integrated framework to guide evidence-informed policymaking. The framework includes nine decision-making criteria and allows for the addition of other context-specific criteria. It also emphasizes elements of the decision-making process that can give greater legitimacy, fairness, and transparency to the policy decision, such as the use of deliberative processes and assessment of conflicts of interest. We offer the framework as a tool to help government policy makers use evidence in a structured and transparent way when making decisions about public health policy options.

Keywords: Conflict of interest; Deliberative process; Evidence-informed policymaking; Public health policy; Stakeholder.

Fig. 1

Evidence-informed decision-making frameworks and processes. The guiding manuals and articles for each of the frameworks are: WHO/GRADE Guidelines the WHO Guideline Handbook and GRADE articles [13, 14, 19, 40]; EU Health Technology Assessment The HTA Core Model® [15, 50, 51]; WHO Essential Medicines List—WHO regulations and manuals [17, 18, 54]; and WHO Evidence-informed policy guidance WHO evidence briefs for policy guiding manual [53]. EU European Union; GRADE Grading of Recommendations Assessment, Development and Evaluation; WHO World Health Organization

Fig. 2

An integrated framework to guide evidence-informed policymaking