Policy, practice, and politics
In the advent of the Zika scare, it is clear that the need for evidence and sensationalism are difficult to balance, and due to the pressure from the media, many governments and various entities, responded in haste and with probably very little time to analyze their recommendations. A similar case was seen in the wake of the Ebola outbreak. The global community has seen and experienced the consequences: fear and confusion of managing and controlling a disease that has limited evidence and knowledge base, and lack of historical antecedents to support the actions taken.
However, we often do have the evidence more or less readily available to respond to the health information needs and to the requests from policy makers. Unfortunately, more often than not, this information is too complex and difficult to determine what is correct and what is simply popular belief. The plethora of publications makes it difficult to sift through and summarize, so that there is an adequate process of translation from evidence generated by researchers, to policy and practice.
Hence, we must strive to address the needs of the target audience. According to Wickremasinghe et al, there are at least six primary audience groups—professionals, practitioners, researchers, academics, advocates, and policymakers. To meet the varying knowledge needs of these groups successfully, collaborative planning is required. The four essential characteristics to consider when planning an output—Readability, Relevance, Rigour and Resources.
The barriers that need to be overcome for the implementation of evidence based decision-making in policy and practice are summarised by Andermann et al as:
1. missing the window of opportunity – if the evidence required is not available (or the resources/infrastructure not in place) at a time, key decisions need to be made then the chance for evidence-based actions is lost
2. knowledge gaps and uncertainty
3. controversy, irrelevant and conflicting evidence – making it unclear which path to follow and increasing the possibility of incorrect or non-evidence based decisions being made
4. vested interests and conflicts of interest.
With this in mind, the right evidence should be timely and readily available, in the proper format and adequate language, showing how it is relevant, how it relates to other health policies and expected outcomes, as well as possible consequences if not taken into account. Also, as Andermann et al clearly point out, we must take into account possible vested interests from other researchers and entities, resulting in conflict of interests affecting the desired end results. Andermann et al used the words “Political savvy”, and they are right, it is a skill we often lack as researchers.
Author: Van Charles Lansingh
Van Charles Lansingh has worked in Latin America, North America, South East Asia, and the Pacific. He is on the International Advisory Panel of the Ophthalmic News & Education (O.N.E.™) Network from the AAO (American Academy of Ophthalmology) and ICO (International Council of Ophthalmology), and a member of the Group of Experts of WHO (World Health Organization) / PAHO (Pan American Health Organization) since May 2006.