Harnessing evidence and values in health policy implementation

Abstract

The importance of harnessing research evidence (hereafter evidence) and public values (hereafter values) in health policy implementation (hereafter policy implementation) is widely recognized. Evidence helps policy implementers to find answers to implementation-related questions (e.g., How to address barriers to implementation that may exist at citizen, provider and system levels? What are the most cost-effective interventions?). A culturally sensitive implementation approach that considers values can minimize resistance from the public to policy implementation and contribute to achieving implementation goals. Hence, there is a global push to harness evidence and values in policy implementation. Despite the importance of harnessing evidence and values, little work has been undertaken to understand how the concepts of evidence and values are perceived in the context of policy implementation and how different factors affect the harnessing of evidence and values. This thesis addresses these knowledge gaps through three manuscripts that use a range of methods and approaches to 1) clarify the concepts of harnessing evidence and values in the context of policy implementation; 2) develop a framework that explains how different factors affect policy implementers’ decision to harness evidence and values; 3) apply the framework in the context of public health policy implementation and adjust as needed; and 4) elicit public health leaders’ perspectives about key strategies that can support harnessing evidence and values. These chapters together make substantive, theoretical and methodological contributions to the field of health policy implementation research, and in particular, to the efforts to strengthen support for harnessing evidence and values in health policy implementation.