Post on 15-Dec-2014
description
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EVIDENCE
Sharing experience on challenges
TO POLICY
Emilie RobertUniversité de Montréal
© E. Robert, 2014
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Some definitions…
• Policyo ‘a definite course or method of action selected from
among alternatives and in light of given conditions to guide and determine present and future decisions’ (Merriam Webster)
© E. Robert, 2014
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Some definitions…
• Policyo ‘a definite course or method of action selected from
among alternatives and in light of given conditions to guide and determine present and future decisions’ (Merriam Webster)
© E. Robert, 2014
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Some definitions…
• Policyo ‘a definite course or method of action selected from
among alternatives and in light of given conditions to guide and determine present and future decisions’ (Merriam Webster)
• Policy vs. politicso ‘Policy is mostly about the design and implementation
of a particular intervention. Politics is about how the decision was made.’ (C. Tyler)
© E. Robert, 2014
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• Policy-makero ‘a person responsible for or involved in formulating
policies, especially in politics.’ (Oxford Dictionaries)
Some definitions…
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• Policy-makero ‘a person responsible for or involved in formulating
policies, especially in politics.’ (Oxford Dictionaries)o ‘the invisible man’ (E. Robert)
Some definitions…
© E. Robert, 2014
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Two planets: different objectives and constraints
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Researchers are from Venus…• “Publish or perish”• Get funding• Conduct research• Teach• Supervise students• Present in conferences• Etc.
Two planets: different objectives and constraints
© E. Robert, 2014
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Researchers are from Venus…• “Publish or perish”• Get funding• Conduct research• Teach• Supervise students• Present in conferences• Etc.
Policy-makers are from Mars…• Negociate with stakeholders• Ensure accountability to
population / electorate• Comply with existing
agenda• Integrate policy
recommendations from hierarchy
• Etc.
Two planets: different objectives and constraints
© E. Robert, 2014
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Researchers are from Venus…• “Publish or perish”• Get funding• Conduct research• Teach• Supervise students• Present in conferences• Etc.
Policy-makers are from Mars…• Negociate with stakeholders• Ensure accountability to
population / electorate• Comply with existing
agenda• Integrate policy
recommendations from hierarchy
• Etc.
• Move evidence to policy… • Use evidence for policy…
Two planets: different objectives and constraints
© E. Robert, 2014
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Entering the policy ‘arena’
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Entering the policy ‘arena’
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• Opacity and complexity of the policy process
• Several ‘layers’ of policy-makers
• A more or less shifting policy landscape
• Presence of ‘gate keepers’
• Contestants
Entering the policy ‘arena’
© E. Robert, 2014
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• Opacity and complexity of the policy process
• Several ‘layers’ of policy-makers
• A more or less shifting policy landscape
• Presence of ‘gate keepers’
• Contestants
Entering the policy ‘arena’
© E. Robert, 2014
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No “one-size fits all” strategy
© E. Robert, 2014
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No “one-size fits all” strategy
© E. Robert, 2014
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“How do we deal with obesity?”
“Cancer prevalence is
high.”
Congruence with policy-makers’ preoccupations
No “one-size fits all” strategy
© E. Robert, 2014
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“How do we deal with obesity?”
“Cancer prevalence is
high.”
“User fees finance our
health system”
“User fees are a threat to health.”
Congruence with policy-makers’ preoccupations
Congruence with policy-makers’ ideas
No “one-size fits all” strategy
© E. Robert, 2014
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“How do we deal with obesity?”
“Cancer prevalence is
high.”
“User fees finance our
health system”
“User fees are a threat to health.”
Congruence with policy-makers’ preoccupations
Congruence with policy-makers’ ideas
Networks
No “one-size fits all” strategy
© E. Robert, 2014
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“How do we deal with obesity?”
“Cancer prevalence is
high.”
“User fees finance our
health system”
“User fees are a threat to health.”
Congruence with policy-makers’ preoccupations
Congruence with policy-makers’ ideas
Networks
Timing
No “one-size fits all” strategy
© E. Robert, 2014
21
“How do we deal with obesity?”
“Cancer prevalence is
high.”
“User fees finance our
health system”
“User fees are a threat to health.”
Congruence with policy-makers’ preoccupations
Congruence with policy-makers’ ideas
Networks
Timing
No “one-size fits all” strategy
© E. Robert, 2014
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In practice… Example 1
• Aboriginal communities (Canada)
• Mandate from the regional health authority
• Research objective:– To understand successes and challenges
of implementing intervention
• Evaluation objective: – To improve the intervention in
communities where it is already implemented.
– To provide lessons for scaling up the intervention
© E. Robert, 2014
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Facilitators Challenges
Guidelines for Aboriginal research
Several layers of audiences
High stakes
Financial resources
Mandate from policy-makers
In practice… Example 1
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• Realist review on user fee exemption policies in sub-Sahara Africa
• “Hot” topics since 2005…
• “Sexy” method since 2012…
• Doctoral research (Ph.D.) at the University of Montreal starting 2008
In practice… Example 2
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In practice… Example 2
Missed opportunity?
Low involvement
of policy-makers
Long research process
New ‘hot’ topics (UHC,
PBF…) « … It seems fair to say that at least in terms of retrospective studies on the formulation and implementation of country fee exemption policies, we are reaching a data saturation point. » (B. Meessen, 2013)
Health Policy and Planning Debated
« Producing evidence on the complexity of user fees abolition interventions is crucial to support the implementation of universal coverage (…) Calling all young researchers, emerging voices and other people-centred scientists! Could we see some potential solutions at the Third Global Symposium on Health Systems Research? » (V. Ridde and E. Robert, 2014)
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A When there is a will, there is a way...
B The way is far from straightforward...
C … and it is very context-dependent.
Moving evidence to policy is like fishing… You never know if you’ll catch the fish, but
there are hints to approach your goal.
Take home messages
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Emilie Robert is a Ph.D. candidate in public health at the University of Montreal. She is also an evaluation and KT consultant.
Contact: emilierobert.udem@gmail.com