Utilisation of evidence in health policy processes: Findings from the HEPVIC project in India, Vietnam and China

Background. The importance of developing more evidence-informed health policy is well recognised. However evidence can take many forms including formal research and more informal types. Most studies have focused on getting research into policy and practice (GRIPP) with less attention to informal evidence. Furthermore, little is known as to how and the degree to which evidence is used in agenda-setting, development or implementation of health policies. This presentation will compare the use of evidence in health policy processes in Vietnam, India and China.
Methods. The HEPVIC project conducted qualitative studies of health policy processes in Vietnam, India and China using maternal health as a case study. Data collection methods included semi-structured interviews, document reviews, participatory workshops and focus group discussions. Data analysis was conducted using the framework approach in each country, followed by comparative analysis of country data.
Findings. Policy actors use different types of evidence ranging from surveys, to individuals’ experiences.  More formal evidence was influential in the development of health sector-specific policies such as skilled birth attendance, whereas we found a number of examples of more informal evidence (such media reports or lobbying campaigns) in multisectoral policies related to adolescent sexual and reproductive health and domestic violence. In many cases, surveys were commissioned, but health management information system played a relatively minor role. The perceived quality and use of evidence by policy-makers is related to its source and the reputation of actors.
Conclusions. There is a potential for the use of evidence at all stages of the policy process from setting the agenda to monitoring and evaluation of implementation. Relationships between actors are an important consideration in the use of evidence. Although some findings from this project can be generalised beyond maternal health, further research is needed to contribute to the growing body of knowledge in the field.