Formulating health policies pose numerous challenges. It usually occurs at a fast pace, involves disciplines outside healthcare and is required to be steeped in good economic and sometimes social reasoning. Often there is dearth of good research to base these policies on. Extensive and excellent research is usually published to dissect a policy after it is implemented instead of providing a sound basis to one. It is imperative that academics are made aware of these shortfalls so that they base their studies, report their evidence and steer their message in a manner that is useful for policymaking.
A lack of research and absence of quality/usable studies often plague policymaking in healthcare.
In a paper published in the journal BMC Med, Christopher Whitty, a healthcare policymaker in the UK has pointed that lack of evidence-based policymaking is primarily owing to three reasons. Firstly, there is an absence of research in the domain that requires policy intervention. Secondly, policymakers are not being able to identify existing research in a desired area of policymaking. Thirdly, appropriate research sometimes cannot be used for policymaking, for the want of desired components in them.
What should research papers include?
Research papers that are useful in informing policy usually state the policy problem clearly. While a research activity need not necessarily be carried out for or to influence policymaking, a little attention to such a possibility will go a long way in making use such a body of work. A policy problem may be different than a scientific problem and hence its mention brings clarity to those intending to use it.
Characteristics of research useful for policymaking include transparent methodology, a clear outlining of limitations and weaknesses and a lack of bias. They are also not advocacy documents. A lot of research work, particularly in the social sciences, lack the above attributes. This does not augur well for policymakers and hence there need to be checks and balances in place. Researcher bias, often owing to affiliations and conflicts of interest, is a daunting problem and must be negated. Researchers should also avoid becoming advocates of a particular policy and should leave it to qualified policymakers.
Often, the pace of research activity and policy formulation does not match, with the former slower than the latter. It is often in the quest of perfection, and the massive institutional maze that one has to work in, that research work inches at a slow pace. Projects intending to be used for policymaking thus should be simple (not simpler), should be without design complexities and should publish results in timely way. Another hindrance which needs to be removed is the difficult language (too much jargon, not enough explanations in plain English) used by authors.
Objectivity, timeliness, rigour, sound design, and easily conveyable language are attributes that a policymaker seeks in a research work.
I will cite an example in the field of nutrition to explain the points discussed. If a policy is to be formulated to address junk food consumption by children, it needs to have sound research as its basis. First, there need to be enough people working, and in the targeted population, in that domain. Second, their design has to be foolproof as children will be affected. The research work should be free of any bias that could have crept in owing to researcher's preferences or external pressure from stakeholders. Importantly, such a body of work must also be completed in a timely manner, for a delay would mean that children would be affected by the consequences of a lack of policy.
Towards better policymaking
Health policy, owing to its impact, needs to be based on good quality research work. Increasingly, randomized control trials are being used in policymaking and it has resulted in increased efficiency. However there are plenty of gaps there. A lack of research and absence of quality/usable studies often plague policymaking in healthcare. Objectivity, timeliness, rigour, sound design, and easily conveyable language are attributes that a policymaker seeks in a research work to base his policy design on. Researchers must be made aware and they should strive to meet these needs. Academia can then truly complement policymaking.
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