WHO/Europe promotes evidence-informed policy-making in the WHO European Region. As part of this effort, its programme on evidence, information and policy facilitates the different stages of the process:
- define: clearly define the health problem or issue;
- search: efficiently search for research evidence;
- appraise: critically and efficiently appraise the research sources;
- synthesize: interpret/form options or recommendations for practice or policy based on the literature found;
- adapt: adapt the information to a local context;
- implement: decide whether to use the adapted evidence in practice or policy; and
- evaluate: evaluate the effectiveness of implementation efforts.
In 2003, on the advice of the European Advisory Committee on Health Research (EACHR), WHO/Europe adopted an initial broad definition of evidence that included research findings and context-related information from other types of knowledge: “findings from research and other knowledge that may serve as a useful basis for decision-making in public health and health care” (1).
WHO/Europe is adapting and building on this early definition, and working with partners to better meet the needs of European countries. This work supports the approach that evidence supports decisions, but does not determine them.
Evidence to inform policy-makers can be sought in different ways, depending on several factors, including: the timeframe in which the researcher has to operate (how quickly a policy-maker requires a response), the resources available and the type of evidence required (for example, global or local). The nature of the query or policy-maker’s request dictates the type of evidence and how it is made available. If no evidence is found, the alternative measures available may require consideration.
Many different initiatives, databases and search strategies are available internationally to help policy-makers and those who support them. WHO’s Health Evidence Network (HEN), which synthesizes evidence and provides access to key materials in this area, is one example.
Making an informed decision requires understanding what its impact may be in the local setting. For instance, what works well in one country or health system may not be so successful in another. A key challenge for policy-makers and researchers is therefore to determine whether research evidence about the effects of an option is applicable to their settings.
WHO/Europe engages with Member States to produce publications that synthesize available research evidence on potential policy options for good practice, so that decision-makers can consider means and strategies for innovation in their systems. The publications do not aim to provide an ideal model or recommended approach, but help decision-makers by packaging the research evidence in an accessible and usable format.(1) European Advisory Committee on Health Research (EACHR). Considerations in defining evidence for public health. “International Journal of Technology Assessment in Health Care”, 2003, 19(3):559–573.