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There has been an enormous increase in interest in the use of evidence for public policymaking, but the vast majority of work on the subject has failed to engage with the political nature of decision making and how this influences the ways in which evidence will be used (or misused) within political areas. This book provides new insights into the nature of political bias with regards to evidence and critically considers what an 'improved' use of evidence would look like from a policymaking perspective. Part I describes the great potential for evidence to help achieve social goals, as well as the challenges raised by the political nature of policymaking. It explores the concern of evidence advocates that political interests drive the misuse or manipulation of evidence, as well as counter-concerns of critical policy scholars about how appeals to 'evidence-based policy' can depoliticise political debates. Both concerns reflect forms of bias – the first representing technical bias, whereby evidence use violates principles of scientific best practice, and the second representing issue bias in how appeals to evidence can shift political debates to particular questions or marginalise policy-relevant social concerns. Part II then draws on the fields of policy studies and cognitive psychology to understand the origins and mechanisms of both forms of bias in relation to political interests and values. It illustrates how such biases are not only common, but can be much more predictable once we recognise their origins and manifestations in policy arenas. Finally, Part III discusses ways to move forward for those seeking to improve the use of evidence in public policymaking. It explores what constitutes 'good evidence for policy', as well as the 'good use of evidence' within policy processes, and considers how to build evidence-advisory institutions that embed key principles of both scientific good practice and democratic representation. Taken as a whole, the approach promoted is termed the 'good governance of evidence' – a concept that represents the use of rigorous, systematic and technically valid pieces of evidence within decision-making processes that are representative of, and accountable to, populations served.

There has been a growing global concern for improving the use of evidence to inform health policy in recent years. Increasingly there is recognition that individual projects or programmes building evidence synthesis skills, may be limited in their effect without a broader consideration of the systems in place which 'embed' or 'institutionalise' evidence informed policy making practices (Alliance for Health Policy and Systems Research and WHO 2007). The GRIP-Health programme is a five year project supported by the European Research Council which studies the political nature of health policy to understand how to best improve the use of evidence. This explicitly political lens enables us to focus on the contested nature of health issues as well as the institutions that shape the use of evidence in health policy making. We understand institutions as including both formal structures and rules, as well as informal norms and practices (Lowndes and Roberts 2013). The GRIP-Health programme follows the World Health Organization's view that Ministries of Health remain the ultimate stewards of a nation's health, and further play a key role in providing information to guide health decisions (World Health Organization 2000, Alvarez-Rosette, Hawkins, and Parkhurst 2013). As such, GRIP-Health is particularly concerned with the structures and rules created by government to gather, synthesise, or otherwise provide evidence to inform policy making. This working paper is one of a series of six briefs covering a set of countries in which the GRIP-Health programme is undertaking research. This brief presents an overview of what is termed the 'Evidence Advisory System' (EAS) for health policy making within the country of interest, which is taken to encompass the key entry points through which research evidence can make its way into relevant health policy decisions. This can include both formal (government mandated) and informal structures, rules, and norms in place. Individual reports in this series can be useful for those considering how to improve evidence use in specific country settings, while taken together the reports identify the differences that can be seen across contexts, permitting reflection or comparison across countries about how evidence advisory systems are structured – including which responsibilities are given to different types of bodies, and how well evidence advice aligns with decision making authority structures.

There has been a growing global concern for improving the use of evidence to inform health policy in recent years. Increasingly there is recognition that individual projects or programmes building evidence synthesis skills, may be limited in their effect without a broader consideration of the systems in place which 'embed' or 'institutionalise' evidence informed policy making practices (Alliance for Health Policy and Systems Research and WHO 2007). The GRIP-Health programme is a five-year project supported by the European Research Council which studies the political nature of health policy to understand how to best improve the use of evidence. This explicitly political lens enables us to focus on the contested nature of health issues as well as the institutions that shape the use of evidence in health policy making. We understand institutions as including both formal structures and rules, as well as informal norms and practices (Lowndes and Roberts 2013). The GRIP-Health programme follows the World Health Organization's view that Ministries of Health remain the ultimate stewards of a nation's health, and further play a key role in providing information to guide health decisions (World Health Organization 2000, Alvarez-Rosette, Hawkins et al. 2013). As such, GRIP-Health is particularly concerned with the structures and rules created by government to gather, synthesise, or otherwise provide evidence to inform policy making. This working paper is one of a series of six briefs covering a set of countries in which the GRIP-Health programme is undertaking research. This brief presents an overview of what is termed the 'Evidence Advisory System' (EAS) for health policy making within the country of interest, which is taken to encompass the key entry points through which research evidence can make its way into relevant health policy decisions. This can include both formal (government mandated) and informal structures, rules, and norms in place. Individual reports in this series can be useful for those considering how to improve evidence use in specific country settings, while taken together the reports identify the differences that can be seen across contexts, permitting reflection or comparison across countries about how evidence advisory systems are structured – including which responsibilities are given to different types of bodies, and how well evidence advice aligns with decision making authority structures.

In recent years, there has been a marked increase in interest in the use of evidence for public policymaking. Yet the vast majority of work in this area has failed to engage with the political nature of decision making and how this influences the ways in which evidence is used (or misused) within political arenas. This series of briefs provides new insights into the nature of political bias with regards to evidence, and critically considers what an 'improved' use of evidence would look like from a policymaking perspective. Collectively, it summarises ideas presented in the book: The Politics of Evidence: from Evidence Based Policy to the Good Governance of Evidence – published in 2017 by Routledge, and available from late 2016 electronically for free (open access) (http://bit.ly/2eQ3By2).

Human-wildlife conflicts are increasing throughout Virginia. As the level of frustration and dissatisfaction rises among affected residents of a community, decision-makers within local government face escalating demands and expectations from constituents. Although community leaders lack legal authority to make or implement decisions on managing wildlife populations, they do exert considerable influence on how management is conducted in their community by regulatory agencies. Relatively little is known about the level of knowledge community leaders possess about wildlife or the specific attitudes and perceptions they maintain relative to human-wildlife conflict resolution. To gain better understanding of the mindset of these leaders, we conducted a statewide assessment of elected officials (city/town councils, county boards of supervisors), city and town managers or county administrators, directors of municipal animal control units, and county-based natural resource agents with Virginia Cooperative Extension. Specifically, participants were asked about their views on the extent and severity of human-wildlife conflicts in their community, the importance they assigned to inherent risks associated with human-wildlife conflicts, their perceptions and attitudes about who has or should have a role in resolving such complaints, and their knowledge of and opinions about community-based co-management of human-wildlife conflicts. Respondents overall demonstrated a reasonable amount of knowledge about wildlife, although elected officials and administrators displayed somewhat lower knowledge than did animal control officers and extension agents. Most respondents lacked clear familiarity with and understanding of the agencies or entities that have legal authority over wildlife and the specific roles these parties fill. Although respondents expressed guarded optimism and agreement that responsibility for resolving human-wildlife conflicts should be a shared endeavor between the local community and the regulatory agencies, they identified crucial impediments that likely would impose difficulty on seeing community-based co-management become a reality.

BACKGROUND: Observational epidemiological and biological data indicate clear synergies between Herpes simplex virus type 2 (HSV-2) and HIV, whereby HSV-2 enhances the potential for HIV acquisition or transmission. In 2001, the World Health Organization (WHO) launched a call for research into the possibilities of disrupting this cofactor effect through the use of antiherpetic therapy. A WHO Expert Meeting was convened in 2008 to review the research results. The results of the trials were mostly inconclusive or showed no impact. However, the WHO syndromic management treatment guidelines were modified to include acyclovir as first line therapy to treat genital ulcer disease on the basis of the high prevalence of HSV-2 in most settings, impact and cost-benefit of treatment on ulcer healing and quality of life among patients. METHODS: This paper examines the process through which the evidence related to HIV-HSV-2 interactions influenced policy at the international level and then the mechanism of international to national policy transfer, with Ghana as a case study. To better understand the context within which national policy change occurs, special attention was paid to the relationships between researchers and policy-makers as integral to the process of getting evidence into policy. Data from this study were then collected through interviews conducted with researchers, program managers and policy-makers working in sexual health/STI at the 2008 WHO Expert Meeting in Montreux, Switzerland, and in Accra, Ghana. RESULTS: The major findings of this study indicate that investigations into HSV-2 as a cofactor of HIV generated the political will necessary to reform HSV-2 treatment policy. Playing a pivotal role at both the international level and within the Ghanaian policy context were 'policy networks' formed either formally (WHO) or informally (Ghana) around an issue area. These networks of professionals serve as the primary conduit of information between researchers and policy-makers. Donor influence was cited as the single strongest impetus and impediment to policy change nationally. CONCLUSIONS: Policy networks may serve as the primary driving force of change in both international context and in the case of Ghana. Communication among researchers and policy-makers is critical for uptake of evidence and opportunities may exist to formalize policy networks and engage donors in a productive and ethical way.

This article explores how malaria control in sub-Saharan Africa is shaped in important ways by political and economic considerations within the contexts of aid-recipient nations and the global health community. Malaria control is often assumed to be a technically driven exercise: the remit of public health experts and epidemiologists who utilise available data to select the most effective package of activities given available resources. Yet research conducted with national and international stakeholders shows how the realities of malaria control decision-making is often more nuanced. Hegemonic ideas and interests of global actors, as well as the national and global institutional arrangements through which malaria control is funded and implemented, can all influence how national actors respond to malaria. Results from qualitative interviews in seven malaria endemic countries indicate that malaria decision-making is constrained or directed by multiple competing objectives, including a need to balance overarching global goals with local realities, as well as a need for National Malaria Control Programmes to manage and coordinate a range of non-state stakeholders who may divide up regions and tasks within countries. Finally, beyond the influence that political and economic concerns have over programmatic decisions and action, our analysis further finds that malaria control efforts have institutionalised systems, structures, and processes that may have implications for local capacity development in malaria control.

This chapter examines how the political dynamics of aid relationships can affect the use of evidence within health policymaking. Empirical examples from Cambodia, Ethiopia and Ghana illustrate how relationships between national governments and donor agencies influence the ways in which evidence is generated, selected, or utilised to inform policymaking. We particularly consider how relationships with donors influence the underlying systems and processes of evidence use. We find a number of issues affecting which bodies or forms of evidence are taken to be policy relevant, including: levels of local technical capacity to utilise or synthesise evidence; differing stakeholder framing of issues; and the influence of non-state actors on sector-wide systems of agenda setting. The chapter also reflects on some of the key governance implications of these arrangements in which global actors promote forms of evidence use – often under a banner of technical efficiency – with limited consideration for local representation or accountability.

Introduction: Generating country-level political commitment will be critical to driving forward action throughoutthe United Nations Decade of Action on Nutrition (2016-2025). In this review of the empirical nutrition policy literature we ask: what factors generate, sustain and constrain political commitment for nutrition, how, and under what circumstances? Our aim is to inform strategic 'commitment-building' actions. Method: We adopted a framework synthesis method and realist review protocol. An initial framework was derived from relevant theory and then populated with empirical evidence to test and modify it. Five steps were undertaken: initial theoretical framework development; search for relevant empirical literature; study selection and quality appraisal; data extraction, analysis and synthesis; and framework modification. Results: 75 studies were included. We identified 18 factors that drive commitment, organized into five categories: actors; institutions; political and societal contexts; knowledge, evidence and framing; and capacities and resources. Irrespective of country-context, effective nutrition actor networks, strong leadership, civil society mobilization, supportive political administrations, societal change and focusing events, cohesive and resonant framing, and robust data systems and available evidence, were commitment drivers. Low and middle-income country studies also frequently reported international actors, empowered institutions, vertical coordination, and capacities and resources. In upper-middle and high-income country studies private sector interference frequently undermined commitment. Conclusion: Political commitment is not something that simply exists or emerges accidentally; it can be created and strengthened over time through strategic action. Successfully generating commitment will likely require a 'core set' of actions with some context-dependent adaptations. Ultimately, it will necessitate strategic actions by cohesive, resourced and strongly-led nutrition actor networks that are responsive to the multi-factorial, multi-level and dynamic political systems in which they operate and attempt to influence. Accelerating the formation and effectiveness of such networks over the Nutrition Decade should be a core task for all actors involved.

Introduction Generating country-level political commitment will be critical to driving forward action throughout the United Nations Decade of Action on Nutrition (2016–2025). In this review of the empirical nutrition policy literature, we ask: what factors generate, sustain and constrain political commitment for nutrition, how and under what circumstances? Our aim is to inform strategic 'commitment-building' actions.Method We adopted a framework synthesis method and realist review protocol. An initial framework was derived from relevant theory and then populated with empirical evidence to test and modify it. Five steps were undertaken: initial theoretical framework development; search for relevant empirical literature; study selection and quality appraisal; data extraction, analysis and synthesis and framework modification.Results 75 studies were included. We identified 18 factors that drive commitment, organised into five categories: actors; institutions; political and societal contexts; knowledge, evidence and framing; and, capacities and resources. Irrespective of country-context, effective nutrition actor networks, strong leadership, civil society mobilisation, supportive political administrations, societal change and focusing events, cohesive and resonant framing, and robust data systems and available evidence were commitment drivers. Low-income and middle-income country studies also frequently reported international actors, empowered institutions, vertical coordination and capacities and resources. In upper-middle-income and high-income country studies, private sector interference frequently undermined commitment.Conclusion Political commitment is not something that simply exists or emerges accidentally; it can be created and strengthened over time through strategic action. Successfully generating commitment will likely require a core set of actions with some context-dependent adaptations. Ultimately, it will necessitate strategic actions by cohesive, resourced and strongly led nutrition actor networks that are responsive to the multifactorial, multilevel and dynamic political systems in which they operate and attempt to influence. Accelerating the formation and effectiveness of such networks over the Nutrition Decade should be a core task for all actors involved.

BACKGROUND:Declining malaria prevalence and pressure on external funding have increased the need for efficiency in malaria control in sub-Saharan Africa (SSA). Modelled Plasmodium falciparum parasite rate (PfPR) maps are increasingly becoming available and provide information on the epidemiological situation of countries. However, how these maps are understood or used for national malaria planning is rarely explored. In this study, the practices and perceptions of national decision-makers on the utility of malaria risk maps, showing prevalence of parasitaemia or incidence of illness, was investigated. METHODS:A document review of recent National Malaria Strategic Plans was combined with 64 in-depth interviews with stakeholders in Kenya, Malawi and the Democratic Republic of Congo (DRC). The document review focused on the type of epidemiological maps included and their use in prioritising and targeting interventions. Interviews (14 Kenya, 17 Malawi, 27 DRC, 6 global level) explored drivers of stakeholder perceptions of the utility, value and limitations of malaria risk maps. RESULTS:Three different types of maps were used to show malaria epidemiological strata: malaria prevalence using a PfPR modelled map (Kenya); malaria incidence using routine health system data (Malawi); and malaria prevalence using data from the most recent Demographic and Health Survey (DRC). In Kenya the map was used to target preventative interventions, including long-lasting insecticide-treated nets (LLINs) and intermittent preventive treatment in pregnancy (IPTp), whilst in Malawi and DRC the maps were used to target in-door residual spraying (IRS) and LLINs distributions in schools. Maps were also used for operational planning, supply quantification, financial justification and advocacy. Findings from the interviews suggested that decision-makers lacked trust in the modelled PfPR maps when based on only a few empirical data points (Malawi and DRC). CONCLUSIONS:Maps were generally used to identify areas with high prevalence in order to ...