Program Evaluation of Population- and System-Level Policies: Evidence for Decision Making

Area of Science:

• Health Policy Analysis
• Decision Science
• Evidence Synthesis

Background:

• Traditional policy evaluations often focus on short-term outcomes, limiting their value for decision-making.
• These evaluations frequently overlook policy-relevant outcomes, opportunity costs, and comprehensive evidence, hindering value for money assessments.
• A gap exists in considering all relevant evidence, alternative actions, and decision uncertainty in policy evaluations.

Purpose of the Study:

• To explore how policy evaluation can be enhanced to better inform decision-making.
• To define the essential evidence required for effective policy decisions.
• To review challenges in policy evaluation and identify potential solutions.

Main Methods:

• Literature review of challenges in policy evaluation.
• Exploration of evidence requirements for decision-making.
• Identification of methods from various disciplines to address evaluation challenges.

Main Results:

• Essential evidence includes impacts on policy-relevant outcomes, costs, opportunity costs, and uncertainty.
• Key challenges in health policy evaluation encompass valuation, comparators, timing, mechanisms, effects, resources, implementation, and generalizability.
• Available methods include causal inference, decision-analytic modeling, theory of change, realist evaluation, and structured expert elicitation.

Conclusions:

• Policy evaluations must provide appropriate evidence to guide decision-making.
• Despite identified challenges, multidisciplinary methods can improve policy evaluation practices.
• Evaluators should align decisions, evidence needs, and methodological approaches.