1. การพัฒนานโยบายด้วยหลักฐานเชิงประจักษ์(Evidence-based policy development)
ดร.ทพญ.ศิริวรรณ พิทยรังสฤษฏ์
Director, International Health Policy Program
กระทรวงสาธารณสุข

2. Good policy
Good policy involves information gained from multiple sources, including
expert knowledge,
existing and new research,
secondary sources, and
stakeholder input.
(Ridenour 2009)

3. Ref: Klein’s presentation on Evidence based policy development

4. Steps in Evidence Based Practice
 Step 1: Formulating a well-built question  Step 2: Identifying articles and other evidence-based resources that answer the question  Step 3: Critically appraising the evidence to assess its validity  Step 4: Applying the evidence  Step 5: Re-evaluating the application of evidence and areas for improvement
Ref: Klein’s presentation on Evidence based policy development

5. Policy adoption (Agenda setting theory)
Hall et al. model
Legitimacy
Feasibility
Support
Kingdon 3-stream model
Problems
Policies (solutions)
Politics (political will)

6. A Theory on agenda setting
Used for academic purpose
Presented by Siriwan Pitayarangsarit 21 July 2004
A Theory on agenda setting
The Hall et al. model
Legitimacy
-those issues with which governments feel they should be concerned
Feasibility
technical knowledge, skills, infrastructure
Support
public support for the issue
Legitimacy
Issues where governments feel most people will accept state intervention.
Issues range from high to low legitimacy.
Examples: most people expect govts to keep law and order in the streets, to defend the country from external aggression
Other areas, legitimacy not easily conferred: China’s one-child population policy; Russia what you could write about; Malawi – short skirts
Feasibility
Refers to the potential for implementing the policy, defined by prevailing technical and theoretical knowledge, financial and other resources.
Example: Cannot integrate STD treatment into FP clinics until health workers can diagnose the diseases, and treat them (which may mean changing sorts of drugs available
Support
Elusive, depends on people’s trust in government, and support for issue
Example: In 1980s not possible for Irish or Argentinian govt to introduce divorce law reform – implacable Church opposition

7. Agenda Setting Through Three Streams
Used for academic purpose
Presented by Siriwan Pitayarangsarit 21 July 2004
Agenda Setting Through Three Streams
The Kingdon model
Problem Stream
indicators
focusing events
feedback
Politics Stream (political will)
visible participants
hidden participants
Policy Stream (solutions)
window of opportunity
Problem stream
Indicators – routine information on health statistics (showing increase in heart disease or rising costs of particular programme)
Focusing event – a crisis – cholera outbreak, or personal experience
Feedback – programmes already in place – eg through evaluations
Politics (political will) stream
Visible participants – organized interests – interest groups – but may also be inside govt eg new president or PM; interest group with new data
Hidden participants – specialists – academics, researchers, consultants
Policy (solutions) stream
Policymakers select from problems and politics streams and make public policy – ie find the political will to make the three streams come together (political will complex: made up of policymakers perceptions of public acceptability, financial & technical feasibility, etc)
Ie policymaking doesn’t occur in linear stages, ie policymakers don’t necessarily proceed from identification of a problem, seek solutions for them.

8. Kingdon’s - 3 Stream model
No Change
Problem
Policy (Solutions)
Politics (Political
will)
Kingdon’s - 3 Stream model
ACTION

9. Thank You
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