Evidence – Informed Policy Formulation and Implementation: A case study of ‘Clean Air Policy’ in Punjab, Pakistan

Abstract

Background: There has been an accelerating momentum globally, for the use of scientific research evidence to support public health policy formulation and implementation. Policymakers, nonetheless use a variety of information over and above research evidence in the process.  A case study of ‘the Clean Air policy’ was undertaken to explore the Policy makers practices related to Evidence Informed Policy in Punjab, Pakistan. Objective: The objective of this study was to investigate policy makers’ perceptions regarding ‘evidence’ and how it is gathered and used in policy formulation and implementation processes Methods: The empirical data was collected by qualitative research techniques. Document review and semi-structured in-depth interviews were conducted with 87 purposively selected policymakers between December’22-October’23.  Data Analysis was guided by principals of grounded theory. A conceptual model for Evidence Informed Policy Formulation and Implementation (derived from the Frameworks of Bowen and Zwi and Dodson et al.) was experientially applied to organize the data. Results: The case study of the ‘Clean Air Policy’ of the Govt. of Punjab highlighted that the policy had been formulated in a structured manner with incorporation of relevant evidence (research and other) at all stages of policy formulation. Policy makers considered ‘evidence’ as an expansive concept not limited to research evidence. Overall, the use of evidence for policy-making and implementation is rooted in complexities inherent to the local context, policymakers understanding and organizational culture and processes.   Conclusion: The study contributed to understanding the arena of Evidence Informed policy practices in Pakistan. Addressing the highlighted challenges can inform strategies for enhancing evidence use in policy processes for improving health system performance.