Legislators learning to interpret evidence for policy

Training for making health policy that has the best impact on a population Should decision-makers allocate budgets for health services, using the best available evidence? Although the answer seems obvious, most resource allocation is unrelated to evidence of what works best. The well-recognized knowledge-to-action gap ( 1 ) has spawned a complex industry of lobbying and knowledge translation. Bridging the gap is a business opportunity for lobbyists, who help to translate evidence in ways that best present a particular interest. Partly to offset these selective, if not frankly biased, interpretations, the last decade has seen an industrial-scale thrust toward systematic reviews to synthesize available evidence ( 2 , 3 ). But systematic reviews mostly systematize what has been published. For many decisions on health services, there is simply no evidence with the quality one gets from a randomized controlled trial (RCT). Thus, policy decision-makers have to find their way through evidence of varying quality and relevance, only rarely packaged to clarify the population health impact of different choices. A 2012 international forum on evidence-informed health policy-making in low- and middle-income countries called for building the capacity of potential research users to evaluate and use research evidence ( 4 ). There are, of course, many levels of research users among health policy-makers and decision-takers. To date, initiatives to build the capacity of research users to interpret evidence have not included actual legislators themselves; instead, they target technical officers and advisers on the assumption that they will then advise the elected representatives appropriately ( 5 ). We will describe an effort to help legislators themselves understand the elements of the evidence they need to make decisions ( 6 ).