As a highly under-skilled and over-critical future public health practitioner, I feel it necessary to confess my severe deficit of knowledge regarding the policy process. Our exploration earlier in the semester of the clash in agendas, priorities and timeframes between policy makers and researchers shed light onto the fact that I am not entirely alone in my academia-induced ignorance of how policy is really happening (Choi et al 2005, Brownson el al 2005). An article a classmate passed along to me clarified for me that I was not alone in my ignorance, and gives me the confidence to share it with you bloggers and classmates.
In “Evidence and Healthy Public Policy: Insights from Health and Political Sciences”, Fafard (2008) analyzes precisely this gap in understanding between health scientists and policy makers. Fafard compares the linear view of policy making often addressed in health literature (Figure 1) to the commonly used stages cycle of the policy realm (Figure 2). It’s interesting and useful to view these visual representations of this process from the respective discipline’s, as they seem to draw out a summary of the mental models that underscore the gap in understanding between these two fields. These two simple representations provide a powerful tool for interrupting the health scientist’s false perception of the policy process by complicating their notion of a linear evidence-to-policy progression.
There are some key differences in policy practice to point out. One major issue surrounding evidence in the agenda setting phase, is how exactly the issue is being framed. As Fafard notes for example, “When an issue is framed as a technical problem, experts can and do often dominate the process of decision-making” (p. 10). A point that brings to my mind the current discourse on Health in all Policies, and the never-ending plea of the health sector for us to be a priority in the face of intersectoral priority setting. The field of resource management comes to mind as a highly interdisciplinary field where it is undoubtedly difficult to prioritize health in the discussion. So how exactly do you frame resource management in a way that encourages the integration of health evidence into decision-making processes? Recent efforts such as Ecohealth make an attempt at this reframing so as to include health experts in the decision-making.
Another important error in the health scientist’s mental model is the apparent halt at policy formulation. To the “policy maker” (“policy makers” and “decision makers”, he points out, are not very well defined in health sciences literature and in fact are can change throughout the policy process) this might however be merely a milestone in a continued process toward successful implementation and evaluation of the policy. This ties into the health scientist’s mental model inserting one decision at the end of the knowledge transfer process, whereas the stages cycle entails various decisions amongst different groups with varied levels of power throughout.
All in all it would seem that the realities of the policy cycle in fact favor the integration of evidence more than a linear model would lead the unversed health scientist to believe. Evidence can take on different forms at different stages of the process, whether it be framing an issue to put it on the agenda or evaluating the impact of a particular policy after its implementation, so there’s hope for us yet.
Brownson R.C. et al (2006). Researchers and Policy Makers: Travelers in Parallel Universes. American Journal of Preventive Medicine, 30(2), 164-172.
Choi B. et al. Can scientists and policy makers work together? Journal of Epidemiology and Community Health, 59, 632-637.
Fafard, P. (2008). Evidence and Healthy Public Policy: Insights from Health and Political Sciences.
Last week we talked about Sabido Methodology and how “Simplemente Maria” or “Simply Maria” was an impressive example of this methodology and how each episode of this soap opera from the 80’s showcased social issues and highlighted them. The Show was so popular even in countries as far as erstwhile Soviet Union, where I was studying at that time, that it was aired dubbed in Russian during prime time. In the transit and public places it was public’s favorite topic for starting conversation, share views and predictions about what will happen next?
Times have changed from the 80s and it will be difficult to expect or predict now that any soap opera will be as popular and effective in highlighting social vices on such a large-scale.
I always wondered about talk shows which appeared on TV, with expert’s views, discussions and recommendations on wide range of topics. I was skeptical about the utility of these talk shows and their effectiveness in bringing changes to quotidian problems faced by common man.I got my answers last year when i learnt about the impacts of chat show “Satyamev Jayate”.
Worldwide many celebrities from Angelina Jolie to Bono of U2 fame are supporting and bringing the media attention to global issues from environment to poverty to health. In India Aamir Khan is doing his bit in a different way.He is considered the Tom Hanks of “Bollywood” (Bollywood-Indian film industry, where roughly 900 movies are made per year, coming to Vancouver on 6th April for TOIFA awards night). Aamir Khan is known for doing things differently. He is among the top three Bollywood actors and three years ago he thought of entering the world of television. He is a social activist at heart and had been talking about environmental issues in the public. Aamir and his team took two years to do the research work and identified issues affecting common people. In May, 2012 with the support of Star Network in India, his chat show on social issues , titled “Satyamev Jayate” meaning Truth triumphs, was launched. The show was aired on Sundays morning at 11:00 and it was said that roads had remarkably less traffic as had happened before in India only during cricket matches between India and Pakistan. There are 1.24 billion (1,249,440,319) connections, 1.6 million followers on Facebook and 91.4 K followers on twitter for “Satyamev Jayate”. There are more than eight million (8,115,739) Community Members.Through this a total of 223,064,210 Indian rupees (more than 3 Million CAD) in donations, have been received for various organizations and NGOs working directly on these issues. In the first season 13 episodes were aired, each focusing on issues of national and global importance including water conservation, community based health Insurance (CBHI) , intimate partner violence (IPV),neoliberalism, medical negligence, and pesticides. The themes of 13 episodes were :
The Idea of India – Episode 13
Water – Episode 12
Old Age – Episode 11
Untouchability – Episode 10
Alcohol Abuse – Episode 9
Toxic Food – Episode 8
Domestic Violence – Episode 7
Persons With Disabilities – Episode 6
Intolerance To Love – Episode 5
Every Life Is Precious – Episode 4
Big Fat Indian Wedding – Episode 3
Child Sexual Abuse – Episode 2
Female feticide – Episode 1
Each episode is of around one hour duration. A summarizing episode on all the 13 episodes and their impacts on policies and society with English subtitles is available at : http://www.youtube.com/watch?v=COrjitFiSXg&playnext=1&list=PL6AF7C1545DB4BA76&feature=results_video
All the 13 episodes with English subtitles are available at:
A few radical solutions for example live in relationship for senior citizens and heart surgeries for $1100 were brought to public attention that were hard to envisage in India few years back.
The impact of this chat show has been nationwide ranging from a national bill on child protection passed in the upper house of Indian parliament to cancellation of registration of doctors involved in female feticide. Few of the successful changes that happened in response to this chat shows are:
Show on the Disabled Jolts Govt into Action
March against female feticide
Unwanted womb removal: Registration of nine private doctors suspended
‘Satyameva Jayate’ inspires sarpanch to act against female foeticide
The URL of its website is www.satyamevjayate.in
Satyamev Jayate, which has struck the right chord with the audiences, has reportedly inspired a British talk show host Tim Sebastian. In case you don’t know who he is – Sebastian is the man behind popular talk show Hard Talk on BBC.
It’s hard to recall a television show from recent with so much impact on policies and social issues of a common man interest.The next season of Satyamev Jayate is planned post September this year.