Rooted in evidence

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The writer, a public health and development consultant, is the author of Patient Pakistan: Reforming and Fixing Healthcare for All in the 21st Century.
The writer, a public health and development consultant, is the author of Patient Pakistan: Reforming and Fixing Healthcare for All in the 21st Century.

IN our times, in line with the ascendency of empirical evidence in global policy frameworks, nations are embarking on a new chapter of governance, driven by data, research, and real-world insights. Their ‘evidence-based policymaking’ means that better utilisation of evidence and research can help save lives, reduce poverty and optimise limited resources.

One such case is that of Pakistan. Despite a rich history and a concentrated focus on policy research matters, evidence-based policymaking is less practised. Reasons range from the urgent necessity of delivering on political manifestos without waiting for the slow evidence-generation processes, non-availability of relevant evidence and research, and underutilised research departments, to research-policy gaps and lack of sustained political and institutionalised will to erect policymaking on the foundation of concrete data. However, these challenges are being addressed.

At the heart of Pakistan’s evolving governance paradigm is practising evidence-based policymaking. Policies must be anchored in credible research, ensuring they are not only politically aspirational but also grounded in reality. Two domains where this approach is making its presence felt are social protection and social health protection.

This fresh approach is evident in the policy matrix at the federal and provincial levels. The matrix at both levels retains a vision centred on citizen welfare. The Benazir Income Support Programme, for instance, is not just a policy initiative but, as borne out by its philosophy of focusing on a safety net for the people, is also a reflection of a commitment to the most vulnerable. Similarly, the Sehat Card initiative has been a tangible stride towards broader universal health coverage, with a view to bringing quality healthcare within the reach of every Pakistani.

A fresh approach to policymaking is necessary.

And yet, despite sound intentions and efforts, the spectrum of policy ambition stretching from conceptualisation to on-ground realisation is replete with challenges. At the centre of these challenges is the need for continuous feedback loops, agile policy adaptability to new research and evidence, and most importantly, a culture of ongoing research and insights into policymaking processes.

The Research Hub, that focuses on social protection and social health protection, represents a strategic answer to this challenge. Conceptualised as a nexus, this new initiative brings together Pakistan’s eminent research institutions, NGOs, development partners and policy architects from various areas including KP, Punjab and the federal government. A collaborative approach is stressed, where research agendas are co-developed and a balance between academic pursuits and real-world policy exigencies is maintained.

The initiative comes at a time of a global momentum towards increasing evidence in policymaking (as also evidenced in the formation of the multi-nation Global Evidence Commission). The usefulness of a collaborative research approach can be seen in its first study on the population’s willingness to participate as co-contributors towards the health insurance programme in KP. The study offers insights into people’s perceptions about the programme, and allows decision-makers to fine-tune modalities to make the programme financially sustainable.

Such research projects, based on evidence-based policy research in health, can help health managers shape their respective programmes to absorb the financial squeeze while keeping their nets wide and inclusive.

An earlier mu­l­ti-country initiative, Strengthening Evidence Use for Development Impact, has foc­used on increasing the use of evidence in pol­icymaking in Uganda, Ghana and Pakistan. Its flagship report on policymaking in the areas of child labour, education and economic development in Pakistan spotlighted the centrality of using evidence. But there was no further follow-up.

The Global Evidence Commission, in its 2022 report and the follow-up 2023 update, further reinforced the importance of improving the use of evidence by formalising domestic evidence-support systems, leveraging global evidence architecture and placing evidence at the heart of policymaking at all levels.

In addition to promoting a culture of evidence-based policy making in line with the recommendations of the Global Evi­d­ence Commission, there is an urgent need for more studies in other policy sectors such as education, housing and the enviro­n­­ment to broaden the practice of on-d­e­m­a­­nd evidence generation in Pakistan.

The writer, a public health and development consultant, is the author of Patient Pakistan: Reforming and Fixing Healthcare for All in the 21st Century.

drarifazad@gmail.com

Twitter: arifazad5

Published in Dawn, December 1st, 2023

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