A Pragmatic Approach to Evidence-Based Public Health Policy

The evidence-based approach is a means to improve the quality, safety and cost-effectiveness of the public sec-tor as a whole, not only the health service. But to be successful, the evidence-based approach needs to be restricted to the stage of the policy process where it really can make a contribution; namely in the choice of intervention. In the policy pro-cess phase that precedes the choice of intervention, i.e. the problem formulation phase, there can by definition be no "evi-dence" available, since no controlled trials can ever prove that one problem is bigger than another. Further, the policy pro-cess phase following the choice of intervention, i.e. the implementation phase, is to date still restricted to research of weaker design and the policy makers need to consider input from many different sources also here. A pragmatic approach, focusing the choice of intervention phase of the policy process, has proved successful in the dissemination of an evidence-based policy for parenting support in Sweden