Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting

 Background: The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions.
Methods: The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health.
Results: In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making.
Conclusions: This study makes an important contribution to understanding how evidence is used within the public health LG context.

Australia’s position on medicines policy in international forums: Intellectual property protection and public health

Universal access to affordable medicines, which are safe, efficacious and of high quality, and which are appropriately used, depends on national legislation that is in turn constrained by a range of international agreements. This regulatory configuration also affects the profitability of the pharmaceutical industry, domestic and international. Tensions and contradictions between industry profitability and public health objectives relate to access, innovation and regulation.

Leaning too far? PISA, policy and Australia's ‘top five’ ambitions

 Australia has declared its ambition to be within the ‘top five’ in the Programme for International Student Assessment (PISA) by 2025. So serious is it about this ambition, that the Australian Government has incorporated it into the Australian Education Act, 2013. Given this focus on PISA results and rankings, we go beyond average scores to take a close look at Australia’s performance in PISA, examining rankings by different geographical units, by item content and by test completion. Based on this analysis and using data from interviews with measurement and policy experts, we show how uninformative and even misleading the ‘average performance scores’, on which the rankings are based, can be. We explore how a more nuanced understanding would point to quite different policy actions. After considering the PISA data and Australia’s ‘top five’ ambition closely, we argue that neither the rankings nor such ambitions should be given much credence.

Moving beyond a ‘bums-on-seats’ analysis of progress towards widening participation: reflections on the context, design and evaluation of an Australian government-funded mentoring programme

In 2010 the Australian Government established the Higher Education Participation and Partnerships programme – a funding agenda to promote programmes that respond to the underrepresentation in higher education of people from what is often denoted low socioeconomic status (SES) backgrounds. Many government-funded programmes and projects have since emerged that respond to the problem of low SES underrepresentation, based on partnerships between higher education providers and other organisations. The arguments made in this paper draw on one such project: a mentoring programme implemented from 2011 to 2013 that targeted the aspirations of Year 9 regional secondary students. We discuss data and documentation that provide insights into the conception and design of the mentoring programme, and the strategies used to evaluate it, in order to discuss how funding and policy contexts influences the possible solutions that might be implemented in response to the underrepresentation in higher education of people from low SES backgrounds.

Integrated practice in the early years in Australia: The assumptions, omissions and contradictions of policy reform

The aim of this article is to examine current national early years’ policy reform, which emphasises the importance of service integration, national quality standards and a quality knowledge base for educators concerning the provision of early childhood education and care. Using Queensland, Australia, as an example, a policy discourse analysis identifies two problematics of implementing current national policy – the early childhood education and care problematic and the integration problematic. The article argues that speedy implementation of a national policy in order to meet national targets has unintended consequences for the knowledge base of educators and the possibility of collaboration within service provision. Although government commitment in this area is evident, these consequences and the current difficulties surrounding integration are the result of the lack of a specific integration strategy, and government investment focussed on the development of an integrated workforce.

Framing ICT policies to facilitate participatory e-government

This paper examines the role of information and communication technology (ICT) policies in shaping the participatory nature of local e-government. It suggests that civic involvement through e-government practices requires a combination of direct and indirect ICT policies (Cohen, van Geenhuizen and Nijkamp, 2005). Direct policies focus on ICT infrastructure development and enhance civic adoption and use of ICTs. ICTs also support policies indirectly through data organisation, information dissemination and the provision of spaces for discourse, deliberation and contributions to decision-making processes. Drawing from policy examples from Australia and the United Kingdom (UK), this paper suggests the need to combine federal guidance with local knowledge, while using policies to support ICTs and using ICTs to support policies. Such a cohesive and integrated policy relationship between federal and local government bodies is needed if local e-government is to advance to facilitate civic engagement.

Interrogating conceptions of “vulnerable youth” in theory, policy and practice

Young people who are considered ‘vulnerable’ or ‘at risk’ are a particular target of various policies, schemes and interventions. But what does vulnerability mean? Interrogating Conceptions of “Vulnerable Youth” explores this question in relation to various policy fields that are relevant to young people, as well for how this plays out in practice and how it is experienced by young people themselves. What makes this book unique is that most authors had the opportunity to jointly explore these issues during a two-day workshop, and their chapters are informed by their cross-agency and cross-discipline discussions, making for a nuanced and thoughtful set of contributions. This collection is highly recommended for researchers and research students in the social sciences, as well as professional staff working in youth policy and youth services, in government departments and in NGOs. “Those who are most vulnerable should receive our greatest moral attention. However, the translation of generalised moral principles into effective policy and programs has never been easy. Political interests have invariably intervened, leading to complex debates about how vulnerability should be defined, classified, measured and represented. In recent years, these debates have become further complicated, as nation-states around the world have preached austerity. This timely book suggests that the responsibility for protecting the vulnerable cannot be left to individuals, but demands collective action, through institutions such as education, health and welfare. It examines some of the ways in which public policies and programs represent those who are vulnerable, involving a range of assumptions about the social, economic and political conditions that produce their vulnerabilities.” From the Foreword by Professor Fazal Rizvi

Neoliberalism, economic restructuring and policy change: precarious housing and precarious employment in Australia

 Housing, employment and economic conditions in many nations have changed greatly over the past decades. This paper explores the ways in which changing housing markets, economic conditions and government policies have affected vulnerable individuals and households, using Australia as a case study. The paper finds a substantial number and proportion of low income Australians have been affected by housing and employment that is insecure with profound implications for vulnerability. Importantly, the paper suggests that in Australia the economic gains achieved as a consequence of mining-related growth in the early 2000s were translated as greater employment security for some on low incomes, but not all. Enhanced access to employment in this period was differentiated by gender, with women largely missing out on the growth in jobs. For the population as a whole, employment gains were offset by increased housing insecurity as accommodation costs rose. The paper finds low income lone parents were especially vulnerable because they were unable to benefit from a buoyant labour market over the decade 2000–2010. They were also adversely affected by national policy changes intended to encourage engagement with paid work. The outcomes identified for Australia are likely to have been mirrored in other nations, especially those that have embraced, or been forced to adopt, more restrictive welfare and income support regimes.

Guidelines for using movement science to inform biodiversity policy

Substantial advances have been made in our understanding of the movement of species, including processes such as dispersal and migration. This knowledge has the potential to improve decisions about biodiversity policy and management, but it can be difficult for decision makers to readily access and integrate the growing body of movement science. This is, in part, due to a lack of synthesis of information that is sufficiently contextualized for a policy audience. Here, we identify key species movement concepts, including mechanisms, types, and moderators of movement, and review their relevance to (1) national biodiversity policies and strategies, (2) reserve planning and management, (3) threatened species protection and recovery, (4) impact and risk assessments, and (5) the prioritization of restoration actions. Based on the review, and considering recent developments in movement ecology, we provide a new framework that draws links between aspects of movement knowledge that are likely the most relevant to each biodiversity policy category. Our framework also shows that there is substantial opportunity for collaboration between researchers and government decision makers in the use of movement science to promote positive biodiversity outcomes.

Conserving koalas: A review of the contrasting regional trends, outlooks and policy challenges

The koala (Phascolarctos cinereus), one of the world's most iconic faunal species, was recently listed under Australian government legislation as vulnerable in the northern states of Queensland and New South Wales and in the Australian Capital Territory, but not in the southern states of Victoria and South Australia. This review synthesises empirical evidence of regional koala population trends, their conservation outlook, and associated policy challenges. Population declines are common in the northern half of the koala's range, where habitat loss, hotter droughts, disease, dog attacks and vehicle collisions are the major threats. In contrast, some southern populations are locally overabundant and are now subject to managed declines. The koala presents the problem of managing a wide-ranging species that now primarily occurs in human-modified landscapes, some of which are rapidly urbanising or subject to large-scale agricultural and mining developments. Climate change is a major threat to both northern and southern populations. The implementation of policy to conserve remaining koala habitat and restore degraded habitat is critical to the success of koala conservation strategies, but habitat conservation alone will not resolve the issues of koala conservation. There needs to be concerted effort to reduce the incidence of dog attack and road-related mortality, disease prevalence and severity, and take into account new threats of climate change and mining. Many of the complex conservation and policy challenges identified here have broader significance for other species whose population trends, and the nature of the threatening processes, vary from region to region, and through time.

Noncommunicable disease prevention and control in Mongolia: a policy analysis

BACKGROUND: Noncommunicable diseases (NCDs) are the major global cause of morbidity and mortality. In Mongolia, a number of health policies have been developed targeting the prevention and control of noncommunicable diseases. This paper aimed to evaluate the extent to which NCD-related policies introduced in Mongolia align with the World Health Organization (WHO) 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. METHODS: We conducted a review of policy documents introduced by the Government of Mongolia from 2000 to 2013. A literature review, internet-based search, and expert consultation identified the policy documents. Information was extracted from the documents using a matrix, mapping each document against the six objectives of the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs and five dimensions: data source, aim and objectives of document, coverage of conditions, coverage of risk factors and implementation plan. 45 NCD-related policies were identified. RESULTS: Prevention and control of the common NCDs and their major risk factors as described by WHO were widely addressed, and policies aligned well with the objectives of the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. Many documents included explicit implementation or monitoring frameworks. It appears that each objective of the WHO 2008-2013 NCD Action Plan was well addressed. Specific areas less well and/or not addressed were chronic respiratory disease, physical activity guidelines and dietary standards. CONCLUSIONS: The Mongolian Government response to the emerging burden of NCDs is a population-based public health approach that includes a national multisectoral framework and integration of NCD prevention and control policies into national health policies. Our findings suggest gaps in addressing chronic respiratory disease, physical activity guidelines, specific food policy actions restricting sales advertising of food products, and a lack of funding specifically supporting NCD research. The neglect of these areas may hamper addressing the NCD burden, and needs immediate action. Future research should explore the effectiveness of national NCD policies and the extent to which the policies are implemented in practice.