Harpham T, Tuan T
London South Bank University, London, England.
Bull World Health Organ. 2006 Aug;84(8):664-8. doi: 10.2471/blt.05.027789.
The use of evidence-based policy is gaining attention in developing countries. Frameworks to analyse the process of developing policy and to assess whether evidence is likely to influence policy-makers are now available. However, the use of evidence in policies on caring for people with mental illness in developing countries has rarely been analysed.
This case study from Viet Nam illustrates how evidence can be used to influence policy. We summarize evidence on the burden of mental illness in Viet Nam and describe attempts to influence policy-makers. We also interviewed key stakeholders to ascertain their views on how policy could be affected. We then applied an analytical framework to the case study; this framework included an assessment of the political context in which the policy was developed, the links between organizations needed to influence policy, external influences on policy-makers and the nature of evidence required to influence policy-makers.
The burden of mental illness among various population groups was large but there were few policies aimed at providing care for people with mental illness, apart from policies for providing hospital-based care for people with severe mental illness.
The national plan proposes to incorporate screening for mental illness among women and children in order to implement early detection and treatment.
Evidence on the burden of mental ill-health in Viet Nam is patchy and research in this area is still relatively undeveloped. Nonetheless the policy process was influenced by the evidence from research because key links between organizations and policy-makers were established at an early stage, the evidence was regarded as rigorous and the timing was opportune.
循证政策在发展中国家正日益受到关注。目前已有分析政策制定过程以及评估证据是否可能影响政策制定者的框架。然而,发展中国家针对精神疾病患者护理政策中证据的使用情况鲜有分析。
越南的这个案例研究说明了证据如何被用于影响政策。我们总结了越南精神疾病负担的证据,并描述了影响政策制定者的尝试。我们还采访了关键利益相关者,以确定他们对政策可能受到何种影响的看法。然后,我们将一个分析框架应用于该案例研究;这个框架包括对政策制定所处政治背景的评估、影响政策所需组织之间的联系、对政策制定者的外部影响以及影响政策制定者所需证据的性质。
不同人群中的精神疾病负担很重,但除了为重症精神疾病患者提供住院治疗的政策外,几乎没有旨在为精神疾病患者提供护理的政策。
国家计划提议将妇女和儿童的精神疾病筛查纳入其中,以便实施早期发现和治疗。
越南精神疾病负担的证据并不完整,该领域的研究仍相对不发达。尽管如此,政策制定过程受到了研究证据的影响,因为组织与政策制定者之间的关键联系在早期就已建立,证据被认为严谨且时机合适。