Waqa Gade, Bell Colin, Snowdon Wendy, Moodie Marj
C-POND, Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Melbourne, Australia.
BMC Public Health. 2017 Jan 9;17(1):51. doi: 10.1186/s12889-016-3944-6.
There is limited research on the use of evidence to inform policy-making in the Pacific. This study aims to identify and describe factors that facilitate or limit the use of evidence in food-related policy-making in the Health and Agriculture Ministries in Fiji.
Semi-structured face-to-face interviews were conducted with selected policy-makers in two government ministries that were instrumental in the development of food-related policies in Fiji designed to prevent Non-Communicable Diseases (NCDs). Snowball sampling was used to recruit, as key informants, senior policy-makers in management positions such as national advisors and directors who were based at either the national headquarters or equivalent. Interviewees were asked about their experiences in developing food-related or other policies, barriers or facilitators encountered in the policy development and implementation process and the use of evidence. Each interview lasted approximately 45-60 minutes, and was conducted in English. Audio-recorded interviews were transcribed, thematically coded and analyzed using N-Vivo 8.0 software.
Thirty-one policy-makers from the Ministry of Health and Medical Services (MoHMS n = 18) and the Ministry of Agriculture (MoA n = 13) in Fiji participated in the study. Whilst evidence is sometimes used in food-related policy-making in both the Health and Agriculture Ministries (including formal evidence such as published research and informal evidence such as personal experiences and opinions), it is not yet embedded as an essential part of the process. Participants indicated that a lack of resources, poor technical support in terms of training, the absence of clear strategies for improving competent use of evidence, procedures regarding engagement with other stakeholders across sectors, varying support from senior managers and limited consultation across sectors were barriers to evidence use. The willingness of organizations to create a culture of using evidence was reported as a facilitator.
The use of evidence in policy-making will only become a reality in Fiji if it is a formalized part of the government's policy-making systems. A systems approach to food-related policy-making and implementation may achieve this by helping Ministries manage the complex and dynamic nature of food-related policy-making in Fiji.
关于利用证据为太平洋地区政策制定提供信息的研究有限。本研究旨在确定和描述促进或限制斐济卫生和农业部在与食品相关的政策制定中使用证据的因素。
对斐济两个在制定旨在预防非传染性疾病（NCDs）的与食品相关政策方面发挥重要作用的政府部门中选定的政策制定者进行了半结构化面对面访谈。采用滚雪球抽样法招募国家总部或同等机构担任管理职务的高级政策制定者作为关键信息提供者，如国家顾问和主任。受访者被问及他们在制定与食品相关或其他政策方面的经验、政策制定和实施过程中遇到的障碍或促进因素以及证据的使用情况。每次访谈持续约45 - 60分钟，以英语进行。对录音访谈进行转录、主题编码，并使用N - Vivo 8.0软件进行分析。
斐济卫生和医疗服务部（MoHMS，n = 18）和农业部（MoA，n = 13）的31名政策制定者参与了该研究。虽然卫生和农业部在与食品相关的政策制定中有时会使用证据（包括已发表研究等正式证据以及个人经验和意见等非正式证据），但它尚未成为该过程的一个基本组成部分。参与者表示，资源短缺、培训方面技术支持不足、缺乏关于提高证据有效使用的明确策略、跨部门与其他利益相关者互动的程序、高级管理人员的支持各异以及跨部门协商有限是证据使用的障碍。据报告，组织愿意营造使用证据的文化是一个促进因素。
只有将证据使用作为政府政策制定系统的一个正式部分，在斐济政策制定中使用证据才会成为现实。与食品相关的政策制定和实施的系统方法可能通过帮助各部门管理斐济与食品相关政策制定的复杂和动态性质来实现这一点。
