Abstract

The evidence-informed approach to policy-making and implementation is, at its core, about better decisions for a better future. It is focused on the effective use of scarce resources, on avoiding harm and maximising good. It is grounded in principles of equity and equality, of accountability and transparency. Given these characteristics, for those of us who work in this field, there is arguably a moral, economic, social and political case for paying closer attention to evidence-informed decision-making ecosystems in the South. Evidence-based policy and implementation, or evidence-informed decision-making in line with the most recent thinking, is often framed from two inter-related but limited perspectives: first, it is viewed as an approach that has originated from ‘developed’ Northern countries, and second, it is conceptualised as a technical intervention. However, there has been a shift in how the approach is conceived, moving away from assumptions that it is an intervention implemented from outside, from the North, for the benefit of the South. As part of this shift, certain initiatives in Africa have gained greater momentum. It is in acknowledging that there are different ways to think (epistemic diversity) about Southern evidence-informed decision-making, that this work has arisen. It seizes on the opportunity to view evidence-informed decision-making in a new light, exploring the evidence ecosystems in the South as systems strongly influenced by, but not defined by, Northern stimuli, including, but not limited to, technical interventions. This work set out to describe the evidence ecosystem in South Africa. In doing so, it finds that the ecosystem is increasingly resilient despite some limitations. It has strong structural foundations, includes many diverse organisations, is supported by not inconsiderable investment, is enabled by growing and significant capacity, contains iterations and innovations, and last but not least, incorporates complexity that gives the ecosystem resilience. The work demonstrates, through its focus on South Africa’s evidence ecosystem, that the global movement has much to learn from the South.

Highlights

  • The evidence-informed approach to policy-making and implementation is, at its core, about better decisions for a better future

  • Evidence-based policy and implementation, or evidence-informed decision-making in line with the most recent thinking, is often framed from two inter-related but limited perspectives: first, it is viewed as an approach that has originated from ‘developed’ Northern countries (White, 2019; Oliver et al, 2015), and second, it is conceptualised as a technical intervention (Guyatt et al, 1992)

  • If we look deeper into individual sectors, we can see how the Constitution and the National Development Plan (NDP) combine with sector-specific legislation and institutional changes to provide a broad foundation for evidence use

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Summary

Introduction

The evidence-informed approach to policy-making and implementation is, at its core, about better decisions for a better future. Evidence-based policy and implementation, or evidence-informed decision-making in line with the most recent thinking, is often framed from two inter-related but limited perspectives: first, it is viewed as an approach that has originated from ‘developed’ Northern countries (White, 2019; Oliver et al, 2015), and second, it is conceptualised as a technical intervention (Guyatt et al, 1992). These perspectives are in part due to the strength of the evidence-based medicine field over the last 30 years, and the tendency within that field to adopt technical, intervention-based thinking. The evidence-based approach was characterised by technical skills and management interventions

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