Evidence and health policy: how linked can they be? Examples from Bavaria

Background: The call for evidence based decision making has long left the realm of clinical medicine. In the complex field of health policy an increasing emphasis is being put on data. The potential of evidence in the health policy process shall be illustrated with three examples and the nature of the relationship of evidence and policy process be explored. Health Policy Examples Bavarian Immunisation Strategy Led by immunisation data showing a north-south gradient in immunisation coverage with further regional disparities, a Bavaria-wide working group prioritised measles and identified target age groups, regions and approaches for intervention. A Bavarian Immunisation Strategy was devised and implemented and is currently being evaluated. Newborn Hearing Screening Programme Evidence of successful early identification and intervention on hearing loss led to the development of a newborn hearing screening programme which initially was piloted in two Bavarian regions and following successful evaluation was rolled out Bavaria-wide and eventually nationwide. Currently the quality of the screening programme is being evaluated on a national level. Bavarian Health Promotion Initiative With the intention to strengthen preventive efforts in Bavaria, a health promotion initiative was developed and implemented with a particular emphasis on epidemiologically derived priority action areas, evidence based and evaluated interventions, complementary health reporting and evaluation of the initiative itself. Discussion: The examples demonstrate that evidence from a variety of sources can be fed into health policy development, can feature at different stages of the policy process and fulfil different functions. However, evidence constitutes only one parameter in health policy decision making which cannot be reduced to a number led algorithm. Health policy decisions also need to correspond to societal, political and ethical dimensions and the legal framework. Data cannot take over health policy decision making, but at its best can inform and support as well as evaluate it.