The Many Meanings of Evidence: A Comparative Analysis of the Forms and Roles of Evidence Within Three Health Policy Processes in Cambodia

Abstract

This chapter investigates the evidence perceived to be relevant to policy decisions for three contrasting health policy examples in Cambodia – tobacco control, HIV/AIDS and performance-based salary incentives. The three health issues show few similarities in how pieces of evidence were used, despite occurring in a policy environment in which evidence-based policymaking is rhetorically championed. Instead, contrasting framings related to the concerns of key stakeholders meant that evidence related to differing issues would be understood in relation to its policy relevance. Stakeholders involved, however, could further be seen to possess differing logics about how to achieve their various outcomes – logics that could further help explain the differences seen in evidence utilisation. Evidence is thus not a uniform concept for which ‘more’ is obviously ‘better’, but rather different constructions and pieces of evidence become relevant in relation to the features of specific health policy decisions.