Kennis als hulpbron : het gebruik van wetenschappelijke kennis bij beleidsvorming in de jeugdgezondheidszorg voor 4-19-jarigen

Abstract

Objectives: In The Netherlands, school health care policy is decentralized to the municipalities and their Municipal Health Services (MHS) in 1990. Since then, an increasing diversity in school health care policy developed, which is is ill-understood, concerning the development of evidence-based public health. Methods: Case-study design in 4 MHS-regions. Documents and half-structured interviews are used as data sources. The analysis of the data is both qualitative and quantitative. Results: Many actors try to influence the policy process: MHS-internal actors like management and professionals as well as external actors like local health care providers, other municipal services, the municipalities and schools. Evidence is found of the use of scientific knowledge: ‘body of knowledge’ information as well as evidence from new research, of both local and (inter)national origin, mainly medical, but also social science research. Mainly School Health management and -professionals use scientific knowledge as a resource to influence the policy process. Other actors try to influence the policy process by using other resources like formal power, money or 'initiative'. The use of scientific knowledge is related to a combined (medical) scientific en political frame of reference. Conclusions: Policy formation in local public health takes place in a network of actors with mutual power-dependency-relations, using different resoures to influence the process. ‘Evidence based public health’ can be promoted by regarding evidence from scientific research as a resource in attempts to influence the policy formation process and the implementation of the outcomes of this process.