Using the WHO Checklist to Identify Domains for Institutionalizing Evidence-Informed Policy-Making in China: A Mapping Review
This mapping review of 168 records characterizes the current state of evidence-informed policy-making institutionalization in China, revealing that existing evidence is heavily concentrated in the Governance and Resources domains within the health and institutional sectors, while highlighting a critical need to strengthen cultural and leadership aspects to broaden institutionalization across other policy areas.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Imagine a government trying to solve a complex problem, like improving public health or managing a city's traffic. In an ideal world, the people making these decisions would not rely solely on intuition or political pressure. Instead, they would look at the best available research, data, and facts to guide their choices. This approach is known as evidence-informed policy-making. It does not mean that facts alone dictate every decision, but rather that facts are systematically weighed alongside values, resources, and community needs. For this system to work well over the long term, it cannot be a one-time event; it must become a routine part of how the government operates. This process of making evidence use a standard habit is called institutionalization. It involves building the structures, rules, and culture that ensure facts are always available and considered when leaders plan the future.
A team of researchers from Lanzhou University in China, working with colleagues from University College London and the World Health Organization, set out to understand how this process is taking shape in China. They wanted to see where the evidence was being used, where it was missing, and what the landscape looked like across the country's vast policy system. To do this, they did not conduct a new experiment or survey people directly. Instead, they performed a mapping review, a method that acts like a cartographer drawing a map of existing knowledge. They gathered every piece of publicly available information they could find, including academic studies and official government documents, to see where the activity was concentrated and where the gaps lay.
The researchers collected a total of 168 records, which included 63 academic studies and 105 official policy documents. They analyzed these records using a specific framework developed by the World Health Organization, which breaks down the work of institutionalization into six key areas. These areas are: Governance (the rules and structures), Resources (money and tools), Partnerships (working together), Standards (consistent methods), Culture (shared values and beliefs), and Leadership (commitment from the top). They also sorted the records by the specific policy sectors they addressed, using the United Nations Sustainable Development Goals as a guide to categorize topics like health, education, and justice.
The map they drew revealed a clear pattern. The most visible evidence of institutionalization was found in the areas of Governance and Resources. This means that the public record is full of documents describing formal structures, such as government agencies dedicated to evidence, and the financial or technical resources allocated to support them. For example, the records showed many instances of policies creating think tanks, establishing expert committees, and funding databases. In contrast, the areas of Culture and Leadership were much less visible in the public record. While the researchers found 17 records discussing organizational culture and 11 discussing leadership commitment as current practices, these numbers were far lower than those for governance. The data suggests that while the "hardware" of the system—buildings, budgets, and rules—is well-documented, the "software"—the daily habits, shared values, and personal drive of leaders to use evidence—is less frequently recorded as an established practice, though it is often mentioned as a goal for the future.
When the researchers looked at which policy sectors were most active, two areas stood out significantly. The largest group of records, 43 in total, focused on health and well-being. This aligns with the fact that the health sector has long been a pioneer in using data and research to guide decisions. The second most active area was peace, justice, and strong institutions, with 38 records. This category largely covered the work of think tanks and advisory bodies that help government leaders make major decisions. Other sectors, such as education, industry, and poverty reduction, had fewer records, and some areas, like clean water and sanitation, had no records at all describing current institutionalization efforts.
The study did not claim to measure how effective these systems are in practice, only how much public evidence exists to show they are being built. The authors noted that the concentration of evidence in health and governance suggests two main ways facts are currently entering the policy process in China: through specialized health support units and through formal advisory channels for government leaders. They also pointed out that the lower visibility of culture and leadership does not necessarily mean these things are absent, but rather that they are harder to capture in official documents. The researchers concluded that while China has established strong formal foundations for using evidence, future efforts should focus on strengthening the less visible organizational conditions, such as leadership commitment and shared culture, to ensure that evidence use becomes a deeply embedded routine across all areas of public policy.
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