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A Student's Guide to Writing aGlobal Health Policy Brief104 Mt. Auburn Street, 3rd FloorCambridge, MA 02138http://gheli.harvard.eduA Student's Guide to Writing a Global Health Policy Brief page 1

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A Student's Guide to Writinga Global Health Policy Brief2017

Table of ContentsIntroduction1Framework for Analyzing Policy Choices3Communication Tools4Building Skills to Write a Policy Brief5Overview of Communication Tools5Exercise 1: Writing a Fact Sheet.5Purpose and Content.6Audience.6Style & Formatting. 7Model Fact Sheets. 7Key Points to Remember.8Exercise 2: Critiquing a Policy Brief.9Purpose and Content. 9How Policy Briefs Use Evidence. 9Attributes of Effective Policy Briefs.10Model Policy Briefs.13General Approach to Critiquing a Policy Brief.13Key Questions to Consider in Your Critique .13Exercise 3: Writing a Policy Brief. 15Purpose and Content.15Audience.15Style & Formatting.15Key Points to Remember.16Writing Support at Harvard. 17References. 18Additional Writing and Data Related Resources. 18Acknowledgments. 19

Source: Progress on Drinking Water and Sanitation. World Health Organization, UNICEF 27/1/9789241507240 eng.pdf?ua 1.Throughout this writing guide, we have included various figures to provide different examples ofthe kinds of evidence that may be used in writing a policy brief. Graphical literacy is an importantskillset to develop in order to first critically analyze data and then connect this data to policy.To leverage primary sources for exploring global health-themed topics, begin with some of thelinks included in the “Additional Writing and Data Related Resources” section.

IntroductionWhat is global health?Global health presents an interdisciplinary set of challenges that transcend national boundaries.Global health is not “foreign health,” “international health,” or “health of the poor.” Rather,global health refers to the health of all populations in the world, regardless of nation state,geographical position, or stage of development. It includes an interdisciplinary set of challengesinvolving health determinants (social, political, economic), collections of health problems, andthe societal responses to both. Global health is inclusive of population-level policies as well asindividual approaches to health promotion and pays special attention to the needs of the mostvulnerable populations. The defining characteristic that makes global health “global,” however,is its central concern with the interconnectedness among populations, the transfer of healthrisks across national borders, and the consequences of globalization on evolving patterns ofhealth, disease, and social determinants.Global health knowledge depends on an understanding of the principal health problemsof different populations, ranging from their physiological basis to their epidemiologicalcontext. Essential in the study of global health are the rigorous methods for measuringpopulation health; the analytic tools necessary for decision making; and the evidencebase for the effectiveness, risks, and costs of interventions, ranging from individualhealth services to population-based instruments of policy. Because global healthchallenges are diverse and interdisciplinary, information from the basic sciences,applied life sciences, and social sciences—including economics, biostatistics, anddemography—is all critical to learn about health conditions that result from a worldthat is becoming ever more interdependent. Some of the most fundamental challengesin global health relate to (1) an unfinished agenda of infections, malnutrition, maternalchild health problems, (2) the rise of non-communicable diseases and injuries, and(3) emerging health risks that transcend national boundaries. To understand thesechallenges, it is important to study patterns of global morbidity and mortality; identifydeterminants that contribute to health inequalities; and discuss both the challengesand responsibility to provide health services to the most vulnerable, includingpopulations of failed or fragile states, refugees, and victims of humanitarian crisesand human rights violations. Case studies and comparative exercises can help you toconfront ethical challenges associated with priority setting, learn how real world policyis critically influenced by cultural norms, systemic factors, health system capacity, andthe economic, social, and political climate, and consider the complex process of howknowledge is translated to evidence-based policy.What is knowledge translation?Knowledge produced through research must be translated into understandable, accessible, andrelevant evidence that can be used by decision makers to mobilize resources, formulate policy,implement programs, and evaluate impact. However, shortcomings found in the translationprocess mean that evidence is not always utilized as effectively as it could be. Indeed, researchfindings are often not synthesized, packaged, or contextualized for those very audiences thatcould have the largest benefit. The resulting discontinuity between research and action issometimes referred to as the “knowledge-action gap.”A Student's Guide to Writing a Global Health Policy Brief page 1

Written communication skills are a key component of effective knowledge translation and a critical tool for successfully meeting global health challenges. Knowledgetranslation is a process that brings together the often disparate realms of researchand action to ensure that health practices, behaviors, and policies are based on reliableevidence. The concept of knowledge translation includes more than the simple handing off of evidence from the researcher to the end user, a process that is sometimestermed “dissemination.” Rather, knowledge translation involves refining or transforming evidence to make it comprehensible and meaningful for the recipient who willbe reviewing and/or implementing it. This process requires not only selecting specificinformation but also organizing and packaging it in ways that vary with both the creator’s intentions and the audience’s needs. Effective knowledge translation thereforerequires communication and partnerships between researchers and key stakeholderswho must understand and use the research; these various audiences include policymakers, health care practitioners, journalists, administrators, and the general public.1The plethora of public health policy research and the variety of audiences it mustreach present considerable challenges to translating knowledge in this field. For onething, as with any piece of writing, you have to choose material that can be used bothto convey your intentions and to satisfy the audience’s requirements, a task that isobviously more complicated when you are faced with voluminous data sources. Youalso have to determine clear, coherent, and effective ways to organize and present thedata before beginning the writing process, and, as you write and edit, make specificrhetorical choices to suit different audiences. For example, you will generally want toinclude more detail, references, and technical jargon in a document intended for atechnical audience than in one intended for non-specialists. The main purpose of thiswriting guide is to assist you with the creation of a policy brief, and it includes examples of different charts, graphs, and tables to give a better sense of the variety ofevidence you may want to consider in communicating your point.Source: Global Status Report on Road Safety 2015. World Health Organization 2015.http://www.who.int/violence injury prevention/road safety status/2015/en.page 2 A Student's Guide to Writing a Global Health Policy Brief

Framework for AnalyzingPolicy ChoicesAn obvious prerequisite to effective translation and communication about globalhealth challenges is a comprehensive understanding of the problem and an analysisof the policy choices. However, contemporary global health problems are generallycomplex, interdisciplinary, and dependent on context. A rubric can be a helpful toolto guide a systematic approach to identifying the elements of the problem, ensuringthat the many kinds of information required for the analysis have been considered,and that the process for comparing different options is comprehensive in its scope.The framework proposed by Stokey and Zeckhauer in 1978 is one of the most usefulframeworks used to guide policy analysis.2 The authors proposed that any accurateanalysis must consist of the following five-step framework:1.Establishing the context. Who are the stakeholders, decision makers, influential actors? What is the nature of the problem and the decision or policy choicethat needs to be made? What are the contextual factors included in the casethat would be important to consider?2.Laying out the alternatives. What are the realistic and feasible options? Whatinformation is needed about the different options or strategies? What are theattributes of each alternative? Are there obvious tradeoffs? What is the timingof the decision and the implementation of the policy choices?3.Predicting the consequences. Given the information about each alternative orstrategy described above, what would the expected outcomes be for each ofthe choices? Which will be most effective? Would subpopulations differentiallybenefit? (e.g., rural versus urban, children versus adults, etc.)4.Valuing the outcomes. What are the decision making criteria—meaning whatoutcomes are valued by the decision maker or stakeholders (e.g., improvinghealth, reducing risk, promoting equity, preferential protection of the poorest,etc.)5.Making a choice. Formulate a recommendation based on the systematic process. Where are the key uncertainties? Which factors were most influential?Where would you have liked better information? Would you have made thesame recommendation if the context significantly changed, for example a different setting?A Student's Guide to Writing a Global Health Policy Brief page 3

Employing a framework such as this will aid both you and your intended audience,whose comprehension of the subject matter will be enhanced by a well-defined methodology. Each step follows from the preceding one, and while your specific goal mayrequire the use of only one—for instance, describing the current circumstances ofan epidemic may only require the first step—for an analysis, you cannot remove anysteps. For instance, any value you place on potential policy choices will be weakenedif you have not previously summarized all the options available. Likewise, you cannotpredict the consequences of an action without a complete understanding of its contextualized background. We will rely on this rubric as we proceed through the writtenexercises for policy communication.Communication ToolsThere are a range of print tools routinely used to translate knowledge about globalhealth, including, but not limited to, research articles, editorials, fact sheets, and policybriefs. Each of these tools has a distinctive format and style, but every one of them,correctly applied, serves a critical function in conveying global health information to avariety of audiences.Choosing which tool to apply to convey a given message is not determined by theissue itself but by the underlying objective, message, motivation, and target audience. Knowing the audience—and why they are being targeted—is key not only toselecting an appropriate communication tool, but also to ensuring that the document successfully communicates the message. As the accompanying box suggests,the target audience may consist of policy makers, technical or disciplinary experts,practitioners, or the public. Technical experts are much more likely reached using a research article than a fact sheet. On the other hand, for the public, a fact sheet couldbe an excellent choice, while a research article is likely to leave the message unheard.Translation in Global Health: Written CommunicationIndicates a common primary target audienceIndicates a potential secondary target audiencepage 4 A Student's Guide to Writing a Global Health Policy Brief

Building Skills to Writea Policy BriefPolicy briefs about global health topics may vary in thei