An overview and comparison of approaches used for health policy analysis: What to use and when?

Abstract Background The growing complexity of public health challenges necessitates effective policies supported by multi-criteria approaches. Such approaches address the limitations of traditional decision-support tools by evaluating multiple objectives and values. While traditional tools can complement each other, their integration provides a more comprehensive understanding of policy effects, aiding evidence-based, resilient policy formulation. Currently, tools like Health Impact Assessment (HIA), Social Cost-Benefit Analysis (SCBA), and Strategic Foresight (SF) are often applied separately. Integrating these tools and understanding their appropriate application can better address diverse policy objectives. This study aimed to explore integration opportunities by comparing health policy tools used at the RIVM. Methods We employed a mixed-method approach, gathering insights from RIVM experts and consultations with Ministry of Health policymakers. Literature reviews and comparisons of the tools informed our analysis, identifying complementary roles for these approaches in addressing policy questions. Results Key findings revealed inconsistent use of HIA at RIVM. However, HIA's value in addressing health equity was acknowledged, a focus less apparent in SCBA and SF. HIA and SF utilize both quantitative and qualitative methods, whereas SCBA is primarily quantitative. Their focal points differ: HIA emphasizes health determinants, SCBA focuses on societal problems, and SF addresses uncertainty. Weaknesses include HIA's lack of economic perspective, SCBA's qualitative limitations, and SF's long-term outlook, which complicates present-day decision-making. Conclusions To enhance HIA's utility, capacity-building and a more compact approach are recommended, enabling its application in time-sensitive contexts or as a complement to SCBA and SF. Key messages • To enhance HIA’s utility, capacity-building and a more compact approach are recommended, enabling its application in time-sensitive contexts or as a complement to SCBA and SF. • Inconsistent use of HIA.