What prevents health policy being 'evidence-based'? New ways to think about evidence, policy and interventions in health

Background: Evidence-based policy decision-making is a dominant paradigm in health but realizing this ideal has proven challenging. Sources of data: This paper conceptually maps health policy, policy studies and social science literature critically engaged with evidence and decision-making. No new data were generated or analysed in support of this review. Areas of agreement: Barriers to evidence-based policy have been documented, with efforts made to increase the uptake of evidence. Areas of controversy: Evident complexities have been regarded as a problem of translation. However, this assumes that policy-making is a process of authoritative choice, and that 'evidence' is inherently valuable policy knowledge, which has been critiqued. Growing points: Alternative accounts urge consideration of how evidence comes to bear on decisions made within complex systems, and what counts as evidence. Areas timely for developing research: An 'evidence-making intervention' approach offers a framework for conceptualizing how evidence and interventions are made relationally in practices, thus working with the politics and contingencies of implementation and policy-making.