Using Evidence in a Highly Fragmented Legislature: The Case of Colombia's Health System Reform

This chapter examines how evidence is used in major policy health policy initiatives in a highly contested political context. Through a case study of legislation proposed in the context of Colombia’s ongoing health systems reformed process, it explores how such use is affected by the specific role played by the legislature within a highly fragmented polity. It draws on an analysis of evidence cited in the drafting of relevant laws in the process of health systems reform. Reflecting the role of the legislature in Colombia’s contested political system, evidence cited in legislative debates was unable to forge consensus amongst relevant policy actors over health system reforms. While scientific research was available and at the disposal of legislators, it was unable to provide the common ground on which to overcome embedded policy positions and form the basis of compromise over the direction of health systems reforms.