Health care evaluation Introduction Health care evaluation is vital in prevention and promotion of health initiatives. It is defined as determining the worth of the health care initiatives against the accepted standard. The key here is who establishes the standard and who makes judgment on it. Spiegelhalter David et al,2003. 1-Author: Nicholas Duff I agree with you that evaluating specific health interventions is a logical measure to determine how effective the health policy that drove the outcome is. The techniques necessary to evaluate health policy are problem identification and process evaluation. The process may be complicated by the fact that policy making is influenced by many factors including the length of the process, expenses incurred the sensitivity of the issue in terms of political practices involved and that the quantifiable targets needed to be identified may not be. 2-Author: Fiona Finnegan I disagree with you that one should evaluate the policy as a whole as compared to evaluating a specific health intervention. One may not be able to have the opportunities to evaluate the policy due to the complexities involved. The writer gives three stages of policy evaluation. In the first and the second stage on identifying whether the policy makers formed the policy with all the information needed, the person evaluating may not be in a position to access the required information and much more it is a tedious process. The final stage is the same as evaluating specific health interventions since one goes out to see how the intervention was implemented and the impact of it thereof. 3-Author: Jon Clair I agree with you that public health management needs a more strategic approach to decision making as opposed to reactive decision making. Even though specific interventions have proved successful in the past, policy formation may have not been evidence based and this calls for decision making approach that is evidence based. The political interventions have hindered having strategic approach to health care and there is basically no will on the political side to invest in such. 4-Author: Leo Nunnink I disagree with you that there is a strategic approach used in the policy decision making and that there is a reactive approach to implementation. The blame and cost shifting has happened while the policies are being made and not in the implementation. Despite, the tact that the national health and hospitals reform commission delivered their final report to the policy makers, there are always influences by the government and other policy makers that super cede such strategic approaches Reference Spiegelhalter D. Keith R., Jonathan M., 2003, Bayesian approaches to clinical trials and health care evaluations, Wiley online publishers