Association for Public Policy Analysis & Management

Policymakers are consistently challenged by complex social problems that cross geographical, jurisdictional, sectoral, and cultural boundaries, which drive together a diverse set of actors operating under dire circumstances and in urgent situations.  The recent outbreak of the Ebola Virus Disease (EVD) represents a dynamic social situation in which policymakers had to respond quickly to coordinate scarce resources and diverse actors across multiple levels of operation, from international donors to service delivery in the local chiefdoms, in a rapidly escalating situation.  This paper examines the range of options available to policymakers operating in this type of dynamic action space and asks how evidence-based policy can be utilized more effectively in these complex situations.  In this EVD outbreak, there were disconnections in response operations leading to a rapid escalation in the case count and the spread of the virus through West Africa.  How did the international response differ in practice from existing policy in responding to infectious diseases, and which factors inhibited the execution of the plan?  How can lessons from West Africa aid policymakers in employing evidence-based policies in future crisis situations?

The World Health Organization (WHO) offers guidance to policymakers developing evidence-based policies and recommends that they include the following steps; define the problem, conduct a systematic review of relevant research, evaluate the research sources, adapt the findings to the current situation, then implement the policy and periodically evaluate the outcomes.  This series of steps underscores the importance of employing a carefully researched set of policies that is adaptive to the local context and responsive to the problem.  Yet, in the Ebola outbreak in West Africa, there were breakdowns at each stage of the response.  In this complex action field, it is essential that information and technical assistance are able to flow throughout the network. 

We employ a mixed-methods approach to assess the interorganizational response to EVD in West Africa to improve performance in future complex events.  These methods include a content analysis of the reports posted on the United Nations Relief Web.  That content was developed into a network analysis showing the interactions among the diverse set of actors operating at different levels of authority and responsibility in this dynamic action situation.  Information communication technology (ICT) and Geographic Information Systems (GIS) offer additional tools that were employed in the response to the Ebola outbreak.  As the world becomes better connected through these technologies, urgent messages can be conveyed to vulnerable populations and policy makers at different levels of operation simultaneously.  GIS offers accurate, timely visual representation  of local needs and resources which can aid policymakers who are tasked with allocating scarce resources.

A Poisson regression of relevant data from UNICEF, UNMEER, and the Humanitarian Data Exchange showed that, at the chiefdom level, medical care coupled with an investment in local capacity building led to a decrease in confirmed cases.  By employing a mixed-methods approach to evaluating the policy decisions made throughout the response, we offer a set of findings and recommendations for future responses in these dynamic policy environments.