ABSTRACT
In public health, evaluation is concerned with trying to assess change at the population or sub-group level rather than at the individual level. Many approaches to evaluation are based on a quantitative scientific paradigm, often drawing substantively on ideas relating to experimental study designs as well as epidemiology more generally. It has become commonplace in public health to use the term 'wicked issues' to refer to entrenched problems that require complex multilevel interventions involving many different agencies and activities. A particularly significant development within the field of public health has been the use of economic evaluation. The aim of this approach is to systematically 'identify measure and compare the costs and outcomes of alternative interventions'. Cost utility analysis (CUA) has also been used in the public health field. Such economic approaches have shown that public health interventions can be cost-saving, as in the case of universal influenza immunization programmes.
