RIVM Handbook: Strategic Public Health Foresight—Theory & Practical Applications

Background

Strategic foresight is gaining traction in public health research and policy, yet it lacks the consolidated methodological foundation of established disciplines. Terminology is inconsistent — foresight, futures studies, forecasting and scenario planning are often used interchangeably — and theoretical underpinnings are rarely made explicit. This hinders comparability across studies, limits methodological critique, and impedes cumulative knowledge development in the field.

Methods

RIVM developed a Handbook for Strategic Public Health Foresight drawing on more than 30 years of conducting the Dutch Public Health Foresight Study and a systematic review of foresight methodology literature. The handbook proposes a four-phase analytical framework: (0) study design, covering epistemological choices and scoping; (1) futures intelligence, addressing horizon scanning and scenario construction; (2) challenge identification; and (3) options for action, linking foresight outputs to policy strategies.

Results

The framework distinguishes between cognitive and normative uncertainty and their methodological implications, clarifies the epistemological differences between exploratory and normative facets, and positions the RIVM’s business-as-usual approach to identifying future challenges — within the broader scenario typology. The handbook further addresses the relationship between foresight and adjacent approaches including health impact assessment and systems analysis.

Discussion

A rigorous methodological framework is a prerequisite for foresight to develop as a scientific discipline within public health. The handbook contributes to this by making implicit methodological choices explicit, enabling inter-study comparison and methodological critique. Key open questions include validation of foresight outputs, integration of quantitative and qualitative methods, and the role of participatory approaches in ensuring both scientific quality and policy relevance.

Key messages

• The RIVM Handbook provides a clear, four-phase framework to strengthen and standardize strategic public health foresight.

• Making methods explicit enables comparison, critique, and cumulative learning, supporting foresight as a scientific discipline.