Abstract
BackgroundThe COVID-19 pandemic increased the need for new valid scientific evidence to support urgent clinical and policy decision making; as well as improved processes for the rapid synthesis, uptake and application of that evidence. Evidence informed policymaking (EIPM) can be considered as a way to access and use the results of evidence in practice. This study aimed to determine what effects COVID-19 had on the way Iranian health managers and policymakers use evidence in their decisions.MethodsThis study was conducted in 2021 applying a qualitative research design. Data was collected through semi-structured interviews. Thirty health care managers, policy makers and medical university faculty members were recruited as the study participants, initially via a purposive sample, followed by snowballing. A conventional content analysis presented by Hsieh and Shannon (2005) was applied for data analysis.ResultsTen main themes emerged from the data including: 1) roles and duties of knowledge brokers (KBs); 2-5) the roles, benefits, barriers and necessities of applying Knowledge Translation Exchange (KTE) tools; 6-8) the facilitators, benefits and barriers to the application of evidence during COVID-19; 9) challenges of rapid evidence production evidence during COVID-19 and 10) consequences of not applying evidence during COVID-19. According to the present conceptual framework, KBs act as an intermediator between the large amounts of knowledge produced and decision makers. KTE tools should be applied to enhance EIPM during COVID-19. Attention should be paid to the facilitators, barriers, benefits and necessities of evidence application during COVID-19 to avoid negative consequences for the health system.ConclusionsResults of this study show that developing KTE tools and activating KBs can be among the main strategies to produce applied actionable messages for policymakers to move toward EIPM; and that this applies even when rapid decision making is required, such as during the COVID-19 pandemic. It is strongly recommended to reinforce the local capacities through supporting scientific networks and relationships between research centers and local and national policymakers. At the same time, attention to local barriers to and facilitators of the application of evidence while facing a pandemic can pave the way to better identification of health system`s problems and rapid responses.
Highlights
The COVID-19 pandemic increased the need for new valid scientific evidence to support urgent clinical and policy decision making; as well as improved processes for the rapid synthesis, uptake and application of that evidence
Thirty experienced healthcare system managers and policy makers participated in the interviews
Results of our study have shown that a failure to use and apply evidence by policymakers during COVID-19 pandemic led to negative consequences including public dissatisfaction, ineffective decision making, organizational collapse, frustration, conflicts and failure to change amongst staff, prohibited organizational improvement and growth
Summary
The COVID-19 pandemic increased the need for new valid scientific evidence to support urgent clinical and policy decision making; as well as improved processes for the rapid synthesis, uptake and application of that evidence. Corona Virus Disease 19 (COVID-19) has been the worst public health disaster in recent decades and it has severely impacted on health systems and economies all over the world. Such an emergency has placed unexpected pressures on decision makers and policymakers at all the levels to make urgent decisions with wide ranging consequences. As COVID-19 spread rapidly throughout the world, managers and policymakers needed to be ready for a rapid response They required both timely and relevant evidence to determine the most promising, implementable, and appropriate courses of action to prevent and control disease. Health care managers, decision makers and policymakers had to deal with very large amounts of trusted and untrusted information; posing a challenge for established decision making processes [2]
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