Evidence-informed Policymaking Research Articles

Exploring evidence use and capacity for health services management and planning in Swiss health administrations: A mixed-method interview study.

Health administrations require evidence, meaning robust information, data, and research, on health services and systems. Little is known about the resources and processes available within administrations to support evidence-informed policymaking. This study assessed Swiss health administrations' capacity for evidence use and investigated civil servants' needs and perspectives regarding the role and use of evidence in health services management and planning. In this mixed-method study, we interviewed civil servants from Swiss German-speaking cantonal health administrations. We quantitatively assessed administrations' organization-level capacity by applying six structured interviews using an existing measurement tool (ORACLe). Individual-level needs and perspectives regarding evidence use and capacity were qualitatively explored with twelve in-depth interviews that were analyzed using the framework method. Respondents indicated moderate evidence-use capacity in all administrations. Administrations displayed a similar pattern of high and low capacity in specific capacity areas, generally with considerable variation within administrations. Most administrations indicated high capacity for producing or commissioning evidence and close relationships with research. They showed limited capacity in the documentation of processes and availability of tools, programs, or training opportunities. Administrations place the responsibility for engagement with evidence at the level of individual civil servants rather than at the organizational level. Although administrations highly value evidence-informed policymaking and consider it vital to effective health services management and planning, they face significant constraints in accessing evidence-specific resources and receive little organizational support. Administrations rely on external capacity to compensate for these limitations and engage with evidence pragmatically. Our findings indicate moderate and improvable capacity for evidence use in Swiss health administrations that place limited value on organizational support. Besides strengthening organizational support, leadership buy-in, particular staff needs, and balancing the implementation of specific measures with the provision of more general resources should be considered to unlock the potential of strengthened engagement with evidence.

Faculty members as academic knowledge brokers in Iran's health sector: a social network analysis study

BackgroundInteraction between researchers and policymakers is an essential factor to facilitate the evidence-informed policymaking. One of the effective ways to establish this relationship and promote evidence-informed policymaking is to employ people or organizations that can play the role of knowledge brokers. This study aims to analyze the communication network and interactions between researchers and policymakers in Iran's health sector and identify key people serving as academic knowledge brokers.MethodsThis study was a survey research. Using a census approach, we administered a sociometric survey to faculty members in the health field in top ten Iranian medical universities to construct academic-policymaker network using social network analysis method. Network maps were generated using UCINET and NetDraw software. We used Indegree Centrality, Outdegree Centrality, and Betweenness Centrality indicators to determine knowledge brokers in the network.ResultsThe drawn network had a total of 188 nodes consisting of 94 university faculty members and 94 policymakers at three national, provincial, and university levels. The network comprised a total of 177 links, with 125 connecting to policymakers and 52 to peers. Of 56 faculty members, we identified four knowledge brokers. Six policymakers were identified as key policymakers in the network, too.ConclusionsIt seems that the flow of knowledge produced by research in the health field in Iran is not accomplished well from the producers of research evidence to the users of knowledge. Therefore, it seems necessary to consider incentive and support mechanisms to strengthen the interaction between researchers and policymakers in Iran's health sector.

National strategies for knowledge translation in health policy-making: A scoping review of grey literature

Background and objectivesWithout strategic actions in its support, the translation of scientific research evidence into health policy is often absent or delayed. This review systematically maps and assesses national-level strategic documents in the field of knowledge translation (KT) for health policy, and develops a practical template that can support Evidence-informed Policy Network (EVIPNet) Europe countries in producing national strategies for evidence-informed policy-making.MethodsWebsites of organizations with strategic responsibilities in KT were electronically searched, on the basis of pre-defined criteria, in July–August 2017, and an updated search was carried out in April–June 2021. We included national strategies or elements of national strategies that dealt with KT activities, as well as similar strategies of individual institutions with a national policy focus. Two reviewers screened the strategies for inclusion. Data were analysed using qualitative content analysis.ResultsA total of 65 unique documents were identified, of which 17 were eligible and analysed for their structure and content. Of the 17, 1 document was a national health KT action plan and 6 documents were institution-level KT strategies. The remaining 10 strategies, which were also included were 2 national health strategies, 5 national health research strategies and 3 national KT strategies (not specific to the field of health alone). In all, 13 structural elements and 7 major themes of health policy KT strategies were identified from the included documents.ConclusionKT in health policy, as emerged from the national strategies that our mapping identified, is based on the production and accessibility of policy-relevant research, its packaging for policy-making and the activities related to knowledge exchange. KT strategies may play different roles in the complex and context-specific process of policy-making. Our findings show that the main ideas of health-specific evidence-informed policy literature appear in these strategies, but their effectiveness depends on the way stakeholders use them. Specific knowledge-brokering institutions and organizational capacity, advocacy about the use of evidence, and close collaboration and co-decision-making with key stakeholders are essential in furthering the policy uptake of research results.

From bench to policy: a critical analysis of models for evidence-informed policymaking in healthcare.

The use of research evidence in policy making is a complex and challenging process that has a long history in various fields, especially in healthcare. Different terms and concepts have been used to describe the relationship between research and policy, but they often lack clarity and consensus. To address this gap, several strategies and models have been proposed to facilitate evidence informed policy making and to identify the key factors and mechanisms involved. This study aims to critically review the existing models of evidence informed policy making (EIPM) in healthcare and to assess their strengths and limitations. A systematic search and review conducted to identify and critically assess EIPM models in healthcare. We searched PubMed, Web of Science and Scopus databases as major electronic databases and applied predefined inclusion criteria to select the models. We also checked the citations of the included models to find other scholars' perspectives. Each model was described and critiqued each model in detail and discussed their features and limitations. Nine models of EIPM in healthcare were identified. While models had some strengths in comprehension, flexibility and theoretical foundations, analysis also identified limitations including: presupposing rational policymaking; lacking alternatives for time-sensitive situations; not capturing policy complexity; neglecting unintended effects; limited context considerations; inadequate complexity concepts; limited collaboration guidance; and unspecified evidence adaptations. The reviewed models provide useful frameworks for EIPM but need further improvement to address their limitations. Concepts from sociology of knowledge, change theory and complexity science can enrich the models. Future EIPM models should better account for the complexity of research-policy relationships and provide tailored strategies based on the policy context.

Open Science and the impact of Open Access, Open Data, and FAIR publishing principles on data-driven academic research: Towards ever more transparent, accessible, and reproducible academic output?

Contemporary evidence-informed policy-making (EIPM) and societies require openly accessible high-quality knowledge as input into transparent and accountable decision-making and informed societal action. Open Science1 supports this requirement. As both enablers and logical consequences of the paradigm of Open Science, the ideas of Open Access, Open Data, and FAIR publishing principles revolutionise how academic research needs to be conceptualised, conducted, disseminated, published, and used. This ‘academic openness quartet’ is especially relevant for the ways in which research data are created, annotated, curated, managed, shared, reproduced, (re-)used, and further developed in academia. Greater accessibility of scientific output and scholarly data also aims at increasing the transparency and reproducibility of research results and the quality of research itself. In the applied ‘academic openness quartet’ perspective, they also function as remedies for academic malaises, like missing replicability of results or secrecy around research data. Against this backdrop, the present article offers a conceptual discussion on the four academic openness paradigms, their meanings, interrelations, as well as potential benefits and challenges arising from their application in data-driven research.

The COVID-19 quandemic

BackgroundThe terms syndemic and infodemic have both been applied to the COVID-19 pandemic, and emphasize concurrent socio-cultural dynamics that are distinct from the epidemiological outbreak itself. We argue that the COVID-19 pandemic has exposed yet another important socio-political dynamic that can best be captured by the concept of a quandemic – a portmanteau of “quantification” and “pandemic”.Main textThe use of quantifiable metrics in policymaking and evaluation has increased throughout the last decades, and is driven by a synergetic relationship between increases in supply and advances in demand for data. In most regards this is a welcome development. However, a quandemic, refers to a situation where a small subset of quantifiable metrics dominate policymaking and the public debate, at the expense of more nuanced and multi-disciplinary discourse. We therefore pose that a quandemic reduces a complex pandemic to a few metrics that present an overly simplified picture. During COVID-19, these metrics were different iterations of case numbers, deaths, hospitalizations, diagnostic tests, bed occupancy rates, the R-number and vaccination coverage. These limited metrics came to constitute the internationally recognized benchmarks for effective pandemic management.Based on experience from the Nordic region, we propose four distinct dynamics that characterize a quandemic: 1) A limited number of metrics tend to dominate both political, expert, and public spheres and exhibit a great deal of rigidity over time. 2) These few metrics crowd-out other forms of evidence relevant to pandemic response. 3) The metrics tend to favour certain outcomes of pandemic management, such as reducing hospitalization rates, while not capturing potential adverse effects such as social isolation and loneliness. 4) Finally, the metrics are easily standardized across countries, and give rise to competitive dynamics based on international comparisons and benchmarking.ConclusionA quandemic is not inevitable. While metrics are an indispensable part of evidence-informed policymaking, being attentive to quandemic dynamics also means identifying relevant evidence that might not be captured by these few but dominant metrics. Pandemic responses need to account for and consider multilayered vulnerabilities and risks, including socioeconomic inequities and comorbidities.

Development of an evidence-informed governance and stewardship framework for elderly healthcare in Iran: A qualitative study

BackgroundThe ageing population poses significant challenges to healthcare systems, necessitating the establishment of high-functioning, integrated frameworks for elderly healthcare. This study aimed to explore the key challenges associated with the stewardship of elderly care in Iran and to develop a holistic stewardship framework. MethodsFor this qualitative study, thirty semi-structured interviews were conducted with key Iranian healthcare stakeholders, utilizing purposive and snowball sampling during 2021–2022. Inductive open coding was utilized to generate new concepts related to key stewardship challenges. The World Health Organization's conceptual framework, outlining the three stewardship tasks, served as the basis for crafting a tailored framework for elderly healthcare stewardship in Iran. ResultsFourteen main challenges and 38 sub-challenges were identified for elderly healthcare stewardship in Iran, categorized according to the WHO framework's three stewardship tasks. Challenges related to WHO stewardship task 1, involving health policy formulation and vision definition, included challenges in vision definition, planning, policymaking, and intergovernmental institutional superiority. Challenges related to WHO stewardship task 2, delineating governance and stewardship through control and regulation, encompassed issues such as support for the elderly, system responsiveness, behavior of healthcare providers, organizational structure, and cross-sectoral leadership challenges. Challenges associated with WHO stewardship task 3, about the use of collective intelligence, explored stakeholder collaboration, information for decision-making, and challenges within the elderly information system, covering data documentation, reporting, analysis, accessibility, distribution, and circulation. Subsequently, a framework was developed, covering areas like defining the vision and direction of health policy, managing information systems, evidence-informed policymaking, and delivering elderly health services with a holistic approach. ConclusionThe present framework shows how a management information system, guided by evidenced-informed policymaking and the formulation of customized health policies, can facilitate the provision of elderly health services based on identified needs. It presents a governance and stewardship pathway that can be adopted by Iranian health policymakers and similar middle-income countries facing analogous challenges in ageing and aged care system stewardship, serving as a model for developing their own frameworks.

Im/migrant Well-Being Part II: Race, Ethnicity, and Legal Challenges to Incorporation and Well-Being

In this introduction to the second issue of a two-part series on Im/migrant Well-being, we discuss examples of how race, ethnicity, and a patchwork of current and proposed state and federal laws contribute to the exclusion of and discrimination of immigrants, hindering their incorporation and having harmful effects on their well-being. Articles discussed in this introduction zoom in into these issues by analyzing in detail how the well-being of immigrants in the United States is threatened by current U.S. immigration laws and policies: from the racial construction of the invasive “100-mile border enforcement zone” to the precarious legal statuses of unaccompanied migrant children, Deferred Action for Childhood Arrivals recipients, and farmworkers. Together, these empirical studies produce robust evidence demonstrating how the racialization and liminal legality of im/migrant communities in the United States adversely affect their belonging, incorporation, and overall well-being. In line with the findings from these articles, and in the absence of federal action on immigration reform in the horizon, the opening commentary following this introduction highlights how immigrant communities and scholars have the power to perform critical acts of brokerage to prevent harm and promote collective well-being by sharing resources and produce collaborative research that contributes toward evidence-informed policymaking.

Negotiating the budget for evidence-informed policy-making: insights from a UK government department

IMPACT Improving how evidence is used in policy formulation requires a better understanding of organizational processes inside government departments, for example budget management. Government departments need to ensure that such processes simultaneously strengthen robustness in the evidence base, improve alignment of the evidence base with policy priorities and contribute to a more cost-effective use of the evidence budget. This requires a nuanced understanding of who should be accountable for managing which aspects of the evidence budget and how these different lines of accountability play out in terms of their ability to foster formal and informal relationships between the policy cadre and the evidence cadre. In an era of rapid global change and declining public sector resources, the authors’ findings will help researchers and senior officials understand how government departments should manage their evidence budgets to improve evidence use.

STRATEGIES FOR INVOLVING OLDER ADULTS AND INFORMAL CAREGIVERS IN HEALTH POLICY DEVELOPMENT: A SCOPING REVIEW

Abstract Encouraging the active involvement of older adults and informal caregivers in policymaking can lead to cost-effective health and long-term care interventions and enhance the creation of responsive policies. As part of the European Union TRANS-SENIOR program, a scoping review was conducted using the Joanna Briggs Institute’s methodology. Published and grey literature was searched. Studies were included if they described the use/evaluation of methods for engaging older adults (65 years and above) and informal caregivers in local, national, or regional health policy development. Analysis was guided by the Multidimensional Framework For Patient And Family Engagement In Health And Health Care. Thirteen engagement strategies were identified from 11 publications meeting the inclusion criteria. Adopting the World Bank’s categorization of citizen engagement methods, strategies were categorized as traditional, deliberative, and others. Older adults and informal caregivers are often consulted to elicit opinions for agenda/priority setting. However, their involvement in other stages of the policy cycle: health policy formulation, implementation, and evaluation, was unclear from the literature. The described engagement methods suggested that older adults and their informal caregivers do not often have shared equal power and shared responsibility in policymaking. Findings will guide policymakers in identifying and incorporating engagement strategies to support evidence-informed policymaking processes that can improve health outcomes for older adults/informal caregivers. Future research is needed on the evaluation of involvement methods.

Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review

BackgroundAn estimated 85% of research resources are wasted worldwide, while there is growing demand for context-based evidence-informed health policymaking. In low- and middle-income countries (LMICs), research uptake for health policymaking and practice is even lower, while little is known about the barriers to the translation of health evidence to policy and local implementation. We aimed to compile the current evidence on barriers to uptake of research in health policy and practice in LMICs using scoping review.MethodsThe scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses-extension for Scoping Reviews (PRISMA-ScR) and the Arksey and O'Malley framework. Both published evidence and grey literature on research uptake were systematically searched from major databases (PubMed, Cochrane Library, CINAHL (EBSCO), Global Health (Ovid)) and direct Google Scholar. Literature exploring barriers to uptake of research evidence in health policy and practice in LMICs were included and their key findings were synthesized using thematic areas to address the review question.ResultsA total of 4291 publications were retrieved in the initial search, of which 142 were included meeting the eligibility criteria. Overall, research uptake for policymaking and practice in LMICs was very low. The challenges to research uptake were related to lack of understanding of the local contexts, low political priority, poor stakeholder engagement and partnership, resource and capacity constraints, low system response for accountability and lack of communication and dissemination platforms.ConclusionImportant barriers to research uptake, mainly limited contextual understanding and low participation of key stakeholders and ownership, have been identified. Understanding the local research and policy context and participatory evidence production and dissemination may promote research uptake for policy and practice. Institutions that bridge the chasm between knowledge formation, evidence synthesis and translation may play critical role in the translation process.

‘What we lacked was the courage to take decisions that differed from the rest of the world’: expert perspectives on the role of evidence in COVID-19 policymaking in Iraq

IntroductionIraq reported its first COVID-19 case on 24 February 2020 and formed a national committee and advisory committees to support its response. While global experts have suggested that the COVID-19...

Enhancing evidence-informed policymaking in medicine and healthcare: stakeholder involvement in the Commons Project for rare diseases in Japan

BackgroundAlthough stakeholder involvement in policymaking is attracting attention in the fields of medicine and healthcare, a practical methodology has not yet been established. Rare-disease policy, specifically research priority setting for the allocation of limited research resources, is an area where evidence generation through stakeholder involvement is expected to be effective. We generated evidence for rare-disease policymaking through stakeholder involvement and explored effective collaboration among stakeholders.MethodsWe constructed a space called ‘Evidence-generating Commons’, where patients, family members, researchers, and former policymakers can share their knowledge and experiences and engage in continual deliberations on evidence generation. Ten rare diseases were consequently represented. In the ‘Commons’, 25 consecutive workshops were held predominantly online, from 2019 to 2021. These workshops focused on (1) clarification of difficulties faced by rare-disease patients, (2) development and selection of criteria for priority setting, and (3) priority setting through the application of the criteria. For the first step, an on-site workshop using sticky notes was held. The data were analysed based on KJ method. For the second and third steps, workshops on specific themes were held to build consensus. The workshop agendas and methods were modified based on participants’ feedback.ResultsThe ‘Commons’ was established with 43 participants, resulting in positive effects such as capacity building, opportunities for interactions, mutual understanding, and empathy among the participants. The difficulties faced by patients with rare diseases were classified into 10 categories. Seven research topics were identified as priority issues to be addressed including ‘impediments to daily life’, ‘financial burden’, ‘anxiety’, and ‘burden of hospital visits’. This was performed by synthesising the results of the application of the two criteria that were particularly important to strengthen future research on rare diseases. We also clarified high-priority research topics by using criteria valued more by patients and family members than by researchers and former policymakers, and criteria with specific perspectives.ConclusionWe generated evidence for policymaking in the field of rare diseases. This study’s insights into stakeholder involvement can enhance evidence-informed policymaking. We engaged in comprehensive discussions with policymakers regarding policy implementation and planned analysis of the participants’ experiences in this project.

New trends in science communication fostering evidence-informed policymaking.

This article aims to assess novel trends in science communication relating to how policymakers in the field of innovation and digitalisation policy consume and use scientific findings. We investigate the mutual influence that science communication and policy have on each other and answer the question how emerging science communication trends in the science-policy nexus might influence the use of scientific findings in the policymaking process. By using Google and the largest scholarly repositories, Google Scholar, ResearchGate, and Academia.edu, from 1 st March to 31 st May 2020, we reviewed policy documents and academic literature containing relevant information on the evolution of characteristics of global, European, and national science communication activities and the interrelated policy responses to identify the most relevant current trends in the evidence-to-policy process alongside three key challenges; trust, translation, and timing. The three identified main trends are (1) a stronger engagement between science and policy, (2) more open, reliable, and accountable science communication practices with policymakers, and (3) the increasing digitalisation and visualisation of science communication. We deepened our investigation by conducting online semi-structured interviews with relevant policy stakeholders at the international and national level between 1 st May and 31 st July 2020. With the support of the European Commission and building on the existing network of partners, we identified decision-makers and advisors with relevant experience in fields related to innovation and digitalisation policy working in four countries that represent different levels of generalized social trust: Austria, Italy, Hungary, and the Netherlands, and at the international/European Union level. After an online consultation process with a global set of policymakers, these theoretical findings were translated to policy recommendations showcasing possible solutions in science communication that may be initiated, strengthened, or continued by policy stakeholders in order to reach a more effective and efficient uptake of scientific findings in evidence-informed policymaking.

3.B. Round table: Learning from the pandemic and implementing lessons learned: moving past the rhetoric

Abstract The COVID-19 pandemic put enormous pressure on our health systems, revealing how we were unprepared for such a global threat. We have gained many insights and learned valuable lessons about what went wrong and how we should prepare for the next pandemic. These lessons are set out in a series on national and international reports. Building Back Better is a concept at the core of many of these recommendations, arguing that we should make our health systems strong, sustainable and resilient. Although calls to learn from the past are commendable and a prerequisite for transparent and evidence-informed health policymaking, we run the risk of them becoming no more than good intentions and rhetoric. It is quite astounding to see how quickly we seem to have forgotten the profound impact of the pandemic on our societies. This does not only apply to citizens, but also to policymakers. There are many other complex and urgent policy problems that require attention - including climate change, migration, the war in Ukraine, and the cost-of-living crisis. It is therefore not difficult to imagine policymakers getting distracted by the immediate political pressures, paying less attention to - seemingly - less pressing issues that require a longer-term strategy, such as implementing the lessons learned from the COVID-19 pandemic. In addition, building back better may be a catchy phrase, but as with many things, it is easier said than done, as there are huge societal challenges that need to be overcome when we want to really strengthen our health systems. Think, for example, about shortages of health workers, which will only increase due to ageing populations. Or competing budgetary pressures, with healthcare only one of many policy areas in dire need of investment. All in all, we have seen the paramount importance of building back better, but there are many challenges in practice. This roundtable will focus on how we can make sure that these lessons learned from the pandemic are actually implemented in our public health and wider health systems. The panelists will represent different perspectives and reflect on: what does the evidence tell us and what is needed at the system-level, the policy-level, and the level of the public health professional? Workshop participants will gain an understanding of what it will take to move from mere buzzwords to action, creating more resilient health systems, a fit-for-purpose and flexible health workforce, and equal access to vaccines and medicines, and what the role of different stakeholders in this could and should be. Key messages • Although we have seen the paramount importance of building our health systems back better, there are many challenges in practice. • Public health leadership, a longer-term vision and an evidence-informed approach are indispensable for realizing strong and resilient health systems. Speakers/Panelists Martin McKee LSHTM, London, UK Natasha Azzopardi Muscat WHO, Copenhagen, Denmark Dineke Zeegers Paget EUPHA Ton Coenen GGD GHOR Nederland, Utrecht, Netherlands

Estimating the burden of Long COVID symptom clusters in Ireland

Abstract Background Long COVID is a multi-system illness with the potential for a substantial impact on society, from increased healthcare costs to economic and productivity losses. Long COVID is an umbrella term with no consensus on the definition. Long COVID burden estimations in Ireland are patchy and unavailable. We set out to estimate the burden of Long COVID symptom clusters (LCSCs) in Ireland from March 2020 to February 2022. Methods Data were obtained from the Health Protection and Surveillance Centre, Ireland. We modelled estimates of the proportion of individuals with Long COVID symptoms based on the Global Burden of Disease Long COVID Study framework. Years Lived with Disability (YLD) due to Long COVID symptom clusters were estimated by age and gender. Results An estimated 1.2 million symptomatic SAR-CoV-2 infection was reported in Ireland between March 2020 and February 2022. Overall, 6.3% of individuals who had symptomatic SARS-CoV-2 experienced LCSCs. About 13,657 individuals [females: 6,724 (95% UI: 2,444, 14,439); males: 6,933 (95% UI: 2,594, 14,515)] experienced LCSCs in the first year, and 58,983 in the second year of the pandemic [females: 30,511 (95% UI: 10,377, 69,087); males: 28,472 (95% UI: 9,779, 63,988). YLD attributable to Long COVID was 1,373 (95% UI: 363, 3878) and 4,687 (95% UI: 1,111, 14,575) in the first and second year of the pandemic, respectively. Females experienced a higher Long COVID burden (3,034 YLD) than males (3,026 YLD). Females aged 25-44 years had the highest burden of Long COVID (994 YLD). Long COVID contributed 81.2% (95% UI: 61.4%, 90.2%) of the total YLD [7,464 (95% UI: 2,399, 20,467)] due to COVID-19 within the period. Conclusions Long COVID estimates are crucially important for evidence-informed policymaking and developing a model of Long COVID care in Ireland. However, the full impact of Long COVID on population health and the healthcare system will be clearer once a core set of health outcomes is developed internationally. Key messages • Post-acute consequences of COVID-19 are the major contributor to the morbidity burden. • Long COVID estimates are crucially important for evidence-informed policymaking and developing a model of Long COVID care in Ireland.

An evidence-informed policymaking (EIPM) competency profile for the Brazilian Health System developed through consensus: process and outcomes

BackgroundEvidence-informed policymaking (EIPM) requires a set of individual and organizational knowledge, skills and attitudes that should be articulated with background factors and needs. In this regard, the development of an EIPM competency profile is important to support the diagnosis, planning and implementation of EIPM.PurposeTo present the process and outcomes of the development of an EIPM competency profile by an expert committee, to be applied in different contexts of the Brazilian Health System.MethodsA committee of experts in EIPM shared different views, experiences and opinions to develop an EIPM competency profile for Brazil. In six consensus workshops mediated by facilitators, the committee defined from macro problems to key actions and performances essential for the competency profile. The development steps consisted of: (1) Constitution of the committee, including researchers, professionals with practical experience, managers, and educators; (2) Development of a rapid review on EIPM competency profiles; (3) Agreement on commitments and responsibilities in the processes; (4) Identification and definition of macro problems relating to the scope of the competency profile; and (5) Outlining of general and specific capacities, to be incorporated into the competency profile, categorized by key actions.ResultsThe development of the EIPM competency profile was guided by the following macro problems: (1) lack of systematic and transparent decision-making processes in health policy management; (2) underdeveloped institutional capacity for knowledge management and translation; and (3) incipient use of scientific evidence in the formulation and implementation of health policies. A general framework of key actions and performances of the EIPM Competency Profile for Brazil was developed, including 42 specific and general key actions distributed by area of activity (Health Management, Scientific Research, Civil Society, Knowledge Translation, and Cross-sectional areas).ConclusionsThe competency profile presented in this article can be used in different contexts as a key tool for the institutionalization of EIPM.

Factors that influence evidence-informed meso-level regional primary health care planning: a qualitative examination and conceptual framework

BackgroundEvidence-informed primary health care (PHC) planning in decentralised, meso-level regional organisations has received little research attention. In this paper we examine the factors that influence planning within this environment, and present a conceptual framework.MethodsWe employed mixed methods: case studies of five Australian Primary Health Networks (PHNs), involving 29 primary interviews and secondary analysis of 38 prior interviews; and analysis of planning documents from all 31 PHNs. The analysis was informed by a WHO framework of evidence-informed policy-making, and institutional theory.ResultsInfluential actors included federal and state/territory governments, Local Health Networks, Aboriginal Community Controlled Health Organisations, local councils, public hospitals, community health services, and providers of allied health, mental health and aged care services. The federal government was most influential, constraining PHNs’ planning scope, time and funding. Other external factors included: the health service landscape; local socio-demographic and geographic characteristics; (neoliberal) ideology; interests and politics; national policy settings and reforms; and system reorganisation. Internal factors included: organisational structure; culture, values and ideology; various capacity factors; planning processes; transition history; and experience. The additional regional layer of context adds to the complexity of planning.ConclusionsLike national health policy-making, meso-level PHC planning occurs in a complex environment, but with additional regional factors and influences. We have developed a conceptual framework of the meso-level PHC planning environment, which can be employed by similar regional organisations to elucidate influential factors, and develop strategies and tools to promote transparent, evidence-informed PHC planning for better health outcomes.

New governance of the digital health agency: a way out of the joint decision trap to implement electronic health records in Germany?

Fragmentation in health systems leads to discontinuities in the provision of health services, reduces the effectiveness of interventions, and increases costs. In international comparisons, Germany is notably lagging in the context of healthcare (data) integration. Despite various political efforts spanning decades, intersectoral care and integrated health data remain controversial and are still in an embryonic phase in the country. Even more than 2 years after its launch, electronic health record (elektronische Patientenakte; ePA) users in Germany constitute only 1 per cent of the statutorily insured population, and ongoing political debates suggest that the path to broader coverage is fraught with complexities. By exploring the main stakeholders in the existing (fragmented) health system governance in Germany and their sectoral interests, this paper examines the implementation of ePA through the lens of corporatism, offering insights based on an institutional decision theory. The central point is that endeavours to better integrate health data for clinical care, scientific research and evidence-informed policymaking in Germany will need to address the roles of corporatism and self-governance.

Challenges and Prospects for Evidence-Informed Policy in Criminology

The relevance of criminology to matters of public policy has been hotly debated throughout the history of the discipline. Yet time and again, we have borne witness to the consequences of harmful criminal justice practices that do little to reduce crime or improve the lives of our most vulnerable populations. Given the urgent need for evidence-informed responses to the problems that face our society, we argue here that criminologists can and should have a voice in the process. Accordingly, this review describes challenges and prospects for evidence-informed policymaking on matters of crime and justice. In terms of challenges, we review discourse on what constitutes evidence, issues with providing guidance under conditions of causal uncertainty, and practical constraints on evidence-informed policymaking. For prospects, we consider the important roles of institutional support, graduate training, and multiple translational strategies for the evidence-informed movement. Finally, we end with several considerations for advancing translational criminology through expanded promotion and tenure criteria, curricula revision, and prioritizing the organization of knowledge. More broadly, our goals are to stimulate disciplinary thinking regarding the ways in which criminology may play a more meaningful role in effectively confronting the ongoing challenges of crime in society.