Background Evidence-informed policy-making (EIPM) requires a set of individual and organizational capacities, linked with background factors and needs. The identification of essential knowledge, skills and attitudes for EIPM can support the development of competency profiles and their application in different contexts. Purpose To identify elements of competency (knowledge, skills and attitudes) for EIPM, according to different professional profiles (researcher, health professional, decision-maker and citizen). Methods Rapid umbrella review. A structured search was conducted and later updated in two comprehensive repositories (BVSalud and PubMed). Review studies with distinctive designs were included, published from 2010 onwards, without language restrictions. Assessment of the methodological quality of the studies was not performed. A meta-aggregative narrative synthesis was used to report the findings. Results Ten reviews were included. A total of 37 elements of competency were identified, eight were categorized as knowledge, 19 as skills and 10 as attitudes. These elements were aggregated into four competency profiles: researcher, health professional, decision-maker and citizen. The competency profiles included different sets of EIPM-related knowledge, skills and attitudes. Strengths and limitations This study is innovative because it aggregates different profiles of competency from a practical perspective, favouring the application of its results in different contexts to support EIPM. Methodological limitations are related to the shortcuts adopted in this review: complementary searches of the grey literature were not performed, and the study selection and data extraction were not conducted in duplicate. Final considerations: conclusions and implications of the findings EIPM requires the development of individual and organizational capacities. This rapid review contributes to the discussion on the institutionalization of EIPM in health systems. The competency profiles presented here can support discussions about the availability of capacity and the need for its development in different contexts.
Resumo As taxas mundiais de cirurgia cesariana têm crescido há 30 anos, correspondendo a mais de 56% dos nascimentos no Brasil. Considerando os agravos ocasionados por cesáreas eletivas na saúde materna e infantil, esta revisão buscou apresentar uma estratégia para a redução dessas taxas. Para realizar a síntese das melhores evidências, adotou-se a metodologia SUPPORT. Foram incluídas revisões sistemáticas publicadas em inglês, português ou espanhol sobre intervenções não clínicas. As buscas resultaram em quatro estudos, que em metanálise associaram o apoio contínuo durante o parto à redução de 25% a 51% nas taxas de cesárea. Igualmente, o apoio contínuo reduziu a duração e as intervenções clínicas desnecessárias durante o trabalho de parto e a probabilidade de bebê com baixo escore de Apgar aos cinco minutos. Além disso, proporcionou melhoria na amamentação e na recuperação da mulher, aumento da satisfação com o processo de nascimento e maiores chances de parto vaginal espontâneo. O apoio contínuo foi benéfico para a gestante e o recém-nascido. A intervenção garante respeito, segurança e qualidade durante o parto, bem como reduz custos hospitalares. Portanto, é uma estratégia efetiva que deve ser adotada nos serviços de saúde para ampliar o acesso das mulheres aos seus direitos.
Background Theory of Change (ToC) has become an established approach to design and evaluate interventions. While ToC should—in line with the growing international focus on evidence-informed health decision-making–consider explicit approaches to incorporate evidence, there is limited guidance on how this should be done. This rapid review aims to identify and synthesize the available literature on how to systematically use research evidence when developing or adapting ToCs in the health sector. Methods A rapid review methodology using a systematic approach, was designed. Eight electronic databases were consulted to search for peer-reviewed and gray publications detailing tools, methods, and recommendations promoting the systematic integration of research evidence in ToCs. The included studies were compared, and the findings summarized qualitatively into themes to identify key principles, stages, and procedures, guiding the systematic integration of research evidence when developing or revising a ToC. Results This review included 18 studies. The main sources from which evidence was retrieved in the ToC development process were institutional data, literature searches, and stakeholder consultation. There was a variety of ways of finding and using evidence in ToC. Firstly, the review provided an overview of existing definitions of ToC, methods applied in ToC development and the related ToC stages. Secondly, a typology of 7 stages relevant for evidence integration into ToCs was developed, outlining the types of evidence and research methods the included studies applied for each of the proposed stages. Conclusion This rapid review adds to the existing literature in two ways. First, it provides an up-to-date and comprehensive review of the existing methods for incorporating evidence into ToC development in the health sector. Second, it offers a new typology guiding any future endeavors of incorporating evidence into ToCs.
Background: Evidence-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. Purpose: To 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. Methods: A 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. Results: The 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). Final considerations: The competency profile presented in this article can be used in different contexts as a key tool for the institutionalization of EIPM.
Background Evidence-Informed Policymaking (EIPM) require a set of individual and organizational capabilities, articulated with background factors and needs. The identification of essential Knowledge, Skills and Attitudes for EIPM can support the formulation of competency profiles and their application in different contexts. Purpose To identify elements of competency (Knowledge, Skills and Attitudes) for EIPM, according to different professional profiles. Methods Rapid scoping review. A structured search was led, and later updated in two comprehensive repositories (BVSalud and PubMed). Review studies with different designs, published from 2010 onwards, without language restriction were included. Assessment of the methodological quality of the studies was not performed. A meta-aggregative narrative synthesis consolidated the findings. Results Ten reviews were included. Eight elements were categorized as Knowledge, 19 as Skills and 10 as Attitudes were identified, totaling 37 elements of competency. These elements were aggregated into four competency profiles (Researcher, Health Professional, Decision-maker and Citizen). The competency profiles included different sets of EIPM-related Knowledge, Skills and Attitudes. Strengths and limitations This study is innovative because it aggregates different profiles of competency and uses a practical perspective, favoring the application of its results in different contexts, to support EIPM. Methodological limitations are related to the shortcuts adopted in this review, especially as it does not include complementary searches of the grey literature and does not carry out, in duplicate, the stages of study selection and data extraction. Final considerations: conclusions and implications of the findings EIPMs require the development of individual and organizational capacities. This rapid scoping review contributes to the discussion on the institutionalization of EIPM in health systems. The competency profiles presented here can support discussions about the availability and need for capacity development in different contexts.
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