BACKGROUND Health systems worldwide have always suffered resource constraints. Therefore, making decisions informed by scientific evidence to optimize costs and prevent wastage of resources is both important and necessary. The current study was designed to identify barriers to evidence-based decision-making (EBDM) in Iran's health system. METHODS Participants were purposively selected. In-depth interviews with policy-makers and focus group discussions (FGDs) with researchers were used to collect data. Thirteen in-depth interviews and six FGDs were held. Data were analysed using thematic analysis. RESULTS The barriers mentioned were categorized into decision-makers' characteristics, the decision-making environment and the research system, with each category consisting of further relevant themes and subthemes. Organizational values, criteria for selecting decision-makers, and the attitude toward EBDM were found to be important barriers to EBDM, and were related to stewardship. CONCLUSION There are various barriers to EBDM at different levels, and multi-dimensional solutions are required to strengthen the impact of scientific evidence on decision-making. Several recognized barriers to EBDM are rooted in health system stewardship, such as the weakness of inter-sectoral collaborations and ill-defined priorities. It appears that improvement of EBDM is secondary to the strengthening of health system stewardship.
BackgroundThe aim of this study was to assess the status of knowledge translation (KT) in Iranian medical science universities in order to assess the strengths and weaknesses of the most important organizations responsible for producing knowledge in the country.MethodsThe KT activities were assessed qualitatively and quantitatively in nine universities using the Self-Assessment Tool for Research Institutes.ResultsThe strengths and weaknesses of universities were determined using seven main themes: priority setting; research quality and timeliness; researchers’ KT capacities; interaction with research users; the facilities and prerequisites of KT; the processes and regulations supporting KT; and promoting and evaluating the use of evidence.The quantitative and qualitative results showed that the Iranian universities did not have an appropriate context for KT. There were significant shortcomings in supportive regulations, facilities for KT activities, and the level of interaction between the researchers and research users.ConclusionsThe shortcomings in KT were mostly in the area of stewardship and policymaking (macro level), followed by planning and implementation at the universities. In order to strengthen KT in Iran, it should occupy a prominent and focused role in the strategies of the country’s health research system.
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