Abstract:Background
The institutionalization of evidence-informed health policy-making (EIHP) is complex and complicated. It is complex because it has many players and is complicated because its institutionalization will require many changes that will be challenging to make. Like many other issues, strengthening EIHP needs a road map, which should consider challenges and address them through effective, harmonized and contextualized strategies. This study aims to develop a road map for enhancing EIHP in … Show more
“…First, as the global literature and case studies described here show, there is greater accumulation of knowledge and experience that has now been collated and can be drawn upon. For example, in early 2022 a paper described a major research study that went much further than we have been able to do in an opinion paper, and applied the lessons from the global literature on the use of evidence to inform health policy-making to the circumstances of a particular country, Iran, in order to develop a roadmap for enhancing such evidence use in Iran [ 64 ]. We hope that our opinion paper will encourage and help facilitate a more thorough analysis of how to enhance the use of economic analysis in Spanish health policies.…”
Section: Lessons From the International Literature And Local Case Stu...mentioning
WHO promotes the use of research in policy-making to drive improvements in health, including in achieving Sustainable Development Goals such as tobacco control. The European Union’s new €95 billion Horizon Europe research framework programme parallels these aims, and also includes commitments to fund economic evaluations. However, researchers often express frustration at the perceived lack of attention to scientific evidence during policy-making. For example, some researchers claim that evidence regarding the return on investment from optimal implementation of evidence-based policies is frequently overlooked. An increasingly large body of literature acknowledges inevitable barriers to research use, but also analyses facilitators encouraging such use. This opinion piece describes how some research is integrated into policy-making. It highlights two recent reviews. One examines impact assessments of 36 multi-project research programmes and identifies three characteristics of projects more likely to influence policy-making. These include a focus on healthcare system needs, engagement of stakeholders, and research conducted for organizations supported by structures to receive and use evidence. The second review suggests that such characteristics are likely to occur as part of a comprehensive national health research system strategy, especially one integrated into the healthcare system. We also describe two policy-informing economic evaluations conducted in Spain. These examined the most cost-effective package of evidence-based tobacco control interventions and the cost-effectiveness of different strategies to increase screening coverage for cervical cancer. Both projects focused on issues of healthcare concern and involved considerable stakeholder engagement. The Spanish examples reinforce some lessons from the global literature and, therefore, could help demonstrate to authorities in Spain the value of developing comprehensive health research systems, possibly following the interfaces and receptor model. The aim of this would be to integrate needs assessment and stakeholder engagement with structures spanning the research and health systems. In such structures, economic evaluation evidence could be collated, analysed by experts in relation to healthcare needs, and fed into both policy-making as appropriate, and future research calls. The increasingly large local and global evidence base on research utilization could inform detailed implementation of this approach once accepted as politically desirable. Given the COVID-19 pandemic, increasing the cost-effectiveness of healthcare systems and return on investment of public health interventions becomes even more important.
“…First, as the global literature and case studies described here show, there is greater accumulation of knowledge and experience that has now been collated and can be drawn upon. For example, in early 2022 a paper described a major research study that went much further than we have been able to do in an opinion paper, and applied the lessons from the global literature on the use of evidence to inform health policy-making to the circumstances of a particular country, Iran, in order to develop a roadmap for enhancing such evidence use in Iran [ 64 ]. We hope that our opinion paper will encourage and help facilitate a more thorough analysis of how to enhance the use of economic analysis in Spanish health policies.…”
Section: Lessons From the International Literature And Local Case Stu...mentioning
WHO promotes the use of research in policy-making to drive improvements in health, including in achieving Sustainable Development Goals such as tobacco control. The European Union’s new €95 billion Horizon Europe research framework programme parallels these aims, and also includes commitments to fund economic evaluations. However, researchers often express frustration at the perceived lack of attention to scientific evidence during policy-making. For example, some researchers claim that evidence regarding the return on investment from optimal implementation of evidence-based policies is frequently overlooked. An increasingly large body of literature acknowledges inevitable barriers to research use, but also analyses facilitators encouraging such use. This opinion piece describes how some research is integrated into policy-making. It highlights two recent reviews. One examines impact assessments of 36 multi-project research programmes and identifies three characteristics of projects more likely to influence policy-making. These include a focus on healthcare system needs, engagement of stakeholders, and research conducted for organizations supported by structures to receive and use evidence. The second review suggests that such characteristics are likely to occur as part of a comprehensive national health research system strategy, especially one integrated into the healthcare system. We also describe two policy-informing economic evaluations conducted in Spain. These examined the most cost-effective package of evidence-based tobacco control interventions and the cost-effectiveness of different strategies to increase screening coverage for cervical cancer. Both projects focused on issues of healthcare concern and involved considerable stakeholder engagement. The Spanish examples reinforce some lessons from the global literature and, therefore, could help demonstrate to authorities in Spain the value of developing comprehensive health research systems, possibly following the interfaces and receptor model. The aim of this would be to integrate needs assessment and stakeholder engagement with structures spanning the research and health systems. In such structures, economic evaluation evidence could be collated, analysed by experts in relation to healthcare needs, and fed into both policy-making as appropriate, and future research calls. The increasingly large local and global evidence base on research utilization could inform detailed implementation of this approach once accepted as politically desirable. Given the COVID-19 pandemic, increasing the cost-effectiveness of healthcare systems and return on investment of public health interventions becomes even more important.
“…Box 1 shows institutional arrangement of HTA related to health insurance coverage. However, the gap between evidence and health policy still needs to be investigated, because healthcare priority setting is a political and value-laden process that involves factors that go beyond the clinical and economic effects of healthcare services (6). Institutional arrangement of Iran’s HTA program for insurance coverage decision making. Scoping: The Secretariat of the High Council for Health Insurance, HCHI, affiliated with the Ministry of Health and Medical Education, MoHME, is in charge, among others, of screening all requests for new healthcare insurance coverage.…”
Section: Introductionmentioning
confidence: 99%
“…Box 1 shows institutional arrangement of HTA related to health insurance coverage. However, the gap between evidence and health policy still needs to be investigated, because healthcare priority setting is a political and value-laden process that involves factors that go beyond the clinical and economic effects of healthcare services (6).…”
Introduction
Integrating social values into health technology assessment processes is an important component of proper healthcare priority setting. This study aims to identify social values related to healthcare priority setting in Iran.
Method
A scoping review was conducted on original studies that investigating social values in the healthcare system in Iran. The databases of PubMed, EMBASE, and EBSCO were searched with no restrictions on time and language. The reported criteria were clustered using Sham’s framework of social value analysis in health policy.
Results
Twenty-one studies published between 2008 and 2022 met the inclusion criteria. Fourteen of the included studies followed a quantitative approach with different methods to identify criteria, and the remaining seven studies used a qualitative approach. A total of fifty-five criteria were extracted and clustered into necessity, quality, sustainability, and process categories. Only six studies found criteria that were related to processes. Only three studies used public opinions as a source of value identification and eleven studies investigated the weight of criteria. None of the included studies explored the interdependency of the criteria.
Conclusion
Evidence suggests that several criteria other than cost per health unit also need to be considered in healthcare priority setting. Previous studies have paid little attention to the social values that underlie priority setting and policy-making processes. To reach consensus on social values related to healthcare priority setting, future researches need to involve broader stakeholders’ perspectives as a valuable source of social values in a fair process.
“…A number of reports have provided credible information confirming that evidence produced through research can improve the health policy process by gathering valuable data regarding different phases of policy-making [ 7 – 9 ]. In other words, the promotion of EIPM can reduce the barriers to evidence utilization by health policy-makers [ 10 , 11 ]. It has been argued that policy-makers are simply the end-users of the evidence that is produced by researchers, so it is unrealistic to expect them to incorporate and adapt all policies to local conditions [ 12 , 13 ].…”
Section: Introductionmentioning
confidence: 99%
“…Although in recent years various measures and interventions have been implemented in Iran's health system to strengthen and institutionalize EIPM, in reality, obtaining and using high-quality evidence is a challenging issue, and many policy decisions are still not informed by evidence [ 22 ]. Also, the use of research evidence in health policies is not systematic, comprehensive and well institutionalized [ 10 ]. In some cases, health policies are rushed and politicized without sufficient research and evidence and without scientifically getting to the root of the problem [ 23 ].…”
Background
Providing valid evidence to policy-makers is a key factor in the development of evidence-informed policy-making (EIPM). This study aims to review interventions used to promote researchers’ and knowledge-producing organizations’ knowledge and skills in the production and translation of evidence to policy-making and explore the interventions at the individual and institutional level in the Iranian health system to strengthen EIPM.
Methods
The study was conducted in two main phases: a systematic review and a qualitative study. First, to conduct the systematic review, the PubMed and Scopus databases were searched. Quality appraisal was done using the Joanna Briggs Institute checklists. Second, semi-structured interviews and document review were used to collect local data. Purposive sampling was used and continued until data saturation. A qualitative content analysis approach was used for data analysis.
Results
From a total of 11,514 retrieved articles, 18 papers were eligible for the analysis. Based on the global evidence, face-to-face training workshops for researchers was the most widely used intervention for strengthening researchers’ capacity regarding EIPM. Target audiences in almost all of the training programmes were researchers. Setting up joint training sessions that helped empower researchers in understanding the needs of health policy-makers had a considerable effect on strengthening EIPM. Based on the local collected evidence, the main interventions for individual and institutional capacity-building were educational and training programmes or courses related to the health system, policy-making and policy analysis, and research cycle management. To implement the individual and institutional interventions, health system planners and authorities and the community were found to have a key role as facilitating factors.
Conclusion
The use of evidence-based interventions for strengthening research centres, such as training health researchers on knowledge translation and tackling institutional barriers that can prevent well-trained researchers from translating their knowledge, as well as the use of mechanisms and networks for effective interactions among policy-makers at the macro and meso (organizational) level and the research centre, will be constructive for individual and institutional capacity-building. The health system needs to strengthen its strategic capacity to facilitate an educational and training culture in order to motivate researchers in producing appropriate evidence for policy-makers.
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