scholarly journals Policy options for strengthening evidence-informed health policy-making in Iran: overall SASHA project findings

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Reza Majdzadeh ◽  
Haniye Sadat Sajadi ◽  
Bahareh Yazdizadeh ◽  
Leila Doshmangir ◽  
Elham Ehsani-Chimeh ◽  
...  

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 Iran based on steps of planning. Methods This study consisted of three phases: (1) identifying barriers to EIHP, (2) recognizing interventions and (3) measuring the use of evidence in Iran's health policy-making. A set of activities was established for conducting these, including foresight, systematic review and policy dialogue, to identify the current and potential barriers for the first phase. For the second phase, an evidence synthesis was performed through a scoping review, by searching the websites of benchmark institutions which had good examples of EIHP practices in order to extract and identify interventions, and through eight policy dialogues and two broad opinion polls to contextualize the list of interventions. Simultaneously, two qualitative-quantitative studies were conducted to design and use a tool for assessing EIHP in the third phase. Results We identified 97 barriers to EIHP and categorized them into three groups, including 35 barriers on the “generation of evidence” (push side), 41 on the “use of evidence” (pull side) and 21 on the “interaction between these two” (exchange side). The list of 41 interventions identified through evidence synthesis and eight policy dialogues was reduced to 32 interventions after two expert opinion polling rounds. These interventions were classified into four main strategies for strengthening (1) the education and training system (6 interventions), (2) the incentives programmes (7 interventions), (3) the structure of policy support organizations (4 interventions) and (4) the enabling processes to support EIHP (15 interventions). Conclusion The policy options developed in the study provide a comprehensive framework to chart a path for strengthening the country’s EIHP considering both global practices and the context of Iran. It is recommended that operational plans be prepared for road map interventions, and the necessary resources provided for their implementation. The implementation of the road map will require attention to the principles of good governance, with a focus on transparency and accountability.

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Haniye Sadat Sajadi ◽  
Reza Majdzadeh ◽  
Elham Ehsani-Chimeh ◽  
Bahareh Yazdizadeh ◽  
Sima Nikooee ◽  
...  

Abstract Background Current incentive programmes are not sufficient to motivate researchers and policy-makers to use research evidence in policy-making. We conducted a mixed-methods design to identify context-based policy options for strengthening motivations among health researchers and policy-makers to support evidence-informed health policy-making (EIHP) in Iran. Methods This study was conducted in 2019 in two phases. In the first phase, we conducted a scoping review to extract interventions implemented or proposed to strengthen motivations to support EIHP. Additionally, we employed a comparative case study design for reviewing the performance evaluation (PE) processes in Iran and other selected countries to determine the current individual and organizational incentives to encourage EIHP. In the second phase, we developed two policy briefs and then convened two policy dialogues, with 12 and 8 key informants, respectively, where the briefs were discussed. Data were analysed using manifest content analysis in order to propose contextualized policy options. Results The policy options identified to motivate health researchers and policy-makers to support EIHP in Iran were: revising the criteria of academic PE; designing appropriate incentive programmes for nonacademic researchers; developing an indicator for the evaluation of research impact on policy-making or health outcomes; revising the current policies of scientific journals; revising existing funding mechanisms; presenting the knowledge translation plan when submitting a research proposal, as a mandatory condition; encouraging and supporting mechanisms for increasing interactions between policy-makers and researchers; and revising some administrative processes (e.g. managers and staff PEs; selection, appointment, and changing managers and reward mechanisms). Conclusions The current individual or organizational incentives are mainly focused on publications, rather than encouraging researchers and policy-makers to support EIHP. Relying more on incentives that consider the other impacts of research (e.g. impacts on health system and policy, or health outcomes) is recommended. These incentives may encourage individuals and organizations to be more involved in conducting research evidence, resulting in promoting EIHP. Trial registration NA.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  

Abstract Acknowledging the role of economic arguments in political discourses and decision-making, researchers have begun to pay more attention to the fiscal implications of different health policy options for migrants. As yet, empirical evidence on economic effects of policy responses to migration and the societal costs or cost-effectiveness of competing strategies to address migrants’ health needs is scarce. Methodological challenges such as limited availability and accessibility of decent data often impede the generation of robust evidence. Further, little is known as to how evidence can effectively be moved into policy; e.g., the actual clout of economic arguments in migration policies debates, as opposed to other evidence- or value-based arguments, hitherto remains unclear. In other social policy domains such as educational and labour market integration, economic evaluations have become routine components of policy assessments. And under the title of, e.g., knowledge translation, strategies for the introduction of research evidence into political decision-making processes have been developed. The combination of similar goals and challenges suggests that there are opportunities to build bridges across sectors and disciplines - e.g., public health, social epidemiology, economics, social policy, data science - as well as across research-practice-divides, for the purposes of mutual learning and the joint improvement of research outcomes. The goal of this workshop is to start such learning processes by bringing together researchers and professionals from different fields, by sharing existing knowledge, and by jointly exploring the following questions: What are the thematic intersections, tensions and synergies between the different disciplines? What are common goals and questions? Which kinds of different knowledge complement each other towards those goals?Where are options for mutual learning, methodological transfer and/or synthesis? How can they help to overcome current challenges in estimating the costs of divergent migrant health policies?What can be learnt from existing knowledge translation strategies as regards the role of research for migrant health policy making?What challenges and open questions remain? The workshop will start with a brief introduction of key concepts and objectives. The first presentation will use three case studies to reflect on the potential of economic evaluation for improving health screening and assessment policies for asylum seekers in Germany. The second presentation will provide input from seminal research on public policy in migration contexts. A third presentation will summarize previous activities and insights of the work group “Economic arguments in migrant health policy making”. The following discussion will examine the above noted questions by tapping into the presenters’ expertise and the audience’s experience. The workshop will be closed with a summary of lessons learnt and directions for future research. Key messages Economic arguments play a central role in policy-making; but economic analyses of different migrant health policy options are hampered by various methodological challenges and tensions. Seminal research in other social policy domains offers potential for mutual learning, toward the end of generating valid economic evidence on the cost-benefits of migrants’ greater in-/exclusion.


Author(s):  
Marziyeh Azadiyan ◽  
Abbas Vosoogh Moghaddam ◽  
Ali Farhadi Mahalli

Background: Good governance in the last two decades attracted the attention of scientific and international circles around the world. It is a type of governance that is committed to supporting and promoting human health. In order to achieve good governance, components have been identified that knowledge of the weight and importance of each component is undoubtedly necessary to achieve the desired results in the policy-making of the Iranian health system. Methods: This research is descriptive-survey in terms of goal setting and methodology. The multi-stage stratification and availability method was used for sampling and the theoretical saturation rule was used to determine the sample size. In order to define and explain the concept of components of good governance and health policy-making, the library method and review of reference sources were used. 100 survey managers and experts in the Ministry of Health and Golestan, Mazandaran and Neishabour Universities of Medical Sciences were interviewed using a survey method and using a checklist tool (researcher-made (pairwise comparisons)). To analyze the data, Chang's improved fuzzy AHP method and Expert choice software were used. Results: Among the components of good governance (for the policy-making process of the Iranian health system), the rule of law included the most important component. After the rule of law, consensus and agreement, transparency, accountability, justice and fairness, effectiveness and efficiency and ethics were in the next ranks. Conclusion: Good governance is a new narrative of concepts such as democracy, human rights and justice to pursue people-centered human development goals. The rankings obtained from the analyses of this research indicate the need to pay more attention to the rule of law in the health policy-making cycle. It is suggested that in designing the health sector of the seventh economic, social and cultural development plan, executive strategies are paid attention to strengthening the components of good governance, respectively.


Author(s):  
Sultana Al Sabahi ◽  
Michael G. Wilson ◽  
John N. Lavis ◽  
Fadi El-Jardali ◽  
Kaelan Moat ◽  
...  

Background: In response to worldwide calls for the need to support evidence-informed policy-making (EIPM), more countries are increasingly interested in enhancing their efforts to use research to inform policy-making. In order to inform the efforts of those asked to lead the support of EIPM, our aim is to develop a conceptual framework to guide the process of establishing a policy support organization (PSO). Methods: We conducted a critical interpretive synthesis (CIS). We conducted a two steps literature review. In the second step, we systematically searched OVID EMBASE, PsychInfo, HealthStar, CINAHL, Web of Science, Social Science Abstract, Health Systems Evidence, and ProQuest Dissertations and Theses Global databases for documents reporting the establishment of PSOs and the contextual factors influencing the process of establishing these organizations. We assessed the eligibility of the retrieved articles and synthesized the findings iteratively. Results: We included 52 documents in the synthesis. Our findings suggest that a PSO establishment process has four interconnected stages: awareness, development, assessment, and maturation. The process of establishing a PSO is iterative and influenced by political, research and health systems contextual factors, which determine the availability of the resources and the trust between researchers and policy-makers. The contextual factors have an impact on each other, and the challenges that arise from one factor can be mitigated by other factors. Conclusion: For those interested in establishing a PSO, our framework provides a road map for identifying the most appropriate starting point and the factors that might influence the establishment process. Leaders of such PSOs can use our findings to expand or refine their scope of work. Given that this framework focuses only on PSOs in the health sector, an important next step for research would be to include other sectors from social systems and identify any additional insight that can enhance our framework.


2004 ◽  
Vol 14 (3) ◽  
pp. 225-237 ◽  
Author(s):  
Gunnar Kaati ◽  
Michael Sjöström ◽  
Monika Vester

2008 ◽  
Vol 52 (3) ◽  
pp. 311-326 ◽  
Author(s):  
Virginia Berridge

“History matters—pass it on” was the slogan of a campaign launched in England in the summer of 2006 to raise public awareness of the huge contribution that history, heritage and the built environment make to our qualify of life. A resumé commented,It unites the whole heritage sector, led by the National Trust, English Heritage, the Historic Houses Association and the Heritage Lottery Fund, and events will be held over the next six months at hundreds of historic locations across England and Wales. Supporters include David Starkey, Tristram Hunt, Simon Thurley, Stephen Fry, Bill Bryson, Shami Chakrabarti, Tony Benn and Boris Johnson.


Author(s):  
David Hughes

A volume on health reforms under the Coalition must necessarily expand its focus beyond Westminster to consider the larger UK policy context. Legislation enacted in 1998 established devolved assemblies in Scotland, Wales and Northern Ireland with power to make law or issue executive orders in certain specified areas, including health services. This meant that an English NHS overseen by the Westminster Parliament now existed alongside separate NHS systems accountable to devolved governments in the other UK countries. Thus, the major Coalition health reforms heralded by the Health and Social Care Act 2012 applied in the main to England only. However, devolved administrations needed to formulate appropriate policy responses that either maintained differences or moved closer to the English policies. This chapter describes the divergent approaches between the four UK NHS systems, but also sheds light on the nature of coalition policy making.


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