Policy options for strengthening evidence‑informed health policy‑making in Iran: overall SASHA project findings
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.
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).
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