Rodríguez Daniela C, Hoe Connie, Dale Elina M, Rahman M Hafizur, Akhter Sadika, Hafeez Assad, Irava Wayne, Rajbangshi Preety, Roman Tamlyn, Ţîrdea Marcela, Yamout Rouham, Peters David H
Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America.
World Health Organization, Geneva, Switzerland.
Health Res Policy Syst. 2017 Aug 1;15(1):65. doi: 10.1186/s12961-017-0227-3.
The capacity to demand and use research is critical for governments if they are to develop policies that are informed by evidence. Existing tools designed to assess how government officials use evidence in decision-making have significant limitations for low- and middle-income countries (LMICs); they are rarely tested in LMICs and focus only on individual capacity. This paper introduces an instrument that was developed to assess Ministry of Health (MoH) capacity to demand and use research evidence for decision-making, which was tested for reliability and validity in eight LMICs (Bangladesh, Fiji, India, Lebanon, Moldova, Pakistan, South Africa, Zambia).
Instrument development was based on a new conceptual framework that addresses individual, organisational and systems capacities, and items were drawn from existing instruments and a literature review. After initial item development and pre-testing to address face validity and item phrasing, the instrument was reduced to 54 items for further validation and item reduction. In-country study teams interviewed a systematic sample of 203 MoH officials. Exploratory factor analysis was used in addition to standard reliability and validity measures to further assess the items.
Thirty items divided between two factors representing organisational and individual capacity constructs were identified. South Africa and Zambia demonstrated the highest level of organisational capacity to use research, whereas Pakistan and Bangladesh were the lowest two. In contrast, individual capacity was highest in Pakistan, followed by South Africa, whereas Bangladesh and Lebanon were the lowest.
The framework and related instrument represent a new opportunity for MoHs to identify ways to understand and improve capacities to incorporate research evidence in decision-making, as well as to provide a basis for tracking change.
如果政府要制定基于证据的政策，要求和使用研究的能力至关重要。现有的旨在评估政府官员在决策中如何使用证据的工具对低收入和中等收入国家（LMICs）存在重大局限性；这些工具很少在LMICs中进行测试，且仅关注个人能力。本文介绍了一种开发出来用于评估卫生部（MoH）要求和使用研究证据进行决策的能力的工具，该工具在八个LMICs（孟加拉国、斐济、印度、黎巴嫩、摩尔多瓦、巴基斯坦、南非、赞比亚）进行了信度和效度测试。
工具开发基于一个新的概念框架，该框架涉及个人、组织和系统能力，项目取自现有工具和文献综述。在初步的项目开发和预测试以解决表面效度和项目措辞问题后，该工具精简为54个项目以进行进一步验证和项目精简。国内研究团队对203名卫生部官员进行了系统抽样访谈。除了标准的信度和效度测量外，还使用探索性因素分析来进一步评估这些项目。
确定了30个项目，分为代表组织和个人能力结构的两个因素。南非和赞比亚在使用研究方面的组织能力水平最高，而巴基斯坦和孟加拉国是最低的两个。相比之下，巴基斯坦的个人能力最高，其次是南非，而孟加拉国和黎巴嫩最低。
该框架和相关工具为卫生部提供了一个新机会，以确定理解和提高将研究证据纳入决策的能力的方法，同时也为跟踪变化提供了基础。
