Mapulanga Patrick, Raju Jaya, Matingwina Thomas
Department of Knowledge and Information Stewardship, University of Cape Town , Cape Town, Western Cape, South Africa.
Department of Information Science, National University of Science and Technology Zimbabwe , Bulawayo, Zimbabwe.
Leadersh Health Serv (Bradf Engl). 2019 May 7;32(2):226-250. doi: 10.1108/LHS-09-2018-0050. Epub 2019 Mar 21.
The purpose of this study is to examine levels of health research evidence in health policies in Malawi.
DESIGN/METHODOLOGY/APPROACH: The study selected a typology of health policies in Malawi from 2002 to 2017. The study adopted the SPIRIT conceptual framework and assessed the levels of research evidence in health policy, systems and services research using the revised SAGE policy assessment tool. Documentary analysis was used to assess levels of health research evidence in health policies in Malawi.
In 29 (96.7 per cent) of the health policies, policy formulators including healthcare directors and managers used generic search engines such as Google or Google Scholar to look for heath research evidence. In 28 (93.3 per cent) of the health policies, they searched for grey literature and other government documents. In only 6 (20 per cent) of the heath policy documents, they used academic literature in a form of journal articles and randomised controlled trials. No systematic reviews or policy briefs were consulted. Overall, in 23 (76.7 per cent) of the health policy documents, health research evidence played a minimal role and had very little influence on the policy documents or decision-making.
RESEARCH LIMITATIONS/IMPLICATIONS: The empirical evidence in the health policy documents are limited because of insufficient research citation, low retrievability of health research evidence in the policy documents and biased selectivity of what constitutes health research evidence.
The study indicates that unfiltered information (data from policy evaluations and registries) constitutes majority of the research evidence in health policies both in health policy, systems and services research. The study seeks to advocate for the use of filtered information (peer reviewed, clinical trials and data from systematic reviews) in formulating health policies.
ORIGINALITY/VALUE: There is dearth of literature on the levels of health research evidence in health policy-making both in health policy, systems and services research. This study seeks to bridge the gap with empirical evidence from a developing country perspective.
本研究旨在考察马拉维卫生政策中的卫生研究证据水平。
设计/方法/途径：该研究选取了2002年至2017年马拉维卫生政策的类型。研究采用了SPIRIT概念框架，并使用修订后的SAGE政策评估工具评估卫生政策、系统和服务研究中的研究证据水平。采用文献分析法评估马拉维卫生政策中的卫生研究证据水平。
在29项（96.7%）卫生政策中，包括医疗主任和管理人员在内的政策制定者使用谷歌或谷歌学术等通用搜索引擎来寻找卫生研究证据。在28项（93.3%）卫生政策中，他们搜索了灰色文献和其他政府文件。在仅6项（20%）卫生政策文件中，他们使用了期刊文章和随机对照试验形式的学术文献。未查阅系统评价或政策简报。总体而言，在23项（76.7%）卫生政策文件中，卫生研究证据发挥的作用极小，对政策文件或决策的影响微乎其微。
研究局限/启示：由于研究引用不足、政策文件中卫生研究证据的可检索性低以及对构成卫生研究证据的选择性存在偏差，卫生政策文件中的实证证据有限。
该研究表明，在卫生政策、系统和服务研究中，未经过滤的信息（来自政策评估和登记处的数据）构成了卫生政策中研究证据的大部分。该研究旨在倡导在制定卫生政策时使用经过滤的信息（同行评审、临床试验和系统评价的数据）。
原创性/价值：在卫生政策、系统和服务研究中，关于卫生决策中卫生研究证据水平的文献匮乏。本研究旨在从发展中国家的角度，用实证证据填补这一空白。
