ThinkWell, Washington, DC, USA.
Ifakara Health Institute, Dar es Salaam, Tanzania.
Glob Health Sci Pract. 2022 Feb 28;10(1). doi: 10.9745/GHSP-D-21-00264.
In many low- and middle-income countries, planning cycles and policy decisions are not always informed by cost evidence, even where relevant and recent cost evidence is available. The Immunization Costing Action Network (ICAN) project was a research and learning community designed to strengthen country capacity to generate immunization cost evidence and to understand and improve the evidence-to-policy linkages for the evidence. We identified key factors that increase the likelihood that health policy makers will use evidence for policy making or planning, which shaped the development of a 6-step evidence to policy and practice (EPP) facilitated process. ICAN used the EPP process in Indonesia, Tanzania, and Vietnam from 2016-2019. The experience resulted in several insights regarding country priorities related to cost evidence and factors that determine uptake. Cost evidence is more likely to be used if it answers a specific policy question prioritized by the immunization program, while the use case is less clear and urgent for routine planning and program management. Nonhealth ministries and subnational stakeholders can provide important perspectives to inform the research and its usability. The use case for evidence should be revisited periodically as divergences from formal planning cycles are common and new policy windows open. Ensuring evidence is available at the right time is critical, even if this requires a sacrifice between rigor and speed. Engaging a small group of stakeholders, rather than an individual, to champion the research may be more effective, and the research has greater legitimacy if it is produced by multidisciplinary country teams. Evidence and messages should be tailored for and packaged targeting different audiences. Going forward, continued support is necessary to bridge the divide between those who generate cost evidence and those who translate evidence for policy and planning decisions.
在许多低收入和中等收入国家，即使有相关的、最近的成本证据，规划周期和政策决策也并非总是基于成本证据。免疫成本行动网络（ICAN）项目是一个研究和学习社区，旨在加强国家生成免疫成本证据的能力，并了解和改善证据与政策之间的联系，以利用证据。我们确定了增加卫生政策制定者将证据用于决策或规划的可能性的关键因素，这些因素塑造了一个六步证据到政策和实践（EPP）的便利过程。ICAN 于 2016 年至 2019 年在印度尼西亚、坦桑尼亚和越南使用了这一 EPP 流程。该经验使我们对与成本证据相关的国家优先事项以及决定采用率的因素有了一些深入了解。如果成本证据回答了免疫规划优先考虑的具体政策问题，那么它更有可能被使用，而对于常规规划和项目管理，使用案例则不太明确和紧迫。非卫生部门和国家以下各级利益攸关方可以提供重要的观点，为研究及其可用性提供信息。应定期审查证据的使用案例，因为与正式规划周期的差异很常见，并且新的政策窗口会打开。确保证据在适当的时间可用至关重要，即使这需要在严谨性和速度之间做出牺牲。与一小群利益攸关方而不是个人合作，倡导研究可能更有效，如果研究是由多学科的国家团队进行的，则具有更大的合法性。证据和信息应针对不同的受众进行调整和包装。今后，有必要继续支持那些生成成本证据的人和那些将证据转化为政策和规划决策的人之间的鸿沟。
