Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Kamuzu University of Health Sciences, Blantyre, Malawi.
Health Res Policy Syst. 2023 Jun 6;21(1):44. doi: 10.1186/s12961-023-00987-7.
The roles and functionality of technical working groups (TWGs) in the health sectors vary across countries, still they aim to support government and ministries in formulating evidence-informed recommendations for policies and facilitate dialogue and alignment of activities among stakeholders within the health sector. Thus, TWGs have a role in enhancing the functionality and effectiveness of the health system structure. However, in Malawi, the functionality of TWGs and how they utilize research evidence to contribute to decision-making is not monitored. This study sought to understand the TWGs' performance and functionality in enabling evidence-informed decision-making (EIDM) in Malawi's health sector.
A cross-sectional descriptive qualitative study. Data were collected through interviews, documents review and observation of three TWG meetings. Qualitative data were analysed using a thematic approach. The WHO-UNICEF Joint Reporting Form (JRF) was used to guide the assessment of TWG functionality.
TWG functionality varied in the Ministry of Health (MoH) in Malawi. The reasons for those perceived to be functioning well included meeting frequently, diverse representation of members, and that their recommendations to MoH were usually considered when decisions were made. For the TWGs that were perceived as not functioning well, the main reasons included lack of funding, periodic meetings and discussions that needed to provide clear decisions on the actions to be taken. In addition, evidence was recognized as important in decision-making, and research was valued by decision-makers within the MoH. However, some of the TWGs lacked reliable mechanisms for generating, accessing and synthesizing research. They also needed more capacity to review and use the research to inform their decisions.
TWGs are highly valued and play a critical role in strengthening EIDM within the MoH. Our paper highlights the complexity and barriers of TWG functionality in supporting pathways for health policy-making in Malawi. These results have implications for EIDM in the health sector. This suggests that the MoH should actively develop reliable interventions and evidence tools, strengthen capacity-building and increase funding for EIDM.
技术工作组（TWG）在卫生部门的角色和职能因国家而异，但它们旨在支持政府和部委制定基于证据的政策建议，并促进卫生部门利益相关者之间的对话和活动协调。因此，TWG 在增强卫生系统结构的功能和有效性方面发挥作用。然而，在马拉维，TWG 的功能以及它们如何利用研究证据为决策做出贡献并没有得到监测。本研究旨在了解 TWG 在促进马拉维卫生部门循证决策（EIDM）方面的表现和功能。
这是一项横断面描述性定性研究。通过访谈、文件审查和观察三次 TWG 会议收集数据。使用主题方法分析定性数据。采用世界卫生组织-联合国儿童基金会联合报告表（JRF）来指导 TWG 功能评估。
TWG 在马拉维卫生部的功能存在差异。那些被认为运作良好的 TWG 的原因包括频繁开会、成员的多样化代表，以及他们向卫生部提出的建议通常在做出决策时被考虑。对于那些被认为运作不佳的 TWG，主要原因包括缺乏资金、定期会议和讨论，这些会议和讨论需要就将要采取的行动做出明确的决定。此外，证据被认为是决策的重要因素，研究受到卫生部决策者的重视。然而，一些 TWG 缺乏生成、获取和综合研究的可靠机制。他们还需要更多的能力来审查和利用研究来为他们的决策提供信息。
TWG 受到高度重视，在加强卫生部循证决策方面发挥着关键作用。我们的论文强调了 TWG 功能在支持马拉维卫生政策制定途径方面的复杂性和障碍。这些结果对卫生部门的循证决策具有启示意义。这表明卫生部应积极制定可靠的干预措施和证据工具，加强能力建设，并增加循证决策的资金。
