Decision-making of knowledge brokers in moving evidence to action along pathways in global health

Theresa Canova Norton

‘An e-mail never made me change the way I do things’, a colleague once said. Implicit in this statement is the idea that passively receiving information alone is unlikely to motivate change. How might this observation inform the way we approach disseminating the best available evidence? This is what we explore in our Evidence & Policy article, ‘Maybe we can turn the tide’: an explanatory mixed-methods study to understand how knowledge brokers mobilise health evidence in low- and middle-income countries’.

Knowledge brokers are intermediaries who provide a potentially vital role galvanising change. Studies of knowledge brokers have mostly taken place in high-income countries, so we know much less about knowledge brokers in LMICs. To help address this gap, a global health focused research team conducted three studies following up with knowledge broker participants of international conferences in 2012, 2013 and 2015. The aim was to identify whether evidence from the conferences was shared with others and led to actions such as changes in health policy and practice, and what factors influenced decisions to share and act on evidence.

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What types of knowledge do policymakers need to respond to the COVID-19 pandemic?

Claire Bynner and Anna Terje

In a recent article published in Evidence & Policy, we explored the use of Aristotle’s three knowledge types: empirical knowledge, technical knowledge and practical wisdom, in the everyday work and decision-making of frontline public service professionals.  

Our qualitative case study of a Scottish local authority revealed the importance of integrating and recognising the different types of knowledge that are needed to respond to complex policy problems, often referred to as ‘wicked’ problems. Understanding the craft of integrating different types of knowledge, and valuing what can be learnt from frontline workers, is key in achieving impactful evidence-informed policy.

In the current context of a rapidly changing policy landscape resulting from COVID-19, making policy decisions informed by the most appropriate types of evidence is crucial. In this blog, we discuss how Aristotle’s knowledge types can help us understand the types of evidence that should be considered in this ever changing landscape.

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Implementing shared decision-making into practice: embracing complexity

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Sarah Munro

How do we implement shared decision-making into routine practice? Health systems are struggling with this question worldwide. Instead of simplifying this challenge into barriers and facilitators, what if we embraced its complexity? 

In recent years there have been increasing calls for the implementation of shared decision-making in routine clinical care. Shared decision-making is particularly helpful for decisions where there are multiple appropriate options, and the ‘best’ decision rests with the patient’s preferences.

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To understand evidence use, understand the goals of decision makers

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Justin Parkhurst

What does it mean to use evidence in policymaking? This seemingly simple question has been remarkably under-defined in all the calls for increased use of evidence. Indeed, many of those who champion ‘evidence-based policymaking’ do little to explain what it means for a policy to be evidence-based, and have trouble explaining what evidence use actually means when decision makers have multiple competing goals and social concerns. Evidence is simply seen as a good thing – and more use is better – without really considering what that means or what happens when there is disagreement around which evidence to use for what goals.

Policy scholars who study evidence, on the other hand, have approached the issue from the perspective that ‘evidence use’ can mean any number of things within a policy setting. The literature can, therefore, appear divided into two extremes: either evidence use is taken for granted to be a known (assumed to be good) thing, with little consideration of political realities, or alternatively it is seen as multidimensional, the form of which is constructed by the nature of policy ideas, processes, and interactions.

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Lessons for public health decision making in urgent and uncertain times

The ECDC Public Health Emergency Team

Accounts of medical professionals performing triage due to the over-burden of healthcare systems during the COVID-19 pandemic are hard to hear. They are a microcosm of dynamics that are occurring globally, where public health authorities and governments are attempting to simultaneously understand and respond to a swiftly moving global pandemic. In this article, the European Centre for Disease Prevention and Control Public Health Emergency team* offer lessons from recent history for decision making during this difficult time.

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