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Table 2 Strategies and the facilitators (+) and barriers (−) to support evidence use in crisis zones

From: Supporting the use of research evidence in decision-making in crisis zones in low- and middle-income countries: a critical interpretive synthesis

System & domain

Facilitators (+) of and barriers (−) to research evidence use in crisis zones in LMICs

Political system

Institutional constraints

• Policy legacies:

(–) Previous decisions based on experience and opinions because of perceived lack of existing research evidence within the national disaster management system resulted in an interpretive effect among the various actors involved in the delivery of humanitarian aid to rely heavily on professional opinion to inform their decision-making instead of also using existing research evidence to clarify a problem, frame options and address implementation considerations alongside other factors that influence decision-making [30, 41, 43, 51, 52]

Interests

• Societal interest groups:

(–) Different actors lobbying government about preferred disaster management approaches based on organisational interests instead of using existing research evidence to clarify a problem, frame options and address implementation considerations alongside other factors that influence decision-making[51, 52]

Strategies aimed at policy-makers to support evidence use

✓ Utilise stakeholder dialogues to place relevant evidence alongside professional opinion and other inputs to decision-making[14]

✓ Use rapid evidence service to answer urgent questions with best available evidence alone or alongside stakeholders’ insights

Health system

Governance arrangements

• Stakeholder involvement and on what terms:

(–) Failure to engage with appropriate groups, in a system that has adopted a networked approach to delegating tasks with humanitarian aid delivery, hinders the collection and sharing of evidence [1, 34, 38, 51, 55]

Strategies aimed at health-system leaders to support evidence use

✓ Leverage software technology to facilitate evidence-informed discussions among stakeholders (e.g. emergency management software programme) [60, 61]

International humanitarian system

Governance arrangements

• Organisational decisions to support evidence-use:

(+) Stewardship role in advocating that existing evidence alongside professional judgement can help inform decision-making about humanitarian responses [1, 30, 39,40,41, 51, 52, 54, 55]

Delivery arrangements

• Supports used to assist those receiving evidence:

(–) Inadequate access to available evidence (e.g. requires payment, evidence scattered across reports and journals) [31, 34, 35, 39,40,41,42, 45, 51, 55]

(–) Inadequate strategies used for communication and collaboration among aid workers and researchers to understand and address their knowledge needs [39, 40, 51, 52, 55]

(–) Inadequate strategies used to share evidence among multi-institutional humanitarian aid organisations and the network of government level stakeholders [1, 38,39,40,41, 47, 50, 51, 53, 55]

(+) Technology, such as social networking capabilities (e.g. Twitter, LinkedIn), is used to support the sharing of information among the various actors involved in the delivery of humanitarian aid and with researchers addressing the knowledge needs of aid workers [39, 51]

Strategies aimed at humanitarian aid decision-makers to support evidence use

✓ Use available evidence websites to access systematic reviews and other types of research evidence [1, 39, 40, 51, 54, 55]

✓ Provide skill-development programmes to enhance aid workers’ capacity to understand and use research studies [1, 38, 47, 50]

✓ Build strategic partnerships among aid workers and researchers to ask relevant research questions [38, 39, 41, 47, 50]

Health research system

Governance arrangements

• Policy authority:

(–) Lack of policy authority to ensure that all personal, organisational and political party-related conflicts of interest are declared in available research evidence by researchers [35, 38, 41]

Financial arrangements

• Funds to:

(+) Conduct research to fill gaps in existing research evidence in a timely manner (e.g. earmarked funds to conduct research in specific crisis zones to address key knowledge gaps) [1, 30, 31, 34, 36, 51, 54, 55]

(+) Share research evidence (e.g. earmarked funds for dissemination of research evidence) [41]

Delivery arrangements

• Enabling use of evidence:

(–) Existing evidence not meeting decision-makers’ needs (e.g. lacks implementations considerations for interventions) [1, 33, 35, 38, 40,41,42,43,44, 46,47,48,49, 51, 52, 54, 55]

(–) Evidence not presented in a concise manner that can be easily understood by non-technical decision-makers [30, 31, 34, 36, 38, 39, 41, 43, 44, 47, 51, 52]

Strategies aimed at research producers to support evidence use

✓ Engage decision-makers’ in research priority-setting processes to develop specific research questions related to humanitarian action in crisis zones [33, 34, 38,39,40,41, 51, 54, 55, 62]

✓ Develop and disseminate actionable messages for decision-makers, particularly by research organisations that produce syntheses or systematic reviews [63]