Table 5 Policy recommendations to strengthen incentives to support EIHP in Iran

Push side

 Revising the current compulsory criteria and areas of academic promotion with emphasis on measuring the impact of research on health policy, systems, and outcomes

*

*

*

Selected

“We have been saying for several years that there is something wrong with the faculty promotion process. Only the article is important, and in this way, one cannot expect the faculty to do applied research work and to have no advantage over it in the end.”

“We are trying to revise the promotion process to make sure that the article is not just a criterion, but accept that it is difficult.”

 Developing appropriate incentive programmes for nonacademic member researchers to persuade them to support EIHP

*

Selected

“There is a problem in our country. It may not be in other places that are not among your interventions. Our researchers are not faculty members. There are now many specialized doctoral students who are not necessarily faculty members. Their performance appraisal programme is like that of employees, and that's not true. We need to write a development plan for them on how we want to motivate them to participate in research.”

 Encouraging the KT initiatives in forms other than publications

*

Merged

“If we can define which KT activities can be effective, measurable, and evaluated other than the article, these can be added to promotion criteria.”

 Designing metrics to measure research impact on policies or health to evaluate the performance of research institutes and journals

*

Selected

“It is ideal to be able to measure the impact of research other than producing an article and evaluate based on it. But it doesn't seem possible.”

“You see, now in other countries, the evaluation of the impact of research is done, so this means that it can be done. We should not eliminate an intervention because it is not done in Iran now. We need to let researchers go and work in that field.”

 Revising the current policies of scientific journals to support health systems research

*

Selected

“We now have 415 journals. It is completely inappropriate for you to worry that the Persians have a problem with indexing. We currently have 113 of these 415 journals in Scopus that are not English and can be considered for the disseminating of applied research results. Of course, it is debatable what type of manuscript is appropriate for applied research other than the original article.”

 Using a variety of media tools for KT initiatives (newspapers, blogs, and social media)

*

Rejected

“Currently, these are in our country, but they are not welcomed because they are not motivated and do not have benefits for individuals.”

Pull side

 Job rotation of employee in research institutes

*

Rejected

“Our human resource regulations allow both faculty and non-faculty to move and mission. But for whom do they do this? What are the advantages of people? Don't be independent at all. These will not be operational until those evaluation criteria change.”

 Using incentives such as sabbaticals or reward for users of evidence

*

Merged

“These can be included in the same performance appraisal criteria.”

 Putting the measurement of the use of evidence and having the skill of using the evidence in the criteria of employment, retention, performance evaluation, and promotion of employees, managers, and organizations

*

*

Merged

“These can be included in the same performance appraisal criteria.”

 Using the research memorandums

*

Merged

“If an institute like NIHR can define and implement a mechanism that, for example, to conduct a required study, the decision is made by both the policy-maker and not necessarily the Ministry of Health, even the parliament, and the scientific community, and speak and state the conditions and expectations. All of this can be seen there.”

 Organizational support (regulation and supportive culture) for using evidence

*

Rejected

"It is very general, and that what you said will be done will provide this support and capacity."

 Establishing a space for participatory approaches between policy-makers and researchers

*

Merged

“In my opinion, what you wrote is what we have now, but as our colleagues said, it should be motivation, and motivation is through revising our current evaluation system.”

 Revising some administrative processes, including manager and staff PE; selection, appointment and changing of managers and reward mechanisms, to add output-based criteria for EIHP efforts

*

Selected

“Nowadays, this system of evaluating the performance of managers and employees, which is central, is of no use. There is no way to differentiate between a manager and an employee who uses evidence. At the level of managers, this is much worse. Now, with this system, how can they find the user manager of the evidence and give him a score? If we want to work in a principled and correct way, as you mentioned in other countries, we must be able to identify with any evaluation system and show the manager who uses the evidence.”

“It is imperative to set criteria so that we can objectively measure how much a decision-maker has used the evidence and, of course, not from any evidence, but to find the evidence and evaluate it and take it into account in decision-making.”

Exchange side

 Revision of existing funding mechanisms to support HPSR and KT initiatives

*

*

Selected

“Currently, the share of applied research in research budgets is low. More emphasis is on clinical or basic studies. They [applied research] do not provide immediate results of applied research, but it is not a reason for less attention. If research priorities did not equate applied research with other research, it could motivate. We all know how different and sometimes difficult, the details of applied research are, especially when it comes to engaging with people in the community.”

 Encouraging and supporting different mechanisms for increasing interactions between policy-makers and researchers

*

*

Selected

“There is still a gap between practice and science in our system, except in a few cases. We integrated medical education to bring science and practice closer together. But we were not very successful. The heel of Achilles' heel is to be able to use the experiences we previously had as a result of the interaction of action and science and remove this wall.”

 Holding training courses on KT and encouraging individual participation

*

*

Merged

“These can be considered in a comprehensive plan for policy-makers and research collaboration.”

 Presenting the KT plan when submitting a research proposal, as an obligatory prerequisite to receiving grants

*

*

Selected

“Now, in the proposals of some research centres, it is necessary to submit a KT plan, but only things are filled, even the university site has seen cases for KT activities, but it has not been implemented very well. A bit more serious needs to be taken.”

 Proposing performance-based grants

*

Rejected

“Until we fully identify the expected outputs of applied research (other than the paper), it's hard to say what grant's performance is to support it. These are good, but they are more suitable for the next steps.”