ArticleHealth research policy and systems2017
Generating demand for and use of evaluation evidence in government health ministries: lessons from a pilot programme in Uganda and Zambia.
Article in Health research policy and systems, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed.
- [Critical factors for institutionalizing evidence-informed decision-making in healthcare organizationsFactores críticos para la institucionalización de la toma de decisiones basada en la evidencia en las organizaciones de salud].Revista panamericana de salud publica = Pan American journal of public health · 2025Article
- Policy implementation and outcome evaluation: establishing a framework and expanding capacity for advocacy organizations to assess the impact of their work in public policy.Health research policy and systems · 2024Article
- Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review.Health research policy and systems · 2023Article
- Closing the Virtual Gap in Health Care: A Series of Case Studies Illustrating the Impact of Embedding Evaluation Alongside System Initiatives.Journal of medical Internet research · 2021Article
- What, why and how do health systems learn from one another? Insights from eight low- and middle-income country case studies.Health research policy and systems · 2019Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Demand-Driven Evaluations for Decisions (3DE) programme was piloted in Zambia and Uganda in 2012-2015. It aimed to answer evaluative questions raised by policymakers in Ministries of Health, rapidly and with limited resources. The aim of our evaluation was to assess whether the 3DE model was successful in supporting and increasing evidence-based policymaking, building capacity and changing behaviour of Ministry staff.
methodsUsing mixed methods, we compared the ex-ante theory of change with what had happened in practice, why and with what results (intended and unintended), including a qualitative assessment of 3DE's contribution. Data sources included a structured quality assessment of the five impact evaluations produced, 46 key informant interviews at national and international levels, structured extraction from 170 programme documents, a wider literature review of relevant topics, and a political economy analysis conducted in Zambia.
resultsWe found that 3DE had a very limited contribution to changing evidence-based policymaking, capacity and behaviour in both countries as a result of having a number of aspirations not all compatible with one another. Co-developing evaluation questions was more time-consuming than anticipated, Ministry evidence needs did not fit neatly into questions suitable for impact evaluations and constricted timeframes for undertaking trials did not necessarily produce the most effective results and value for money. The evaluation recommended a focusing of objectives and a more strategic approach to strengthening evaluative demand and capacity.
conclusionsLessons emerge that are likely to apply in other low- and middle-income settings, such as the importance of supporting evaluative thinking and capacity within wider institutions, of understanding the political economy of evidence use and its uptake, and of allowing for some flexibility in terms of programme targets. Fixating on one type of evidence is unhelpful in the context of institutions like ministries of health, which require a wide range of evidence to plan and deliver programmes. In addition, having success tied to indicators, such as number of 'policy decisions made', provides potentially perverse incentives and neglects arguably more important aspects such as incremental programmatic adjustments and improved implementation.
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