Developing and utilizing a tool for assessing the status of evidence-informed health policy-making in Iran (SASHA study)

Abstract

Abstract IntroductionIn order to promote evidence-informed health policy-making (EIHP) and address its challenges, it is necessary to measure it more objectively. In this study, as part of a bigger study entitled “A roadmap for strengthening evidence-informed health policy-making in Iran”, we tried to develop a tool to measure the instrumental use of evidence in health policy-making and to utilize it. MethodsWe performed literature review and in-depth interviews to develop and standardize the SASHA tool. The SASHA tool was developed based on the policy-making cycle and the evidence required for each cycle in five sections, clarifying the problem, identifying and selecting appropriate solutions, contextualizing, implementing, and monitoring & evaluation of the selected solutions. After standardizing the tool, we assessed 14 policies/programs using document review and semi-structured interviews with key persons related to each policy. Results Based on our results, the SASHA tool is an appropriate tool for guiding and measuring evidence-informed policy-making. SASHA has been successful in certain aspects and unsuccessful in others in objectively measuring the EIHP status. The most important limitation in this regard was the lack of policy-making documentation that makes policy-makers the only sources of data, which not only imposes information bias but also reduces the possibility of data triangulation. The role of evidence derived from systematic reviews and secondary data analysis was very poor.ConclusionThis study has shown that the feasibility of the SASHA tool in objectively measuring EIHP depends on the availability of data on decision-making processes throughout policy-making cycles. The policymaker’s experience is dominant in problem identification and agenda-setting and the roles of systematic reviews and secondary data analysis are weak in all policy cycle stages.